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AKI prevention

Ehud Chorin, Eyal Ben-Assa, Maayan Konigstein, May-Tal Rofe, Aviram Hochstadt, Naama Galli, Michael Schnapper, Yaron Arbel, Ilan Rabey, Jeremy Ben Shoshan, Amir Halkin, Itzhak Herz, Ariel Finkelstein, Samuel Bazan, Gad Keren, Shmuel Banai
BACKGROUND: Radiologists and cardiologists have a remarkably different approach to the clinical importance and to the need for prophylactic treatment of contrast-induced acute kidney injury (CI-AKI). OBJECTIVES: To evaluate the efficacy of forced diuresis with matched controlled hydration (FMH) in a real-world, high risk population. METHODS: This is an investigator-driven, single-center, retrospective analysis of prospectively collected data...
October 11, 2016: International Journal of Cardiology
Yan Sun, Ping-An Peng, Yue Ma, Xiaoli Liu, Yi Yu, Shuo Jia, Xiaohan Xu, Sijing Wu, Yujie Zhou
Contrast-induced acute kidney injury (CI-AKI) is a serious complication of the administration of iodinated contrast media (CM) for diagnostic and interventional cardiovascular procedures and is associated with substantial morbidity and mortality. While the preventative measures can mitigate the risk of CI-AKI, there remains a need for novel and effective therapeutic approaches. The pathogenesis of CI-AKI is complex and not completely understood. CM-induced renal tubular cell apoptosis caused by the activation of endoplasmic reticulum (ER) stress is involved in CI-AKI...
October 25, 2016: Current Vascular Pharmacology
Arne Ring, Tom Morris, Marcin Wozniak, Nikol Sullo, William Dott, Veerle Verheyden, Tracy Kumar, Nigel Brunskill, Rakesh Vaja, Gavin J Murphy
BACKGROUND: Acute kidney injury (AKI) is a common and severe complication of cardiac surgery. There is no effective prevention or treatment. Sildenafil citrate (Revatio®, Pfizer Inc), a phosphodiesterase type 5 inhibitor, prevents post cardiac surgery AKI in pre-clinical studies, however its use is contraindicated in patients with symptomatic cardiovascular disease. METHODS: To assess the safety and pharmacokinetics of intravenous sildenafil in cardiac surgery patients we conducted an open label, dose escalation study with 6 patients per dose level...
October 25, 2016: British Journal of Clinical Pharmacology
Bulent Ergin, Michal Heger, Asli Kandil, Cihan Demirci-Tansel, Can Ince
Ischemia/reperfusion (I/R) is one of the main causes of acute kidney injury (AKI), which is characterized by sterile inflammation and oxidative stress. Immune cell activation can provoke overproduction of inflammatory mediators and reactive oxygen species (ROS), leading to perturbation of the microcirculation and tissue oxygenation associated with local and remote tissue injury. This study investigated whether the clinically employed immunosuppressant mycophenolate mofetil (MMF) was able to reduce I/R-induced renal oxygenation defects and oxidative stress by preventing sterile inflammation...
October 25, 2016: Clinical and Experimental Pharmacology & Physiology
Hoon Suk Park, Chan Joon Kim, Byung-Hee Hwang, Tae-Hoon Kim, Yoon Seok Koh, Hun-Jun Park, Sung-Ho Her, Sung Won Jang, Chul-Soo Park, Jong Min Lee, Hee-Yeol Kim, Doo Soo Jeon, Pum-Joon Kim, Ki-Dong Yoo, Kiyuk Chang, Dong Chan Jin, Ki-Bae Seung
Chronic kidney disease (CKD) is a significant risk factor for contrast induced acute kidney injury (CI-AKI) after percutaneous coronary intervention (PCI). This study included 1592 CKD patients extracted from a prospective multicenter, all comer-based registry of patients undergoing PCI. In multivariate logistic analysis for CI-AKI development, a significant linear trend was observed between the quartiles of HDL-C (quartile 1 vs. 2: odds ratio [OR], 0.716; 95% confidence interval [CI], 0.421-1.219; quartile 1 vs...
October 24, 2016: Scientific Reports
Ryoko Tajima, Takeshi Kimura, Ayaka Enomoto, Kaede Yanoshita, Aki Saito, Satomi Kobayashi, Katsunori Masuda, Kaoruko Iida
BACKGROUND & AIMS: Prevention of non-alcoholic fatty liver disease (NAFLD) through lifestyle modification is an important public health issue. Carbohydrate intake from soft drinks has received particular interest. Owing to differences in dietary habits, however, major contributors to the intake of dietary carbohydrates, such as rice, bread, and noodles, might have more influence on NAFLD prevalence in East Asian countries than consumption of soft drinks. We examined the relationship of the intake of rice, bread, and noodles, as well as overall carbohydrate intake, with NAFLD prevalence in middle-aged Japanese...
October 8, 2016: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
Shurong Li, Shufang Fu, Yichen Xiao, Gaosi Xu
Acute kidney injury (AKI) is a common and severe complication of cardiac surgery, and related rates of both hospitalization and long-term mortality are increasing. A number of studies have explored the preventive effects of perioperative pharmacological therapy on AKI after cardiac surgery. However, the mechanisms of AKI are multifaceted, and no universal treatment has been confirmed as beneficial. We review and analyze several current perioperative pharmacological therapies for AKI after cardiac surgery to identify promising preventive strategies...
October 22, 2016: American Journal of Cardiovascular Drugs: Drugs, Devices, and Other Interventions
Pedro H F Gois, Daniele Canale, Rildo A Volpini, Daniela Ferreira, Mariana M Veras, Vinicius Andrade-Oliveira, Niels O S Câmara, Maria H M Shimizu, Antonio C Seguro
BACKGROUND: Acute kidney injury (AKI) is the most severe complication of rhabdomyolysis. Allopurinol (Allo), a xanthine oxidase inhibitor, has been in the spotlight in the last decade due to new therapeutic applications related to its potent antioxidant effect. The aim of this study was to evaluate the efficacy of Allo in the prevention and treatment of rhabdomyolysis-associated AKI. METHODS: Male Wistar rats were divided into five groups: saline control group; prophylactic Allo (300mg/L of drinking water, 7 days); glycerol (50%, 5ml/kg, IM); prophylactic Allo + glycerol; and therapeutic Allo (50mg/Kg, IV, 30minutes after glycerol injection) + glycerol...
October 18, 2016: Free Radical Biology & Medicine
Melis Kant, Merve Akış, Mehmet Çalan, Tuğba Arkan, Fırat Bayraktar, Miral Dizdaroglu, Hüray İşlekel
Prediabetes is the preclinical stage of type 2 diabetes mellitus (T2DM) with intermediate state of hyperglycemia. Hyperglycemia results in a state of oxidative stress, which may contribute to the production of insulin resistance, β-cell dysfunction and long-term complications of diabetes. Novel approaches are required for prevention and treatment of diabetes. New biomarkers that can be used in risk stratification and therapy control as supplementary to current parameters are needed. These biomarkers may facilitate a more individualized and sufficient treatment of diabetes...
September 26, 2016: DNA Repair
Satoshi Izumi, Guang Hong, Koh Iwasaki, Masayuki Izumi, Yusuke Matsuyama, Mirei Chiba, Takashi Toda, Tada-Aki Kudo
The taste detection system for oral fatty acid may be related to obesity. In addition, sleep is intrinsically and closely related to food intake and metabolism. However, the association of gustatory salivation with body mass index (BMI), daytime sleepiness, or sleep habits is largely unknown. Therefore, we evaluated the relationship between gustatory salivation and BMI, Epworth sleepiness scale (ESS, a daytime sleepiness scale) or sleep habits among 26 healthy young individuals (20 males and 6 females; mean age: 26...
2016: Tohoku Journal of Experimental Medicine
Olga Ruiz-Andres, Maria Dolores Sanchez-Niño, Juan Antonio Moreno, Marta Ruiz-Ortega, Adrian Mario Ramos, Ana Belén Sanz, Alberto Ortiz
Chronic kidney disease (CKD) is associated to an increased risk of death, CKD progression and acute kidney injury (AKI) even from early stages, when glomerular filtration rate (GFR) is preserved. The link between early CKD and these risks is unclear, since there is no accumulation of uremic toxins. However, pathological albuminuria and kidney inflammation are frequent features of early CKD and the production of kidney protective factors may be decreased. Indeed, Klotho expression is already decreased in CKD category G1 (normal GFR)...
October 19, 2016: American Journal of Physiology. Renal Physiology
Esther Peters, Bülent Ergin, Asli Kandil, Ebru Gurel-Gurevin, Andrea van Elsas, Rosalinde Masereeuw, Peter Pickkers, Can Ince
Two small clinical trials indicated that administration of bovine intestinal alkaline phosphatase (AP) improves renal function in critically ill patients with sepsis-associated acute kidney injury (AKI), for which the mechanism of action is not completely understood. Here, we investigated the effects of a newly developed human recombinant AP (recAP) on renal oxygenation and hemodynamics and prevention of kidney damage and inflammation in two in vivo AKI models. To induce AKI, male Wistar rats (n=18) were subjected to renal ischemia (30min) and reperfusion (I/R), or sham-operated...
October 16, 2016: Toxicology and Applied Pharmacology
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
Tennille N Webb, Stuart L Goldstein
PURPOSE OF REVIEW: The incidence of cardiac surgery-associated acute kidney injury (CS-AKI) continues to increase and is associated with significant morbidity and mortality. Early diagnosis and identification of patients at risk are extremely important. Therefore, identifying associated risk factors, biomarkers for earlier detection, prevention and therapeutic options for CS-AKI warrant special attention. RECENT FINDINGS: The current diagnosis of acute kidney injury (AKI) largely depends upon the functional biomarkers serum creatinine and oliguria leading to delays in diagnosis and worsening outcomes...
September 29, 2016: Current Opinion in Anaesthesiology
Gillian Balbir Singh, Soe Hee Ann, Jongha Park, Hyun Chul Chung, Jong Soo Lee, Eun-Sook Kim, Jung Il Choi, Jiho Lee, Shin-Jae Kim, Eun-Seok Shin
OBJECTIVE: Remote ischemic preconditioning (RIPC) induces transient episodes of ischemia by the occlusion of blood flow in non-target tissue, before a subsequent ischemia-reperfusion injury. When RIPC is applied before percutaneous coronary intervention (PCI), the kidneys may be protected against ischemia-reperfusion injury and subsequently contrast-induced acute kidney injury (CI-AKI). The aim of this study was to evaluate the efficacy of RIPC for the prevention of CI-AKI in patients with diabetes with pre-existing chronic kidney disease (CKD) undergoing elective PCI...
2016: PloS One
Prameela Konda, Di Ai, Carlos E Guerra, Andrea Rodriguez-Restrepo, Reza J Mehran, David Rice, Wayne Hofstetter, Jagtar Heir, Peter Kwater, Vijaya Gottumukkala, Mike Hernandez, Juan P Cata
OBJECTIVE: To identify risks factors associated with acute kidney injury (AKI) after esophageal cancer surgery. DESIGN: This was a retrospective study. SETTING: Single academic center. PARTICIPANTS: Subjects with non-metastatic esophageal cancer. Patients were excluded if they were younger than 18 years and had missing data. MEASUREMENTS AND MAIN RESULTS: Primary outcome of the study was AKI according to AKI Network criteria...
July 21, 2016: Journal of Cardiothoracic and Vascular Anesthesia
Tomoki Tada, Kensaku Aki, Wataru Oboshi, Kazuyoshi Kawazoe, Toshiyuki Yasui, Eiji Hosoi
BACKGROUND: The hyperfunction and activation of platelets have been strongly implicated in the development and recurrence of arterial occlusive disease, and various antiplatelet drugs are used to treat and prevent such diseases. New antiplatelet drugs and many other drugs have been developed, but some drugs may have adverse effects on platelet functions. OBJECTIVE: The aim of this study was to establish an evaluation method for evaluating the effect and adverse effect of various drugs on platelet functions...
2016: Drug Design, Development and Therapy
Xiaole Su, Xinfang Xie, Lijun Liu, Jicheng Lv, Fujian Song, Vlado Perkovic, Hong Zhang
BACKGROUND: To simultaneously evaluate the relative efficacy of multiple pharmacologic strategies for preventing contrast-induced acute kidney injury (AKI). STUDY DESIGN: Systematic review containing a Bayesian network meta-analysis of randomized controlled trials. SETTING & POPULATION: Participants undergoing diagnostic and/or interventional procedures with contrast media. SELECTION CRITERIA FOR STUDIES: Randomized controlled trials comparing the active drug treatments with each other or with hydration alone...
October 1, 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Henrique Palomba, Isac Castro, Luis Yu, Emmanuel A Burdmann
BACKGROUND: Acute kidney injury (Dasta et al., Nephrol Dial Transplant 23(6):1970-1974, 2008) following cardiac surgery is associated with higher perioperative morbidity and mortality, but its impact on long term development of chronic kidney disease (CKD) is uncertain. METHODS: A total of 350 patients submitted to elective cardiac surgery were evaluated for AKI, defined as an increase in serum creatinine (SCr) ≥ 0.3 mg/dL over baseline value. Univariate and multivariate analysis were used to study pre, intra and postoperative parameters associated with occurrence CKD after 12 months of follow-up...
October 4, 2016: Journal of Nephrology
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