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https://www.readbyqxmd.com/read/28629397/optimal-timing-of-renal-replacement-therapy-initiation-in-acute-kidney-injury-the-elephant-felt-by-the-blindmen
#1
Chih-Chung Shiao, Tao-Min Huang, Herbert D Spapen, Patrick M Honore, Vin-Cent Wu
Renal replacement therapy (RRT) is a key component in the management of severe acute kidney injury (AKI) in critically ill patients. Many cohort studies, meta-analyses, and two recent large randomized prospective trials which evaluated the relationship between the timing of RRT initiation and patient outcome remain inconclusive due to substantial differences in study design, patient population, AKI definition, and RRT indication. A cause-specific diagnosis of AKI based on current staging criteria plus a sensitive biomarker (panel) that allows creating a homogeneous study population is definitely needed to assess the impact of early versus late initiation of RRT on patient outcome...
June 20, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28620570/perforated-bladder-as-a-cause-of-abdominal-ascites-in-a-patient-presenting-with-acute-onset-abdominal-pain
#2
Raj Shah, Madhuri Ramakrishnan, Beenish Ahmed, Khalil Abuamr, Osama Yousef
Bladder perforation, especially when atraumatic, is a rare cause of ascites and is often difficult to differentiate from other causes of abdominal pain and ascites in the acute setting.  A 43-year-old Caucasian woman with a history of multiple sclerosis presented with acute abdominal pain. A computed tomography (CT) scan of her abdomen and pelvis without contrast revealed ascites, acute kidney injury (AKI) was noted on laboratory workup, and very little urine was drained by Foley catheter. Over the next several days, the patient's clinical condition deteriorated with no definitive diagnosis...
May 11, 2017: Curēus
https://www.readbyqxmd.com/read/28616708/comparison-of-different-definitions-of-acute-kidney-injury-in-extremely-low-birth-weight-infants
#3
Vikas Chowdhary, Ramya Vajpeyajula, Mohit Jain, Syeda Maqsood, Rupesh Raina, Deepak Kumar, Maroun J Mhanna
BACKGROUND: The definition of acute kidney injury (AKI) has evolved over the years, and three definitions have been adapted including pediatric risk injury failure, loss of kidney function (pRIFLE), Acute Kidney Injury Network (AKIN), and Neonatal Modified Kidney Disease Improving Global Outcomes (KDIGO). We sought to report the prevalence and outcome of (AKI) according to the three existing definitions in extremely low birth weight (ELBW) infants. METHODS: In a retrospective cohort study, medical records of all ELBW infants (<1000 g) admitted to our neonatal intensive care unit (NICU) between Jan 2002 and Dec 2011 were reviewed...
June 14, 2017: Clinical and Experimental Nephrology
https://www.readbyqxmd.com/read/28616210/acute-kidney-injury-an-overview-of-diagnostic-methods-and-clinical-management
#4
Daniel Hertzberg, Linda Rydén, John W Pickering, Ulrik Sartipy, Martin J Holzmann
Acute kidney injury (AKI) is a common condition in multiple clinical settings. Patients with AKI are at an increased risk of death, over both the short and long term, and of accelerated renal impairment. As the condition has become more recognized and definitions more unified, there has been a rapid increase in studies examining AKI across many different clinical settings. This review focuses on the classification, diagnostic methods and clinical management that are available, or promising, for patients with AKI...
June 2017: Clinical Kidney Journal
https://www.readbyqxmd.com/read/28604760/developing-a-neonatal-acute-kidney-injury-research-definition-a-report-from-the-niddk-neonatal-aki-workshop
#5
Michael Zappitelli, Namasivayam Ambalavanan, David J Askenazi, Marva M Moxey-Mims, Paul L Kimmel, Robert A Star, Carolyn L Abitbol, Patrick D Brophy, Guillermo Hidalgo, Mina Hanna, Catherine M Morgan, Tonse N K Raju, Patricio Ray, Zayhara Reyes-Bou, Amani Roushdi, Stuart L Goldstein
Normal developmental changes during postnatal life hinder the development of an AKI definition and advancement of neonatal AKI research. This report summarizes the expert discussion at a National Institute of Diabetes and Digestive and Kidney Diseases sponsored neonatal AKI workshop, on knowledge gaps in defining neonatal AKI. The most important knowledge gaps and neonatal AKI definition research recommendations were agreed upon and defined. Several challenges were identified in defining neonatal AKI using serum creatinine (SCr) and urine output criteria applied in adults and children...
June 12, 2017: Pediatric Research
https://www.readbyqxmd.com/read/28602971/new-developments-in-hepatorenal-syndrome
#6
Ayse L Mindikoglu, Stephen C Pappas
Hepatorenal Syndrome (HRS) continues to be one of the major complications of decompensated cirrhosis leading to death in the absence of liver transplantation. Challenges in precisely evaluating renal function in the patient with cirrhosis remain due to the limitations of serum creatinine (Cr) alone in estimating glomerular filtration rate (GFR); current GFR estimating models appear to underestimate renal function. Newer models incorporating renal biomarkers, such as the Cr-Cystatin C GFR Equation for Cirrhosis appear to more accurately estimate true GFR...
June 7, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28594397/establishment-of-a-quick-and-highly-accurate-breath-test-for-aldh2-genotyping
#7
Ikuo Aoyama, Shinya Ohashi, Yusuke Amanuma, Kenshiro Hirohashi, Ayaka Mizumoto, Makiko Funakoshi, Mihoko Tsurumaki, Yukie Nakai, Katsuyuki Tanaka, Mariko Hanada, Aki Uesaka, Tsutomu Chiba, Manabu Muto
OBJECTIVES: Acetaldehyde, the first metabolite of ethanol, is a definite carcinogen for the esophagus, head, and neck; and aldehyde dehydrogenase 2 (ALDH2) is a mitochondrial enzyme that catalyzes the metabolism of acetaldehyde. The ALDH2 genotype exists as ALDH2*1/*1 (active ALDH2), ALDH2*1/*2 (heterozygous inactive ALDH2), and ALDH2*2/*2 (homozygous inactive ALDH2). Many epidemiological studies have reported that ALDH2*2 carriers are at high risk for esophageal or head and neck squamous cell carcinomas by habitual drinking...
June 8, 2017: Clinical and Translational Gastroenterology
https://www.readbyqxmd.com/read/28580076/postoperative-acute-kidney-injury
#8
REVIEW
Jung Tak Park
Acute kidney injury (AKI) after cardiac surgery is a common and serious complication. Several definitions of AKI have been proposed recently, and include both increases in serum creatinine levels and decreases in urine output as diagnostic criteria. The pathophysiology of postoperative AKI is complex and involves both ischemic injury and systemic inflammation. Identifying risk factors, such as old age, underlying diabetes, heart failure, and obesity, may aid in the application of preventative methods for postoperative AKI...
June 2017: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/28579710/assessment-of-knowledge-of-acute-kidney-injury-among-non-nephrology-doctors-in-two-government-hospitals-in-ondo-city-southwest-nigeria
#9
Oluseyi Adejumo, Ayodeji Akinbodewa, Oladimeji Alli, Pirisola Olufemi, Abolarin Olatunji
BACKGROUND: Adequate knowledge of acute kidney injury (AKI) among doctors is essential for its prevention, early diagnosis and management. Assessing knowledge of AKI among doctors is necessary to identify areas of deficiencies and key areas to be emphasized when organizing educational programs aimed at improving AKI care. This study determined the knowledge of AKI among non-nephrology doctors in Ondo City, Southwest Nigeria. MATERIALS AND METHODS: This was a cross-sectional descriptive study carried out in two government hospitals in Ondo City using a self-administered pretested questionnaire that assessed knowledge of AKI among non-nephrology doctors...
March 2017: Ethiopian Journal of Health Sciences
https://www.readbyqxmd.com/read/28573142/advances-in-the-diagnosis-and-treatment-of-acute-kidney-injury-in-cirrhosis-patients
#10
REVIEW
Lei Lei, Liangping Li, Hu Zhang
Liver cirrhosis is a common progressive and chronic clinical liver disease. Due to the strong compensation ability of the liver, no obvious symptoms develop in the early stage. However, multiple systems are involved in decompensation of the liver. Acute kidney injury (AKI) is one of the most serious complications, characterized by a sharp drop in the glomerular filtration rate (GFR); a rapid increase in Scr and BUN, as well as sodium and water storage; and a disturbance of acid-base balance. The mortality rate is high, and the prognosis is very poor...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28570592/a-prospective-study-of-the-demographics-management-and-outcome-of-patients-with-acute-kidney-injury-in-cape-town-south-africa
#11
Thandiwe A L Dlamini, Peter J Heering, Tawanda Chivese, Brian Rayner
AIM: To study the demographics and outcome of acute kidney injury (AKI) at Groote Schuur Hospital, Cape Town, South Africa. METHODS AND FINDINGS: A prospective observational study of AKI fulfilling the Kidney Disease: Improving Global Outcomes definition, from 8 July 2012 to 8 July 2013. Ethics approval was granted by the University of Cape Town Human Research Ethics Committee. Consent was waived because patient data was de-identified and patient management was not adversely affected by the study...
2017: PloS One
https://www.readbyqxmd.com/read/28555296/acute-kidney-injury-in-premature-newborns-definition-etiology-and-outcome
#12
Vesna Stojanović, Nenad Barišić, Tanja Radovanović, Milena Bjelica, Borko Milanović, Aleksandra Doronjski
BACKGROUND: Neonatal acute kidney injury (AKI) is common and is associated with poor outcomes. New criteria for the diagnosis of AKI were introduced based on the increase in serum creatinine (SCr) levels and/or reduction of urine output (UOP). Yet, there is no generally accepted opinion so far, which criteria (whether SCr, UOP, or their combination) are the most appropriate to diagnose neonatal AKI. METHODS: The retrospective study included 195 prematurely born neonates who fulfilled all inclusion criteria (with at least two SCr measurements)...
May 29, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28545421/diagnostic-performance-of-serum-blood-urea-nitrogen-to-creatinine-ratio-for-distinguishing-prerenal-from-intrinsic-acute-kidney-injury-in-the-emergency-department
#13
Guillaume Manoeuvrier, Kalyane Bach-Ngohou, Eric Batard, Damien Masson, David Trewick
BACKGROUND: The blood urea nitrogen to creatinine ratio (BCR) has been used since the early 1940s to help clinicians differentiate between prerenal acute kidney injury (PR AKI) and intrinsic AKI (I AKI). This ratio is simple to use and often put forward as a reliable diagnostic tool even though little scientific evidence supports this. The aim of this study was to determine whether BCR is a reliable tool for distinguishing PR AKI from I AKI. METHODS: We conducted a retrospective observational study over a 13 months period, in the Emergency Department (ED) of Nantes University Hospital...
May 25, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28540634/simplifying-contrast-induced-acute-kidney-injury-prediction-after-primary-percutaneous-coronary-intervention-the-age-creatinine-and-ejection-fraction-score
#14
Gustavo N Araujo, Fernando Pivatto Junior, Bruno Fuhr, Elvis P Cassol, Guilherme P Machado, Felipe H Valle, Luiz C Bergoli, Rodrigo V Wainstein, Carisi A Polanczyk, Marco V Wainstein
Contrast-induced acute kidney injury (CI-AKI) is a common event after percutaneous coronary intervention (PCI). Presently, the main strategy to avoid CI-AKI lies in saline hydration, since to date none pharmacologic prophylaxis proved beneficial. Our aim was to determine if a low complexity mortality risk model is able to predict CI-AKI in patients undergoing PCI after ST elevation myocardial infarction (STEMI). We have included patients with STEMI submitted to primary PCI in a tertiary hospital. The definition of CI-AKI was a raise of 0...
May 24, 2017: Cardiovascular Intervention and Therapeutics
https://www.readbyqxmd.com/read/28525779/systematic-review-and-meta-analysis-of-renal-replacement-therapy-modalities-for-acute-kidney-injury-in-the-intensive-care-unit
#15
Danielle M Nash, Sebastian Przech, Ron Wald, Daria O'Reilly
PURPOSE: To compare clinical outcomes among critically ill adults with acute kidney injury (AKI) treated with continuous renal replacement therapy (CRRT), intermittent hemodialysis (IHD) or sustained low efficiency dialysis (SLED). MATERIALS AND METHODS: We completed a systematic review and meta-analysis of studies published in 2015 or earlier using MEDLINE®, EMBASE®, Cochrane databases and grey literature. Eligible studies included randomized clinical trials (RCTs) or prospective cohort studies comparing outcomes of mortality, dialysis dependence or length of stay among critically ill adults receiving CRRT, IHD or SLED to treat AKI...
May 9, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28515179/arginase-2-mediates-renal-ischemia-reperfusion-injury
#16
Wesley M Raup-Konsavage, Ting Gao, Timothy K Cooper, Sidney M Morris, W Brian Reeves, Alaa S Awad
Novel therapeutic interventions for preventing or attenuating kidney injury following ischemia/reperfusion injury (IRI) remain a focus of significant interest. Currently, there are no definitive therapeutic or preventive approaches available for ischemic acute kidney injury (AKI). Our objective is to determine (a) whether renal arginase activity or expression is increased in renal IRI and (b) whether arginase plays a role in development of renal IRI. The impact of arginase activity and expression on renal damage was evaluated in male C57BL/6J (WT) and arginase-2 deficient (Arg2(-/-) ) mice subjected to bilateral renal ischemia for 28min followed by reperfusion for 24h...
May 17, 2017: American Journal of Physiology. Renal Physiology
https://www.readbyqxmd.com/read/28491853/infection-associated-acute-interstitial-nephritis-a-case-report
#17
Rupesh Raina, Shirisha Ale, Tushar Chaturvedi, Luke Fraley, Robert Novak, Natthavat Tanphaichitr
BACKGROUND: Acute interstitial nephritis (AIN) is a clinico-pathological syndrome associated with a variety of infections, drugs, and sometimes with unknown causes. It is a common cause of acute kidney injury (AKI) and subsequent renal impairment, which often times is under-diagnosed. Infection-associated AIN occurs as a consequence of many systemic bacterial, viral, and parasitic infec-tions; however, its incidence has decreased significantly after the advent of antimicrobials. Infection-associated AIN presents with both oliguric or non-oliguric renal insufficiency, without the classical clinical triad of AIN (fever, rash, and arthralgia)...
March 2017: Journal of Nephropathology
https://www.readbyqxmd.com/read/28491339/the-clinical-epidemiology-and-30-day-outcomes-of-emergency-department-patients-with-acute-kidney-injury
#18
Frank Xavier Scheuermeyer, Eric Grafstein, Brian Rowe, Jay Cheyne, Brian Grunau, Aaron Bradford, Adeera Levin
BACKGROUND: Acute kidney injury (AKI) is associated with increased mortality and dialysis in hospitalized patients but has been little explored in the emergency department (ED) setting. OBJECTIVE: The objective of this study was to describe the risk factors, prevalence, management, and outcomes in the ED population, and to identify the proportion of AKI patients who were discharged home with no renal-specific follow-up. DESIGN: This is a retrospective cohort study using administrative and laboratory databases...
2017: Canadian Journal of Kidney Health and Disease
https://www.readbyqxmd.com/read/28487864/non-dialytic-management-of-acute-kidney-injury-in-newborns
#19
REVIEW
Vishal Pandey, Deepak Kumar, Prashant Vijayaraghavan, Tushar Chaturvedi, Rupesh Raina
Treating acute kidney injury (AKI) in newborns is often challenging due to the functional immaturity of the neonatal kidney. Because of this physiological limitation, renal replacement therapy (RRT) in this particular patient population is difficult to execute and may lead to unwanted complications. Although fluid overload and electrolyte abnormalities, as seen in neonatal AKI, are indications for RRT initiation, there is limited evidence that RRT initiated in the first year of life improves long-term outcome...
2017: Journal of Renal Injury Prevention
https://www.readbyqxmd.com/read/28474996/association-of-preoperative-hypoalbuminemia-with-postoperative-acute-kidney-injury-in-patients-undergoing-brain-tumor-surgery-a-retrospective-study
#20
Kyungmi Kim, Ji-Yeon Bang, Seon-Ok Kim, Saegyeol Kim, Joung Uk Kim, Jun-Gol Song
OBJECTIVE Hypoalbuminemia is known to be independently associated with postoperative acute kidney injury (AKI). However, little is known about the association between the preoperative serum albumin level and postoperative AKI in patients undergoing brain tumor surgery. The authors investigated the incidence of AKI, impact of preoperative serum albumin level on postoperative AKI, and death in patients undergoing brain tumor surgery. METHODS The authors retrospectively reviewed the electronic medical records and laboratory results of 2363 patients who underwent brain tumor surgery between January 2008 and December 2014...
May 5, 2017: Journal of Neurosurgery
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