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AKI prevention

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https://www.readbyqxmd.com/read/28640195/pharmacogenomic-variants-may-influence-the-urinary-excretion-of-novel-kidney-injury-biomarkers-in-patients-receiving-cisplatin
#1
Cara Chang, Yichun Hu, Susan L Hogan, Nickie Mercke, Madeleine Gomez, Cindy O'Bryant, Daniel W Bowles, Blessy George, Xia Wen, Lauren M Aleksunes, Melanie S Joy
Nephrotoxicity is a dose limiting side effect associated with the use of cisplatin in the treatment of solid tumors. The degree of nephrotoxicity is dictated by the selective accumulation of cisplatin in renal tubule cells due to: (1) uptake by organic cation transporter 2 (OCT2) and copper transporter 1 (CTR1); (2) metabolism by glutathione S-transferases (GSTs) and γ-glutamyltransferase 1 (GGT1); and (3) efflux by multidrug resistance-associated protein 2 (MRP2) and multidrug and toxin extrusion protein 1 (MATE1)...
June 22, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28624882/predicting-acute-kidney-injury-current-status-and-future-challenges
#2
REVIEW
Simona Pozzoli, Marco Simonini, Paolo Manunta
Acute kidney injury (AKI) is characterized by an acute decline in renal function and is associated to increased mortality rate, hospitalization time, and total health-related costs. The severity of this 'fearsome' clinical complication might depend on, or even be worsened by, the late detection of AKI, when the diagnosis is based on the elevation of serum creatinine (SCr). For these reasons, in recent years a great number of new tools, biomarkers and predictive models have been proposed to clinicians in order to improve diagnosis and prevent the development of AKI...
June 17, 2017: Journal of Nephrology
https://www.readbyqxmd.com/read/28624104/acute-kidney-injury-after-liver-transplantation-recent-insights-and-future-perspectives
#3
REVIEW
Jubi E de Haan, Ewout J Hoorn, Hilde R H de Geus
Acute kidney injury (AKI) is a common postoperative complication after liver transplantation (LT). The occurrence of postoperative AKI after LT (Post-LT AKI) is associated with inferior patient and graft outcomes. Post-LT AKI is multifactorial in origin and has been related to the severity of liver disease, pre-LT renal dysfunction, graft quality, perioperative events and toxicity of immunosuppressive therapy. Furthermore it is thought that hepatic ischaemia reperfusion injury might be a driving force in the aetiology of post-LT AKI...
April 2017: Best Practice & Research. Clinical Gastroenterology
https://www.readbyqxmd.com/read/28619098/interventions-to-prevent-hemodynamic-instability-during-renal-replacement-therapy-for-acute-kidney-injury-a-systematic-review-protocol
#4
Adrianna Douvris, Swapnil Hiremath, Lauralyn McIntyre, Lindsey Sikora, Catherine Weber, Edward G Clark
BACKGROUND: Hemodynamic instability during renal replacement therapy (HIRRT) in the form of intradialytic hypotension (IDH) is a frequent complication of hemodialysis in end-stage kidney disease (ESKD), and most studies have focused on this chronic population. However, HIRRT is also an important concern for critically ill ICU patients with acute kidney injury (AKI), complicating an estimated 30% of dialysis treatments in this population. HIRRT can exacerbate organ hypoperfusion in the setting of critical illness and may negatively impact renal recovery in the AKI population...
June 15, 2017: Systematic Reviews
https://www.readbyqxmd.com/read/28616213/postoperative-goal-directed-therapy-and-development-of-acute-kidney-injury-following-major-elective-noncardiac-surgery-post-hoc-analysis-of-pom-o-randomized-controlled-trial
#5
Amour Patel, John R Prowle, Gareth L Ackland
Background: The role of goal-directed therapy (GDT) in preventing creatinine rise following noncardiac surgery is unclear. We performed a post-hoc analysis of a randomized controlled trial to assess the relationship between postoperative optimization of oxygen delivery and development of acute kidney injury (AKI)/creatinine rise following noncardiac surgery. Methods: Patients were randomly assigned immediately postoperatively to receive either fluid and/or dobutamine therapy to maintain/restore their preoperative oxygen delivery, or protocolized standard care (oxygen delivery only recorded)...
June 2017: Clinical Kidney Journal
https://www.readbyqxmd.com/read/28616210/acute-kidney-injury-an-overview-of-diagnostic-methods-and-clinical-management
#6
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/28615146/novel-insights-into-acute-kidney-injury-chronic-kidney-disease-continuum-and-the-role-of-renin-angiotensin-system
#7
REVIEW
Yu-Hsiang Chou, Tao-Min Huang, Tzong-Shinn Chu
Acute kidney injury (AKI) is an independent risk factor for chronic kidney disease (CKD). If injury is mild, a repair process can be adaptive and lead to complete renal recovery. However, severe injury will be accompanied by a maladaptive repair which usually leads to nephron loss, fibrosis, vascular rarefaction, and chronic inflammation. Although various mechanisms underlying AKI-CKD transition have been explored, no intervention has been proved effective to block the transition until very recently. A lack of consensus for monitoring renal function and defining renal recovery after AKI should be the reasons for the slow advance in the discovery of a timely pharmacologic treatment to block AKI-CKD transition...
June 11, 2017: Journal of the Formosan Medical Association, Taiwan Yi Zhi
https://www.readbyqxmd.com/read/28610773/contrast-induced-acute-kidney-injury-in-interventional-cardiology-emerging-evidence-and-unifying-mechanisms-of-protection-by-remote-ischemic-conditioning
#8
REVIEW
Adebayo C Atanda, Oladipupo Olafiranye
Contrast-induced acute kidney injury (CI-AKI) is a common complication of many diagnostic and therapeutic cardiovascular procedures. It is associated with longer in-hospital stay, more complicated hospitalization course, and higher in-hospital morbidity and mortality. With increasing use of contrast media in various diagnostic and interventional procedures, the prevalence of CI-AKI is expected to rise. Although pre-hydration with intravenous normal saline is recommended in patients with elevated risk of CI-AKI, this approach is often not feasible in many clinical settings...
June 6, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28601936/acute-kidney-injury-emerging-pharmacotherapies-in-current-clinical-trials
#9
Stefanie Woolridge Benoit, Prasad Devarajan
Acute kidney injury (AKI) is a significant source of morbidity and mortality in pediatric patients, affecting more than one quarter of critically ill children. Despite significant need, there are no targeted therapies to reliably prevent or treat AKI. Recent advances in our understanding of renal injury and repair signaling pathways have enabled the development of several targeted pharmaceuticals. Here we review emerging pharmacotherapies for AKI that are currently in clinical trials. Categorized by their general mechanism of action, the therapies discussed include anti-inflammatory agents (recAP, AB103, ABT-719), antioxidants (iron chelators, heme arginate), vasodilators (levosimendan), apoptosis inhibitors (QPI-1002), and repair agents (THR-184, BB-3, mesenchymal stem cells)...
June 10, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28601878/role-of-immune-cells-in-acute-kidney-injury-and-repair
#10
Sul A Lee, Sanjeev Noel, Mohanraj Sadasivam, Abdel R A Hamad, Hamid Rabb
Acute kidney injury (AKI) is a significant problem in both native and transplant kidneys. There have been significant advances in understanding the role of immune cells in the early injury and repair from AKI. In this brief review, we aim to update information on the pathophysiologic impact of various immune cells in AKI, with special emphasis on repair. An improved understanding of the AKI immunopathology will lead to new therapies that prevent AKI, accelerate repair, and prevent the progression of AKI to chronic kidney disease...
June 10, 2017: Nephron
https://www.readbyqxmd.com/read/28598051/prevention-and-management-of-acute-kidney-injury-what-a-physician-should-know
#11
Danish Kathuria, N P Singh
The incidence of acute kidney injury (AKI) has been increasing worldwide. The increase is attributable not only to ageing population with multiple comorbidities, polypharmacy, increasing use of contrast for diagnostic and therapeutic procedures but also to the fact that now it is being recognized more often. The 'Zero by 25' initiative by International Society of Nephrology aims at preventing all avoidable deaths from AKI worldwide by the year 2025. It calls for greater awareness about management of AKI among primary care physicians...
May 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/28596479/remote-ischemic-conditioning-for-the-prevention-of-contrast-induced-acute-kidney-injury-in-patients-undergoing-intravascular-contrast-administration-a-meta-analysis-and-trial-sequential-analysis-of-16-randomized-controlled-trials
#12
Chang-Cheng Zhou, Wen-Tao Yao, Yu-Zheng Ge, Lu-Wei Xu, Ran Wu, Xiao-Fei Gao, Kai-Wei Song, Xiao-Min Jiang, Min Wang, Wen-Juan Huang, Yun-Peng Zhu, Liang-Peng Li, Liu-Hua Zhou, Zhong-Le Xu, Sheng-Li Zhang, Jia-Geng Zhu, Wen-Cheng Li, Rui-Peng Jia
OBJECTIVE: We conducted this meta-analysis to examine the effect of remote ischemic conditioning (RIC) on contrast-induced acute kidney injury (CI-AKI) in patients undergoing intravascular contrast administrationon. METHODS: Pubmed, Embase, and Cochrane Library were comprehensively searched to identify all eligible studies by 15th March, 2017. Risk ratio (RR) and weighted mean difference with the corresponding 95% confidence intervals (CI) were used to examine the treatment effect...
May 23, 2017: Oncotarget
https://www.readbyqxmd.com/read/28595180/fibrotic-changes-mediating-acute-kidney-injury-to-chronic-kidney-disease-transition
#13
Eoghainín Ó hAinmhire, Benjamin D Humphreys
End-stage renal disease (ESRD) is common, costly, and it results from progressive chronic kidney disease (CKD). ESRD claims many lives every year. It is increasingly recognized that episodes of acute kidney injury (AKI) predispose to the future development of CKD and ESRD. While our understanding of the pathophysiology of the AKI to CKD transition is improving, there are no validated therapeutic strategies to prevent this transition. In this review, we summarize the recent progress made in defining the cellular and molecular events underlying the AKI to CKD transition and highlight potential therapeutic targets and strategies to reduce the incidence of CKD following AKI...
June 9, 2017: Nephron
https://www.readbyqxmd.com/read/28594397/establishment-of-a-quick-and-highly-accurate-breath-test-for-aldh2-genotyping
#14
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
#15
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/28579836/update-on-the-renal-toxicity-of-iodinated-contrast-drugs-used-in-clinical-medicine
#16
REVIEW
Michele Andreucci, Teresa Faga, Raffaele Serra, Giovambattista De Sarro, Ashour Michael
An important side effect of diagnostic contrast drugs is contrast-induced acute kidney injury (CI-AKI; a sudden decrease in renal function) occurring 48-72 hours after injection of a contrast drug that cannot be attributed to other causes. Its existence has recently been challenged, because of some retrospective studies in which the incidence of AKI was not different between subjects who received a contrast drug and those who did not, even using propensity score matching to prevent selection bias. For some authors, only patients with estimated glomerular filtration rate <30 mL/min/1...
2017: Drug, Healthcare and Patient Safety
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
#17
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/28577069/prevention-of-acute-kidney-injury-and-protection-of-renal-function-in-the-intensive-care-unit-update-2017-expert-opinion-of-the-working-group-on-prevention-aki-section-european-society-of-intensive-care-medicine
#18
M Joannidis, W Druml, L G Forni, A B J Groeneveld, P M Honore, E Hoste, M Ostermann, H M Oudemans-van Straaten, M Schetz
BACKGROUND: Acute kidney injury (AKI) in the intensive care unit is associated with significant mortality and morbidity. OBJECTIVES: To determine and update previous recommendations for the prevention of AKI, specifically the role of fluids, diuretics, inotropes, vasopressors/vasodilators, hormonal and nutritional interventions, sedatives, statins, remote ischaemic preconditioning and care bundles. METHOD: A systematic search of the literature was performed for studies published between 1966 and March 2017 using these potential protective strategies in adult patients at risk of AKI...
June 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28573171/topical-lidocaine-inhibits-spasm-during-colonoscopy-a-double-blind-randomized-controlled-trial-with-video
#19
Daiki Nemoto, Kenichi Utano, Noriyuki Isohata, Shungo Endo, Kensuke Kumamoto, Taka-Aki Koshimizu, Alan Lefor, Kazutomo Togashi
BACKGROUND AND STUDY AIMS:  Topical peppermint oil prevents intestinal spasm, but can cause rebound spasm. Lidocaine hydrochloride, a local anesthetic, may work as an antispasmodic by blocking Na + channels. The aim of this study was to investigate the effect of topical lidocaine on the inhibition of colonic spasm during colonoscopy, compared with peppermint oil. PATIENTS AND METHODS:  A randomized, controlled double-blind trial was conducted in an academic endoscopy unit...
June 2017: Endoscopy International Open
https://www.readbyqxmd.com/read/28572613/mesenchymal-stem-cells-correct-haemodynamic-dysfunction-associated-with-liver-injury-after-extended-resection-in-a-pig-model
#20
Hans-Michael Tautenhahn, Sandra Brückner, Christiane Uder, Silvio Erler, Madlen Hempel, Martin von Bergen, Janine Brach, Sandra Winkler, Franziska Pankow, Claudia Gittel, Manja Baunack, Undine Lange, Johannes Broschewitz, Matthias Dollinger, Michael Bartels, Uta Pietsch, Kerstin Amann, Bruno Christ
In patients, acute kidney injury (AKI) is often due to haemodynamic impairment associated with hepatic decompensation following extended liver surgery. Mesenchymal stem cells (MSCs) supported tissue protection in a variety of acute and chronic diseases, and might hence ameliorate AKI induced by extended liver resection. Here, 70% liver resection was performed in male pigs. MSCs were infused through a central venous catheter and haemodynamic parameters as well as markers of acute kidney damage were monitored under intensive care conditions for 24 h post-surgery...
June 1, 2017: Scientific Reports
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