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AKI classification

Satoru Kudose, Masato Hoshi, Sanjay Jain, Joseph P Gaut
Acute kidney injury (AKI) is a significant cause of morbidity and mortality. Acute tubular injury is considered to be the early pathologic manifestation of AKI, however, the underlying pathology is complex, lacks standards for interpretation, and its relationship with AKI often is unclear or inconsistent. To clarify clinicopathologic correlations in AKI, we evaluated 32 histologic findings in 100 kidney biopsies from patients with AKI as a training set to correlate pathologic findings with clinical AKI grades...
March 13, 2018: American Journal of Surgical Pathology
Li Ning, Zhiguo Li, Dianjun Wei, Haiyan Chen, Chao Yang, Dawei Wu, Yanchun Wang, Jingwei Zhang
Contrast-induced acute kidney injury (CI-AKI) is a serious complication of diagnostic coronary angiograph and percutaneous coronary intervention (PCI). However, the exact pathophysiological mechanisms underlying CI-AKI development are largely unknown. The present study examined whether urinary semaphorin 3A levels predict the development of CI-AKI in patients undergoing PCI. This study enrolled 168 patients with stable angina undergoing elective PCI. Serial urine samples, obtained at baseline and 2, 6, 12, 24, 36, and 48 h post-PCI were analyzed by semaphorin 3A and neutrophil gelatinase-associated lipocalin (NGAL) ELISA kit...
March 1, 2018: Brazilian Journal of Medical and Biological Research, Revista Brasileira de Pesquisas Médicas e Biológicas
Hjalmar R Bouma, Hubert E Mungroop, A Fred de Geus, Daniel D Huisman, Maarten W N Nijsten, Massimo A Mariani, Thomas W L Scheeren, Johannes G M Burgerhof, Robert H Henning, Anne H Epema
BACKGROUND: Perioperative acute kidney injury (AKI) is an important predictor of long-term all-cause mortality after coronary artery bypass (CABG). However, the effect of AKI on long-term mortality after cardiac valve operations is hitherto undocumented. METHODS: Perioperative renal injury and long-term all-cause mortality after valve operations were studied in a prospective cohort of patients undergoing solitary valve operations (n=2,806) or valve operations combined with CABG (n=1,260) with up to 18 years of follow-up...
March 1, 2018: Annals of Thoracic Surgery
Jameela Abdulaziz Kari, Mohamed Ahmed Shalaby, Kholoud Sofyani, Ahmad Saleh Sanad, Albaraa Fuad Ossra, Rayan Smeer Halabi, Maha Hassan Aljuhani, Wael Mohammad Toffaha, Feras Aymen Moria, Samar Sabry, Hanan AbdelAziz Ahmed, Khalid Abdulaziz Alhasan, Sara Sharief, Osama Safdar
BACKGROUND: Acute kidney injury (AKI) is common in critically ill children with significant mortality and morbidity. Serum creatinine is an insensitive and late biomarker compared to newly proposed AKI biomarkers. METHODS: Prospective study in pediatric intensive care unit (PICU) over three months to compare between serum cystatin-C (s-Cys-C) and urinary neutrophil gelatinase-associated lipocalin (uNGAL) as AKI biomarkers at multiple time points with pediatric risk, injury, failure, loss, end-stage renal disease (pRIFLE) classification in diagnosing AKI...
February 20, 2018: World Journal of Pediatrics: WJP
Masakazu Sato, Koji Horie, Aki Hara, Yuichiro Miyamoto, Kazuko Kurihara, Kensuke Tomio, Harushige Yokota
The objective of the present study was to investigate whether deep learning could be applied successfully to the classification of images from colposcopy. For this purpose, a total of 158 patients who underwent conization were enrolled, and medical records and data from the gynecological oncology database were retrospectively reviewed. Deep learning was performed with the Keras neural network and TensorFlow libraries. Using preoperative images from colposcopy as the input data and deep learning technology, the patients were classified into three groups [severe dysplasia, carcinoma in situ (CIS) and invasive cancer (IC)]...
March 2018: Oncology Letters
Joana Gameiro, José Agapito Fonseca, Marta Neves, Sofia Jorge, José António Lopes
Acute kidney injury (AKI) is a common complication in patients undergoing major abdominal surgery. Various recent studies using modern standardized classifications for AKI reported a variable incidence of AKI after major abdominal surgery ranging from 3 to 35%. Several patient-related, procedure-related factors and postoperative complications were identified as risk factors for AKI in this setting. AKI following major abdominal surgery has been shown to be associated with poor short- and long-term outcomes...
February 9, 2018: Annals of Intensive Care
Mira Küllmar, Alexander Zarbock
Acute kidney injury (AKI) is a common complication in critically ill patients and is associated with a worse short- and long-term outcome. The KDIGO (Kidney Disease: Improving Global Outcomes) guidelines suggest to implement preventive strategies in high-risk patients. Definition and classification of acute kidney injury according to the KDIGO criteria are based on an increase in serum creatinine and/or a decrease in urinary output. Renal replacement therapy (RRT) is the only supportive measure in patients with severe AKI...
February 2018: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
Lynn Redahan, Patrick T Murray
There is an expanding body of literature regarding the utility of novel biomarkers in drug-induced kidney injury (DIKI) and other forms of acute kidney injury (AKI). The authors could not thoroughly review this topic without referring to and acknowledging this work. Included is a list of additional articles (see Supplementary Reading List) that have been referenced, but not cited within the body of the text. These references have provided data used within this article and have allowed the authors to discuss the epidemiology of DIKI, its classification, the utility of specific biomarkers, and the impact that comorbid illness and medications can have on their levels...
March 2018: Clinical Pharmacology and Therapeutics
Hyoungnae Kim, Hyunwook Kim, Misol Lee, Min-Uk Cha, Ki Heon Nam, Seong Yeong An, Su-Young Jung, Jong Hyun Jhee, Seohyun Park, Hae-Ryong Yun, Youn Kyung Kee, Hyung Jung Oh, Jung Tak Park, Tae Ik Chang, Tae-Hyun Yoo, Shin-Wook Kang, Seung Hyeok Han
BACKGROUND: Association between high body mass index (BMI) and survival benefit is confounded by comorbid conditions such as nutritional status and inflammation. Patients with acute kidney injury (AKI), particularly those receiving continuous renal replacement therapy (CRRT), are highly catabolic and more susceptible to loss of energy. Herein, we evaluated whether disease severity can modify the relationship between BMI and mortality. METHODS: We conducted an observational study in 1144 patients who had undergone CRRT owing to various causes of AKI between 2010 and 2014...
February 7, 2018: BMC Nephrology
Ling Zhang, Xiaodong Zhuang, Xinxue Liao
BACKGROUND: This study aimed to investigate the effect of acute kidney injury (AKI) on the progression of renal disease and to develop a clinico-pathological nomogram to predict the renal outcome of IgA nephropathy (IgAN) patients, based on Oxford classification score. METHODS: This is a retrospective observational study. A total of 988 IgAN patients treated at our hospital between 2006 and 2011 were included and divided into AKI (n = 82) and non-AKI group (n = 906)...
January 30, 2018: European Journal of Internal Medicine
Zaccaria Ricci, Stefano Romagnoli
BACKGROUND: The acute reduction of kidney function in critically and noncritically ill patients (regardless of their age) is one of the deadliest clinical conditions ever reported in modern medicine. Acute kidney injury (AKI) symptoms are sneaky and potentially difficult to be identified at the right time at the bedside. One of the greatest efforts of the recent history of critical care nephrology has been to find a common classification for AKI definition and staging with the purpose of allowing a timely diagnosis and push forward epidemiologic research...
2018: Contributions to Nephrology
Joana Gameiro, Miguel Gonçalves, Marta Pereira, Natacha Rodrigues, Iolanda Godinho, Marta Neves, João Gouveia, Zélia Costa E Silva, Sofia Jorge, José António Lopes
Although the prognostic effect of obesity has been studied in critically ill patients its impact on outcomes of septic patients and its role as a risk factor for acute kidney injury (AKI) is not consensual. We aimed to analyze the impact of obesity on the occurrence of AKI and on in-hospital mortality in a cohort of critically ill septic patients. This study is retrospective including 456 adult patients with sepsis admitted to the Division of Intensive Medicine of the Centro Hospitalar Lisboa Norte (Lisbon, Portugal) between January 2008 and December 2014...
November 2018: Renal Failure
Christian Albert, Annemarie Albert, Johanna Kube, Rinaldo Bellomo, Nicholas Wettersten, Hermann Kuppe, Sabine Westphal, Michael Haase, Anja Haase-Fielitz
OBJECTIVE: This study aimed to determine the biomarker-specific outcome patterns and short-and long-term prognosis of cardiac surgery-asoociated acute kidney injury (AKI) identified by standard criteria and/or urinary kidney biomarkers. METHODS: Patients enrolled (N = 200), originated a German multicenter study (NCT00672334). Standard risk injury, failure, loss, and end-stage renal disease classification (RIFLE) criteria (including serum creatinine and urine output) and urinary kidney biomarker test result (neutrophil gelatinase-associated lipocalin, midkine, interleukin 6, and proteinuria) were used for diagnosis of postoperative AKI...
December 22, 2017: Journal of Thoracic and Cardiovascular Surgery
John A Kellum, John R Prowle
Acute kidney injury (AKI) is a heterogeneous clinical syndrome that has multiple aetiologies, variable pathogenesis and diverse outcomes. However, these heterogeneities are not reflected in current approaches to the diagnosis and, to some degree, treatment of AKI. For example, congestive heart failure and dehydration can produce identical changes in serum creatinine level and urine output (parameters that are used to define AKI); however, they differ vastly in their physiological contexts and demand completely opposite treatments...
January 22, 2018: Nature Reviews. Nephrology
Soe Ko, Sudharsan Venkatesan, Kushma Nand, Vicki Levidiotis, Craig Nelson, Edward Janus
BACKGROUND: The International classification of diseases (ICD) code is frequently used to identify renal impairment in epidemiologic research. However, Australian studies examining accuracy of this administrative data in coding kidney injury are lacking. AIMS: To compare the ICD 10 coding with the Kidney Disease: Improving Global Outcomes (KDIGO) criteria in diagnosing Acute Kidney Injury (AKI) and/or Chronic Kidney Disease (CKD). METHODS: A retrospective study of 325 patients admitted to General Medicine during January 2012 was performed...
December 28, 2017: Internal Medicine Journal
Husain N Alshaikh, Nevin M Katz, Faiz Gani, Neeraja Nagarajan, Joseph K Canner, Seema Kacker, Peter A Najjar, Robert S Higgins, Eric B Schneider
BACKGROUND: Acute kidney injury (AKI) after major cardiac operations is a potentially avoidable complication associated with increased morbidity, death, and costly long-term treatment. The financial impact of AKI at the population level has not been well defined. We sought to determine the incremental index hospital cost associated with the development of AKI. METHODS: All patients undergoing coronary artery bypass grafting (CABG) or valve replacement operations, or both (clinical classification software codes 43 and 44), between 2008 and 2011 were identified from the Nationwide Inpatient Sample...
December 21, 2017: Annals of Thoracic Surgery
Christian Delles, Naomi J Rankin, Charles Boachie, Alex McConnachie, Ian Ford, Antti Kangas, Pasi Soininen, Stella Trompet, Simon P Mooijaart, J Wouter Jukema, Faiez Zannad, Mika Ala-Korpela, Veikko Salomaa, Aki S Havulinna, Paul Welsh, Peter Würtz, Naveed Sattar
AIMS: We investigated the association between quantified metabolite, lipid and lipoprotein measures and incident heart failure hospitalisation (HFH) in the elderly, and examined whether circulating metabolic measures improve HFH prediction. METHODS AND RESULTS: Overall, 80 metabolic measures from the PROspective Study of Pravastatin in the Elderly at Risk (PROSPER) trial were measured by proton nuclear magnetic resonance spectroscopy (n = 5341; 182 HFH events during 2...
December 11, 2017: European Journal of Heart Failure
Ankit Sakhuja, Kianoush Kashani, Jesse Schold, Wisit Cheungpasitporn, Edward Soltesz, Sevag Demirjian
Background: Acute kidney injury (AKI) is common after coronary artery bypass grafting (CABG) and is associated with poor outcome. Increased hospital procedure volume has been associated with better outcomes. However, the impact of hospital CABG volume on AKI needing dialysis (AKI-D) is less clear. We designed this study to examine (i) the impact of number of annual CABG procedures per hospital (CABG-vol) on AKI-D and inpatient mortality and (ii) if it modifies the relationship between AKI-D and mortality...
December 2017: Clinical Kidney Journal
Gilad Margolis, Amir Gal-Oz, Sevan Letourneau-Shesaf, Shafik Khoury, Gad Keren, Yacov Shacham
BACKGROUND: Acute kidney injury (AKI) following acute ST elevation myocardial infarction (STEMI) is associated with adverse outcomes. The recently proposed KDIGO criteria suggested modifications to the consensus classification system for AKI, namely lowering the threshold of increase in absolute serum creatinine and extending the time frame for AKI detection to 7 days. We evaluated the incidence, risk factors, and long-term mortality associated with AKI as classified by the KDIGO definition in a large single center cohort of consecutive STEMI patients...
November 28, 2017: Journal of Nephrology
Chien-Ning Hsu, Hsiao-Ling Chen, You-Lin Tain
BACKGROUND: Hospital-acquired acute kidney injury (HA-AKI) is associated with an increased risk of childhood mortality; however, only a few studies have addressed community-acquired AKI (CA-AKI). METHODS: AKI Network classification was used to assess community- and hospital-acquired AKI, 2010-2014. Patients with CA-AKI who were admitted to an inpatient setting were categorized as CAA-AKI. CANA-AKI was for CA-AKI not admitted to inpatient care. Epidemiology, factors associated with AKI, in-hospital outcomes were assessed for variation...
November 20, 2017: Pediatric Research
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