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AKI definitions

Ankana Daga, Fredrick Dapaah-Siakwan, Sharina Rajbhandari, Cassandra Arevalo, Agnes Salvador
BACKGROUND: Acute kidney injury (AKI) is common in critically ill premature infants. There is a lack of consensus on the diagnostic definition of AKI in very low birth weight (VLBW) infants. The primary aim of this study was to determine the incidence and risk factors for AKI in VLBW infants using the AKI network (AKIN) and pRIFLE (pediatric Risk, Injury, Failure, Loss, End-Stage) criteria and to evaluate whether Clinical Risk Index for Babies (CRIB II) score is a predictor of AKI. The secondary objective was to determine the extent of agreement between the AKIN and pRIFLE criteria in the diagnosis of AKI in VLBW infants...
September 28, 2016: Pediatrics and Neonatology
J C Menon, J K Joseph, M P Jose, B L Dhananjaya, O V Oommen
INTRODUCTION: Snakebite is an occupational hazard causing considerable morbidity and mortality worldwide, particularly so in tropical countries like India. OBJECTIVE: The aim of this study is to (i) review the demographic, clinical and laboratory findings in patients (1051) admitted with venomous snakebite (ii) to correlate mortality, morbidity and duration of hospital stay with clinical signs, symptoms and laboratory parameters. METHODS: A retrospective study of 1051 patients treated for snakebite over 10 years (2000 - 2009) in Little Flower Hospital, Angamaly, Kerala...
August 2016: Journal of the Association of Physicians of India
Osama Mosa, Milan Skitek, Ales Jerin
CONTEXT AND OBJECTIVE: Acute kidney injury (AKI) is still a headache for clinicians and scientists as a possible reason for increased death among intensive care unit (ICU) patients after invasive cardiac surgery. Furthermore, the diagnostic process for AKI using conventional biomarkers is not sufficient to ensure early warning of this condition because of the morbid influence of non-renal factors that definitively delay the time for the prognosis. These imposed limitations have led to significant amounts of research targeted towards identifying novel biomarkers for AKI with a sustained degree of sensitivity and specificity...
October 13, 2016: São Paulo Medical Journal, Revista Paulista de Medicina
Paolo Angeli, Dimitri Bezinover, Gianni Biancofiore, Anja Bienholz, James Findlay, Catherine Paugam Burtz, Koen Reyntjens, Tetsuro Sakai, Fuat H Saner, Dana Tomescu, Gebhard Wagener, Emmanuel Weiss
Acute kidney injury (AKI) is associated with high perioperative mortality. A series of AKI research breakthroughs are worth mentioning. First, in 2003, serum and urine biomarkers specific to AKI were identified. These biomarkers have contributed to early detection, prevention, and treatment of AKI. In 2004, AKI severity was defined with the Risk, Injury, Failure, Loss, and End-stage kidney disease (RIFLE) criteria, which was developed by the International Consensus Conference Workgroup of the Acute Dialysis Quality Initiative...
October 19, 2016: Minerva Anestesiologica
Qing Wei, Hong Liu, Yan- Tu, Ri-Ning Tang, Yan-Li Wang, Ming-Ming Pan, Bi-Cheng Liu
AIM: Age is an independent risk factor for acute kidney injury (AKI). The causes and outcomes of AKI in children, middle-aged, and older patients are different. The objective of this country-based study was to identify the characteristics and mortality factors for AKI in different age groups in China. METHODS: Using data from 374,286 adult patients (≥18 years) admitted to 44 study hospitals, we investigated the characteristics and mortality risk factors for AKI in four different age groups: 18-39 years of age, 40-59 years of age, 60-79 years of age, and ≥80 years of age...
October 19, 2016: Renal Failure
Geoffrey M Fleming, Rashmi Sahay, Michael Zappitelli, Eileen King, David J Askenazi, Brian C Bridges, Matthew L Paden, David T Selewski, David S Cooper
OBJECTIVE: In a population of neonatal and pediatric patients on extracorporeal membrane oxygenation; to describe the prevalence and timing of acute kidney injury utilizing a consensus acute kidney injury definition and investigate the association of acute kidney injury with outcomes (length of extracorporeal membrane oxygenation and mortality). DESIGN: Multicenter retrospective observational cohort study. SETTING: Six pediatric extracorporeal membrane oxygenation centers...
October 13, 2016: Pediatric Critical Care Medicine
Seon Ha Baek, Ho Jun Chin, Ki Yong Na, Dong-Wan Chae, Sejoong Kim
OBJECTIVE: Blood pressure (BP) is an important target for kidney injury, but few data showed optimal BP in patients with acute kidney injury (AKI) relative to mortality. DESIGN AND METHOD: We performed a retrospective cohort study of 2304 patients who had their creatinine levels measured (≥ 1 measurement) during admission for a period of 1 year (January 1, 2013 through December 31, 2013) at tertiary hospital and were diagnosed with AKI by Kidney Disease Improving Global Outcomes (KDIGO) definition based on serum creatinine criteria...
September 2016: Journal of Hypertension
Lorraine Lau, Zubaida Al-Ismaili, Maya Harel-Sterling, Michael Pizzi, Jillian S Caldwell, Melissa Piccioni, Larry C Lands, Theresa Mottes, Prasad Devarajan, Stuart L Goldstein, Michael R Bennett, Michael Zappitelli
BACKGROUND: Serum cystatin C (CysC) is a more accurate glomerular filtration rate marker than serum creatinine (SCr) and may rise more quickly with acute kidney injury (AKI). METHODS: We performed a prospective cohort study of 81 non-critically ill children during 110 aminoglycoside (AG) treatments. We calculated area under the curve (AUC) for CysC to diagnose SCr-defined AKI and predict persistent AKI. SCr-AKI definition was based on the Kidney Disease: Improving Global Outcomes (≥stage 1: ≥50 % or 26...
October 14, 2016: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
Ramachandran Rameshkumar, Sriram Krishnamurthy, Rajesh Nachiappa Ganesh, Subramanian Mahadevan, Parameswaran Narayanan, Ponnarmeni Satheesh, Puneet Jain
BACKGROUND: Septic acute kidney injury (AKI) accounts for more than half of all cases of AKI in critically ill children. The renal histology was found to alter the management in more than two-third of cases of adult acute renal failure. Better insight into the pathogenesis of pediatric septic AKI could be based on developing a clearer appreciation of the histopathological changes. No comprehensive study of the histopathological features of septic AKI in critically ill children has yet been performed...
October 13, 2016: Clinical and Experimental Nephrology
Thijs C D Rettig, Linda M Peelen, Guillaume S C Geuzebroek, Wilton A van Klei, Christa Boer, Jan Willem van der Veer, Jan Hofland, Ewoudt M W van de Garde, Peter G Noordzij
OBJECTIVE: The aim of this study was to investigate whether acute kidney injury (AKI) after coronary artery bypass grafting can be attributed to intraoperative hypotension during cardiopulmonary bypass (IOH-CPB). DESIGN: Retrospective analysis. SETTING: Tertiary-care hospital. PARTICIPANTS: Patients undergoing on-pump coronary artery bypass grafting from June 2011 to January 2014. INTERVENTIONS: None...
July 30, 2016: Journal of Cardiothoracic and Vascular Anesthesia
Mauro Neri, Gianluca Villa, Francesco Garzotto, Sean Bagshaw, Rinaldo Bellomo, Jorge Cerda, Fiorenza Ferrari, Silvia Guggia, Michael Joannidis, John Kellum, Jeong Chul Kim, Ravindra L Mehta, Zaccaria Ricci, Alberto Trevisani, Silvio Marafon, William R Clark, Jean-Louis Vincent, Claudio Ronco
This article reports the conclusions of a consensus expert conference on the basic principles and nomenclature of renal replacement therapy (RRT) currently utilized to manage acute kidney injury (AKI). This multidisciplinary consensus conference discusses common definitions, components, techniques, and operations of the machines and platforms used to deliver extracorporeal therapies, utilizing a "machine-centric" rather than a "patient-centric" approach. We provide a detailed description of the performance characteristics of membranes, filters, transmembrane transport of solutes and fluid, flows, and methods of measurement of delivered treatment, focusing on continuous renal replacement therapies (CRRT) which are utilized in the management of critically ill patients with AKI...
October 10, 2016: Critical Care: the Official Journal of the Critical Care Forum
Sigrid Beitland, Bård Endre Waldum-Grevbo, Espen Rostrup Nakstad, Jens-Petter Berg, Anne-Marie Siebke Trøseid, Berit Sletbakk Brusletto, Cathrine Brunborg, Geir Øystein Andersen, Kjetil Sunde
BACKGROUND: Post-resuscitation care after out-of-hospital cardiac arrest (OHCA) is challenging due to the threat of organ failure and difficult prognostication. Our aim was to examine whether urine biomarkers could give an early prediction of acute kidney injury (AKI) and outcome. METHODS: This was a prospective observational study of comatose OHCA patients at Oslo University Hospital Ullevål, Norway. Risk factors were clinical parameters and biomarkers measured in spot urine (cystatin C, neutrophil gelatinase-associated lipocalin (NGAL) and the product of tissue inhibitor of metalloproteinase 2 (TIMP-2) and insulin-like growth factor-binding protein 7 (IGFBP7)) at admission and day 3...
October 5, 2016: Critical Care: the Official Journal of the Critical Care Forum
Marlies Ostermann, Michael Joannidis
Acute kidney injury (AKI) is common and is associated with serious short- and long-term complications. Early diagnosis and identification of the underlying aetiology are essential to guide management. In this review, we outline the current definition of AKI and the potential pitfalls, and summarise the existing and future tools to investigate AKI in critically ill patients.
September 27, 2016: Critical Care: the Official Journal of the Critical Care Forum
Seon Ha Baek, Ho Jun Chin, Ki Yong Na, Dong-Wan Chae, Sejoong Kim
OBJECTIVE: Blood pressure (BP) is an important target for kidney injury, but few data showed optimal BP in patients with acute kidney injury (AKI) relative to mortality. DESIGN AND METHOD: We performed a retrospective cohort study of 2304 patients who had their creatinine levels measured (≥ 1 measurement) during admission for a period of 1 year (January 1, 2013 through December 31, 2013) at tertiary hospital and were diagnosed with AKI by Kidney Disease Improving Global Outcomes (KDIGO) definition based on serum creatinine criteria...
September 2016: Journal of Hypertension
Pei-Chun Fan, Chia-Chun Chen, Yung-Chang Chen, Yu-Sun Chang, Pao-Hsien Chu
Acute kidney injury (AKI) is an important clinical issue that is associated with significant morbidity and mortality. Despite research advances over the past decades, the complex pathophysiology of AKI is not fully understood. The regulatory mechanisms underlying post-AKI repair and fibrosis have not been clarified either. Furthermore, there is no definitively effective treatment for AKI. MicroRNAs (miRNAs) are endogenous single-stranded noncoding RNAs of 19~23 nucleotides that have been shown to be crucial to the post-transcriptional regulation of various cellular biological functions, including proliferation, differentiation, metabolism, and apoptosis...
2016: Human Genomics
Roberto Gordillo, Tania Ahluwalia, Robert Woroniecki
BACKGROUND: Hyperglycemia and acute kidney injury (AKI) are common in critically ill children and have been associated with higher morbidity and mortality. The incidence of AKI in children is difficult to estimate because of the lack of a standard definition for AKI. The pediatric RIFLE (Risk, Injury, Failure, Loss of kidney function, and End-stage kidney disease) criteria can be used to define AKI in children. Various biomarkers in urine and blood have been studied to detect AKI in critically ill children...
2016: International Journal of Nephrology and Renovascular Disease
David E Leaf, Sushrut S Waikar
Acute kidney injury (AKI) is an increasingly common and feared complication in hospitalized patients. The selection of appropriate primary and secondary end points is critical to the design and eventual success of clinical trials aimed at preventing and treating AKI. In this article, we provide an overview of AKI definitions and suggestions on the rational selection of end points for clinical trials in various settings, including the prevention of contrast-induced AKI, prevention of cardiac surgery-associated AKI, treatment of established AKI, and treatment of dialysis-requiring AKI...
September 3, 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Jun-Ping Qin, Xiang-You Yu, Chuan-Yun Qian, Shu-Sheng Li, Tie-He Qin, Er-Zhen Chen, Jian-Dong Lin, Yu-Hang Ai, Da-Wei Wu, De-Xin Liu, Ren-Hua Sun, Zhen-Jie Hu, Xiang-Yuan Cao, Fa-Chun Zhou, Zhen-Yang He, Li-Hua Zhou, You-Zhong An, Yan Kang, Xiao-Chun Ma, Ming-Yan Zhao, Li Jiang, Yuan Xu, Bin Du
BACKGROUND: Urine output (UO) is an essential criterion of the Kidney Disease Improving Global Outcomes (KDIGO) definition and classification system for acute kidney injury (AKI), of which the diagnostic value has not been extensively studied. We aimed to determine whether AKI based on KDIGO UO criteria (KDIGOUO) could improve the diagnostic and prognostic accuracy, compared with KDIGO serum creatinine criteria (KDIGOSCr). METHODS: We conducted a secondary analysis of the database of a previous study conducted by China Critical Care Clinical Trial Group (CCCCTG), which was a 2-month prospective cohort study (July 1, 2009 to August 31, 2009) involving 3063 patients in 22 tertiary Intensive Care Units in Mainland of China...
2016: Chinese Medical Journal
Dhaval Kolte, Nathan Spence, Mohamedtauqir Puthawala, Omar Hyder, Christopher P Tuohy, Carolyn B Davidson, Mark W Sheldon, Warren K Laskey, J Dawn Abbott
BACKGROUND: Patients with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI) are at an increased risk of developing contrast-induced acute kidney injury (CI-AKI). Data on the association between transradial (TRA) vs. transfemoral (TFA) access and the risk of CI-AKI in this setting are limited. METHODS: We analyzed data on 1162 patients undergoing primary PCI for STEMI at two tertiary care centers between 2010 and 2014...
July 21, 2016: Cardiovascular Revascularization Medicine: Including Molecular Interventions
Aki Inoue, Naoya Egami, Chisato Fujimoto, Makoto Kinoshita, Tatsuya Yamasoba, Shinichi Iwasaki
OBJECTIVE: To investigate whether both cervical and ocular vestibular myogenic potentials (cVEMPs and oVEMPs) to air-conducted sound (ACS) and bone-conducted vibration (BCV) can help to differentiate vestibular migraine (VM) and Menière's disease (MD). STUDY DESIGN: Retrospective study. SETTINGS: A tertiary referral center. SUBJECTS AND METHODS: Twenty-eight patients with VM, 28 patients with definite unilateral MD, and 28 age-matched controls were included...
November 2016: Annals of Otology, Rhinology, and Laryngology
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