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AKI prevention

Mika Hilvo, Tuire Salonurmi, Aki S Havulinna, Dimple Kauhanen, Eva Ringdal Pedersen, Grethe S Tell, Klaus Meyer, Anna-Maria Teeriniemi, Tiina Laatikainen, Pekka Jousilahti, Markku J Savolainen, Ottar Nygård, Veikko Salomaa, Reijo Laaksonen
AIMS/HYPOTHESIS: Ceramide lipids have a role in the development of insulin resistance, diabetes and risk of cardiovascular disease. Here we investigated four ceramides and their ratios to find the best predictors of incident diabetes. METHODS: A validated mass-spectrometric method was applied to measure Cer(d18:1/16:0), Cer(d18:1/18:0), Cer(d18:1/24:0) and Cer(d18:1/24:1) from serum or plasma samples. These ceramides were analysed in a population-based risk factor study (FINRISK 2002, n = 8045), in a cohort of participants undergoing elective coronary angiography for suspected stable angina pectoris (Western Norway Coronary Angiography Cohort [WECAC], n = 3344) and in an intervention trial investigating improved methods of lifestyle modification for individuals at high risk of the metabolic syndrome (Prevent Metabolic Syndrome [PrevMetSyn], n = 371)...
March 15, 2018: Diabetologia
Chin-Lin Tseng, Orysya Soroka, Leonard M Pogach
AIM: To expand the existing United States Agency for Health Research and Quality (AHRQ) Diabetes composite (AHRQ-DC) to include additional preventable hospitalizations specific or relevant to diabetes. METHODS: A cross-sectional analysis of 834,696 veteran patients with diabetes aged ≥65 years in 2012. An Expanded Diabetes Composite (Expanded-DC) was developed utilizing: (1) the diabetes-specific category: the AHRQ-DC (short-term and long-term complications, uncontrolled diabetes, lower extremity amputations) and two proposed conditions: hypoglycemia and lower extremity ulcers/inflammation/infections (LEU) and (2) the diabetes-relevant category: the AHRQ-Acute Composite (dehydration, pneumonia, urinary tract infections) and one proposed condition, acute kidney injury (AKI)...
February 2, 2018: Journal of Diabetes and its Complications
Anna Zuk, Paul M Palevsky, Linda Fried, Frank E Harrell, Samina Khan, Dianne B McKay, Luke Devey, Lakhmir Chawla, Mark de Caestecker, James S Kaufman, B Taylor Thompson, Anupam Agarwal, Tom Greene, Mark Douglas Okusa, Joseph V Bonventre, Laura M Dember, Kathleen D Liu, Benjamin D Humphreys, Daniel Gossett, Yining Xie, Jenna M Norton, Paul L Kimmel, Robert A Star
AKI is a complex clinical condition associated with high mortality, morbidity, and health care costs. Despite improvements in methodology and design of clinical trials, and advances in understanding the underlying pathophysiology of rodent AKI, no pharmacologic agent exists for the prevention or treatment of AKI in humans. To address the barriers that affect successful clinical translation of drug targets identified and validated in preclinical animal models of AKI in this patient population, the National Institute of Diabetes and Digestive and Kidney Diseases convened the "AKI Outcomes: Overcoming Barriers in AKI" workshop on February 10-12, 2015...
March 9, 2018: Clinical Journal of the American Society of Nephrology: CJASN
Luigi Di Serafino, Maurizio Turturo, Saverio Lanzone, Melissa Marano, Gabriella Scognamiglio, Bruno Trimarco, Plinio Cirillo, Giovanni Esposito, Carlo D'Agostino
Dual-axis rotational coronary angiography (DARCA) has already been shown to reduce both the amount of contrast medium and radiation exposure compared with conventional coronary angiography (CCA). However, a clinical benefit of such imaging modality has never been demonstrated. The aim of this study was to evaluate the efficacy of DARCA to prevent acute kidney injury (AKI) compared with CCA. Consecutive patients who underwent coronary angiography were enrolled to DARCA (n = 80) or CCA (n = 80). Patients presenting with ST-segment elevation myocardial infarction or previously underwent coronary artery bypass graft were excluded...
February 7, 2018: American Journal of Cardiology
Fatma Zehra Oztek-Celebi, Sare Gulfem Ozlu, Ozlem Aydog
BACKGROUND: Acute kidney injury (AKI) is an important clinical condition which is associated with increased mortality and morbidity. This study was performed to identify the factors that influence AKI stage, undergoing renal replacement therapy (RRT) and mortality. METHODS: This study was retrospectively conducted on 219 children with AKI who had been referred to paediatric nephrology division of Dr. Sami Ulus Teaching Hospital during their inpatient treatment from 2008 to 2012...
February 27, 2018: Nephrology
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.
February 26, 2018: American Journal of Cardiovascular Drugs: Drugs, Devices, and Other Interventions
Athanasios Saratzis, Virginia Chiocchia, Ahmad Jiffry, Neelam Hassanali, Surjeet Singh, Christopher H Imray, Matthew J Bown, Asif Mahmood
OBJECTIVE/BACKGROUND: Up to 25% of patients undergoing elective endovascular aneurysm repair (EVAR) develop acute kidney injury (AKI), which is associated with short and long-term morbidity and mortality. There is no high quality randomised evidence regarding prevention of EVAR related AKI. METHODS: A novel AKI prevention strategy for EVAR was devised, based on best evidence and an expert consensus group. This included a bolus of high dose sodium bicarbonate (NaHCO3 ) immediately before EVAR (1 mL/kg of 8...
February 23, 2018: European Journal of Vascular and Endovascular Surgery
Neil J Glassford, Rinaldo Bellomo
Acute kidney injury (AKI) is common, although commonly used clinical diagnostic markers are imperfect. Intravenous fluid administration remains a cornerstone of therapy worldwide, but there is minimal evidence of efficacy for the use of fluid bolus therapy outside of specific circumstances, and emerging evidence associates fluid accumulation with worse renal outcomes and even increased mortality among critically ill patients. Artificial colloid solutions have been associated with harm, and chloride-rich solutions may adversely affect renal function...
April 2018: Critical Care Clinics
Peter K Moore, Raymond K Hsu, Kathleen D Liu
Acute kidney injury (AKI) is a heterogeneous disorder that is common in hospitalized patients and associated with short- and long-term morbidity and mortality. When AKI is present, prompt workup of the underlying cause should be pursued, with specific attention to reversible causes. Measures to prevent AKI include optimization of volume status and avoidance of nephrotoxic medications. Crystalloids are preferred over colloids for most patients, and hydroxyethyl starches should be avoided. Volume overload in the setting of AKI is associated with adverse outcomes, so attention should be paid to overall fluid balance...
February 22, 2018: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Joanne M Bargman, Michael Girsberger
BACKGROUND: Peritoneal dialysis (PD) is one of the corner stones of renal replacement therapy and should be strongly considered if preemptive kidney transplantation is not available. SUMMARY: There are several initiatives that may help the growth in the use of PD around the world. First, PD is an underused and valuable option in patients with heart failure and the chronic cardiorenal syndrome, especially in those with frequent hospitalizations despite optimal medical therapy...
January 26, 2018: Blood Purification
Yi Wen, Yi-Ran Liu, Tao-Tao Tang, Ming-Ming Pan, Sheng-Chun Xu, Kun-Ling Ma, Lin-Li Lv, Hong Liu, Bi-Cheng Liu
Ischemia/reperfusion (I/R) is a critical risk factor for acute kidney injury (AKI). Recent studies provided evidence that tubular epithelial cells (TEC)-associated inflammation aggravates kidney injury and impairs tissue repair after I/R injury. Here we demonstrated that the Nod-like receptor protein 3 (NLRP3) inflammasome is activated by mitochondrial reactive oxygen species (mROS) during I/R injury via direct interactions between the inflammasome and thioredoxin-interacting protein (TXNIP). Firstly, we found that NLRP3 inflammasome activation was induced by I/R injury, peaking at day 3 after reperfusion...
February 22, 2018: International Journal of Biochemistry & Cell Biology
Adrianna Douvris, Gurpreet Malhi, Swapnil Hiremath, Lauralyn McIntyre, Samuel A Silver, Sean M Bagshaw, Ron Wald, Claudio Ronco, Lindsey Sikora, Catherine Weber, Edward G Clark
BACKGROUND: Hemodynamic instability related to renal replacement therapy (HIRRT) may increase the risk of death and limit renal recovery. Studies in end-stage renal disease populations on maintenance hemodialysis suggest that some renal replacement therapy (RRT)-related interventions (e.g., cool dialysate) may reduce the occurrence of HIRRT, but less is known about interventions to prevent HIRRT in critically ill patients receiving RRT for acute kidney injury (AKI). We sought to evaluate the effectiveness of RRT-related interventions for reducing HIRRT in such patients across RRT modalities...
February 22, 2018: Critical Care: the Official Journal of the Critical Care Forum
Masao Iwagami, Hidekazu Moriya, Kent Doi, Hideo Yasunaga, Rei Isshiki, Izumi Sato, Yasuhiro Mochida, Kunihiro Ishioka, Takayasu Ohtake, Sumi Hidaka, Eisei Noiri, Shuzo Kobayashi
Background: Understanding disease seasonality is important for improving clinical practice, hospital resource utilization and community-based preventive care. However, no studies have investigated the seasonality of acute kidney injury (AKI). Methods: In the Tokushukai Medical Database, which includes 38 Japanese community hospitals, we identified hospitalized patients with AKI based on the Kidney Disease: Improving Global Outcomes serum creatinine criteria from January 2012 to December 2014...
February 15, 2018: Nephrology, Dialysis, Transplantation
Minxiong Li, Honghong Zou, Gaosi Xu
No abstract text is available yet for this article.
February 14, 2018: International Journal of Cardiology
Joshua L Golubovsky, Haariss Ilyas, Jinxiao Chen, Joseph E Tanenbaum, Thomas E Mroz, Michael P Steinmetz
BACKGROUND CONTEXT: Postoperative Urinary Retention (POUR) is a very common post-operative complication of all surgeries (5 - 70%) that may lead to complications such as urinary tract infection (UTI), bladder over-distention, autonomic dysregulation, and increased postoperative length of stay (LOS). Within the field of spine surgery, the reported incidence of POUR is highly variable (5.6 - 38%). Lack of clear stratification of surgical level, spinal pathology, and inadequate sample size is a major limitation of available studies concerning POUR following spine surgery that may lead to inconsistency in the incidence of POUR and the ability to model its occurrence and consequences...
February 12, 2018: Spine Journal: Official Journal of the North American Spine Society
Aart J van der Molen, Peter Reimer, Ilona A Dekkers, Georg Bongartz, Marie-France Bellin, Michele Bertolotto, Olivier Clement, Gertraud Heinz-Peer, Fulvio Stacul, Judith A W Webb, Henrik S Thomsen
PURPOSE: The Contrast Media Safety Committee (CMSC) of the European Society of Urogenital Radiology (ESUR) has updated its 2011 guidelines on the prevention of post-contrast acute kidney injury (PC-AKI). The results of the literature review and the recommendations based on it, which were used to prepare the new guidelines, are presented in two papers. AREAS COVERED IN PART 1: Topics reviewed include the terminology used, the best way to measure eGFR, the definition of PC-AKI, and the risk factors for PC-AKI, including whether the risk with intravenous and intra-arterial contrast medium differs...
February 9, 2018: European Radiology
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
Jochen G Raimann, Miguel C Riella, Nathan W Levin
In developing countries with limited medical infrastructure, preservation and recovery of renal function following acute kidney injury (AKI) is difficult. In conjunction with clinical presentation, rapid measurement of renal function is essential for early diagnosis and management. Especially in low- and middle-income countries, simple interventions such as hydration and avoidance of toxins have the highest probability of recovery. In such contexts, measurement of urine volume and osmolality and serum creatinine with point-of-care devices and saliva urea nitrogen dipsticks can be valuable...
February 2018: Clinical Kidney Journal
Haoyuan Jia, Wanzhu Liu, Bin Zhang, Juanjuan Wang, Peipei Wu, Nitin Tandra, Zhaofeng Liang, Cheng Ji, Lei Yin, Xinyuan Hu, Yongmin Yan, Fei Mao, Xu Zhang, Jing Yu, Wenrong Xu, Hui Qian
The clinical application of cisplatin is restricted by its side effects of nephrotoxicity. Human umbilical cord mesenchymal stem cell-derived exosomes (hucMSC-ex) have an important effect in tissue injury repair. Our previous work discovered that pretreatment with human umbilical cord mesenchymal stem cell-derived exosomes (hucMSC-ex) alleviated cisplatin-induced acute kidney injury (AKI) by activating autophagy both in vitro and in vivo. In this study, we further explored the mechanisms of hucMSC-ex in autophagy for preventing cisplatin-induced nephrotoxicity...
2018: American Journal of Translational Research
Judith Kooiman, Jean-Paul P M de Vries, Jan Van der Heyden, Yvo W J Sijpkens, Paul R M van Dijkman, Jan J Wever, Hans van Overhagen, Antonie C Vahl, Nico Aarts, Iris J A M Verberk-Jonkers, Harald F H Brulez, Jaap F Hamming, Aart J van der Molen, Suzanne C Cannegieter, Hein Putter, Wilbert B van den Hout, Inci Kilicsoy, Ton J Rabelink, Menno V Huisman
BACKGROUND: Guidelines advise periprocedural saline hydration for prevention of contrast induced-acute kidney injury (CI-AKI). We analysed whether 1-hour sodium bicarbonate hydration administered solely prior to intra-arterial contrast exposure is non-inferior to standard periprocedural saline hydration in chronic kidney disease (CKD) patients undergoing elective cardiovascular diagnostic or interventional contrast procedures. METHODS: We performed an open-label multicentre non-inferiority trial between 2011-2014...
2018: PloS One
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