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AKI recognition

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https://www.readbyqxmd.com/read/28303073/acute-kidney-injury-definition-pathophysiology-and-clinical-phenotypes
#1
REVIEW
Konstantinos Makris, Loukia Spanou
Acute kidney injury (AKI) is a clinical syndrome that complicates the course and worsens the outcome in a significant number of hospitalised patients. Recent advances in clinical and basic research will help with a more accurate definition of this syndrome and in the elucidation of its pathogenesis. With this knowledge we will be able to conduct more accurate epidemiologic studies in an effort to gain a better understanding of the impact of this syndrome. AKI is a syndrome that rarely has a sole and distinct pathophysiology...
May 2016: Clinical Biochemist. Reviews
https://www.readbyqxmd.com/read/28152018/acute-kidney-injury-burden-in-different-clinical-units-data-from-nationwide-survey-in-china
#2
Xiaojing Tang, Dongping Chen, Shengqiang Yu, Li Yang, Changlin Mei
BACKGROUND: The inpatient morbidity and mortality of acute kidney injury (AKI) vary considerably in different clinical units, yet studies to compare the difference remain limited. METHODS: We compared the clinical characteristics of AKI in Intensive Care Unit (ICU), medical and surgical departments by using the data derived from the 2013 nationwide cross-sectional survey of AKI in China to capture variations among different clinical departments in recognition, management, and outcomes of AKI...
2017: PloS One
https://www.readbyqxmd.com/read/28151579/mediator-cyclin-dependent-kinases-upregulate-transcription-of-inflammatory-genes-in-cooperation-with-nf-%C3%AE%C2%BAb-and-c-ebp%C3%AE-on-stimulation-of-toll-like-receptor-9
#3
Seiji Yamamoto, Tomoko Hagihara, Yoshiyuki Horiuchi, Akira Okui, Shotaro Wani, Tokuyuki Yoshida, Takao Inoue, Aki Tanaka, Takashi Ito, Yutaka Hirose, Yoshiaki Ohkuma
In eukaryotes, the Mediator complex has important roles in regulation of transcription by RNA polymerase II. Mediator is a large complex with more than 20 subunits that form head, middle, tail and CDK/cyclin modules. Among them, CDK8 and/or CDK19 (CDK8/19), and their counterpart cyclin C, form the CDK/cyclin module together with Mediator subunits MED12 and MED13. Despite evidences of both activation and repression, the precise functional roles of CDK8/19 in transcription are still elusive. Our previous results indicate that CDK8/19 recruits epigenetic regulators to repress immunoresponse genes...
February 2, 2017: Genes to Cells: Devoted to Molecular & Cellular Mechanisms
https://www.readbyqxmd.com/read/28141912/high-volume-haemofiltration-for-sepsis-in-adults
#4
REVIEW
Emma Mj Borthwick, Christopher J Hill, Kannaiyan S Rabindranath, Alexander P Maxwell, Danny F McAuley, Bronagh Blackwood
BACKGROUND: Severe sepsis and septic shock are leading causes of death in the intensive care unit (ICU), despite advances in the treatment of patients with severe sepsis and septic shock, including early recognition, appropriate treatment with antibiotics and support of organs that may have been affected by the illness. High-volume haemofiltration (HVHF) is a blood purification technique that may improve outcomes in severe sepsis or septic shock. The technique of HVHF has evolved from renal replacement therapies used in the ICU to treat critically ill patients with acute kidney injury (AKI)...
January 31, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28122032/approaches-to-predicting-outcomes-in-patients-with-acute-kidney-injury
#5
Danielle Saly, Alina Yang, Corey Triebwasser, Janice Oh, Qisi Sun, Jeffrey Testani, Chirag R Parikh, Joshua Bia, Aditya Biswas, Chess Stetson, Kris Chaisanguanthum, F Perry Wilson
Despite recognition that Acute Kidney Injury (AKI) leads to substantial increases in morbidity, mortality, and length of stay, accurate prognostication of these clinical events remains difficult. It remains unclear which approaches to variable selection and model building are most robust. We used data from a randomized trial of AKI alerting to develop time-updated prognostic models using stepwise regression compared to more advanced variable selection techniques. We randomly split data into training and validation cohorts...
2017: PloS One
https://www.readbyqxmd.com/read/28117208/community-acquired-acute-kidney-injury-a-nationwide-survey-in-china
#6
Yafang Wang, Jinwei Wang, Tao Su, Zhen Qu, Minghui Zhao, Li Yang
BACKGROUND: This study aimed to describe the burden of community-acquired acute kidney injury (AKI) in China based on a nationwide survey about AKI. STUDY DESIGN: Cross-sectional and retrospective study. SETTING & PARTICIPANTS: A national sample of 2,223,230 hospitalized adult patients from 44 academic/local hospitals in Mainland China was used. AKI was defined according to the 2012 KDIGO AKI creatinine criteria or an increase or decrease in serum creatinine level of 50% during the hospital stay...
January 20, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28088181/acute-and-chronic-kidney-disease-in-elderly-patients-with-hip-fracture-prevalence-risk-factors-and-outcome-with-development-and-validation-of-a-risk-prediction-model-for-acute-kidney-injury
#7
Christine J Porter, Iain K Moppett, Irene Juurlink, Jessica Nightingale, Christopher G Moran, Mark A J Devonald
BACKGROUND: Hip fracture is a common injury in older people with a high rate of postoperative morbidity and mortality. This patient group is also at high risk of acute kidney injury (AKI) and chronic kidney disease (CKD), but little is known of the impact of kidney disease on outcome following hip fracture. METHODS: An observational cohort of consecutive patients with hip fracture in a large UK secondary care hospital. Predictive modelling of outcomes using development and validation datasets...
January 14, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28076311/biomarkers-of-acute-kidney-injury-the-pathway-from-discovery-to-clinical-adoption
#8
Kianoush Kashani, Wisit Cheungpasitporn, Claudio Ronco
Acute kidney injury (AKI) is a common complication of critical illnesses and has a significant impact on outcomes, including mortality and morbidities. Unfortunately, apart from prophylactic measures, no effective treatment for this syndrome is known. Therefore, early recognition of AKI not only can provide better opportunities for preventive interventions, but also opens many gates for research and development of effective therapeutic options. Over the last few years, several new AKI biomarkers have been discovered and validated to improve early detection, differential diagnosis, and differentiation of patients into risk groups for progressive renal failure, need for renal replacement therapy (RRT), or death...
January 11, 2017: Clinical Chemistry and Laboratory Medicine: CCLM
https://www.readbyqxmd.com/read/28009331/a-study-of-acute-kidney-injury-in%C3%A2-hospitalized-preterm-neonates-in-nicu
#9
N Nagaraj, P K Berwal, A Srinivas, A Berwal
OBJECTIVES: This study was carried out to determine the incidence, clinical features, etiology and outcome of functional and intrinsic acute kidney injury (AKI) in preterm neonates. METHODS: This is a prospective observational study on premature infants admitted to the neonatal intensive care unit (NICU) over an eight month period. All biochemical parameters of renal function tests were monitored and statically analyzed. RESULTS: The study included 450 infants; of them 300 were inborn and 150 infants were outborn and transported to the NICU...
2016: Journal of Neonatal-perinatal Medicine
https://www.readbyqxmd.com/read/27921037/acute-kidney-injury-in-western-countries
#10
REVIEW
Josée Bouchard, Ravindra L Mehta
BACKGROUND: Acute kidney injury (AKI) is frequent and is associated with poor outcomes, including increased mortality, higher risk of chronic kidney disease, and prolonged hospital lengths of stay. The epidemiology of AKI mainly derives from studies performed in Western high-income countries. More limited data are available from Western low-income and middle-income countries (LMICs) located in Central and South America. SUMMARY: In this review, we summarize the most recent data on the epidemiology of AKI in Western countries, aiming to contrast results from industrialized high-income countries with LMICs...
October 2016: Kidney Diseases
https://www.readbyqxmd.com/read/27921036/acute-kidney-injury-in-asia
#11
REVIEW
Li Yang
BACKGROUND: Acute kidney injury (AKI) is a common disorder and is associated with a high morbidity and mortality worldwide. The diversity of the climate and of the socioeconomic and developmental status in Asia has a great influence on the etiology and presentation of AKI in different regions. In view of the International Society of Nephrology's 0by25 initiative, more and more attention has been paid to AKI in Asian countries. SUMMARY: In this review, we summarize the recent achievements with regard to the prevalence and clinical patterns of AKI in Asian countries...
October 2016: Kidney Diseases
https://www.readbyqxmd.com/read/27915348/delayed-nephrology-consultation-and-high-mortality-on-acute-kidney-injury-a-meta-analysis
#12
Débora M Soares, José F Pessanha, Aashish Sharma, Alessandra Brocca, Claudio Ronco
BACKGROUND: Acute kidney injury (AKI) is a complex syndrome associated with substantial morbidity, mortality and costs. Despite advancements in diagnosis and care practice, AKI remains a disorder usually under/late-recognized with high mortality. One of the hidden reasons for poor outcome might be delayed nephrology consultation, with the involvement of the specialist only in severe stages of AKI when renal replacement therapy (RRT) is required. METHODS: We searched PubMed, EMBASE and Cochrane central register for related work on the subject...
2017: Blood Purification
https://www.readbyqxmd.com/read/27915329/acute-kidney-injury-risk-assessment-and-the-nephrology-rapid-response-team
#13
Lilia Maria Rizo-Topete, Mitchell H Rosner, Claudio Ronco
Acute kidney Injury (AKI) is a serious medical condition affecting more than 10 million people around the world annually and resulting in poor outcomes. It has been suggested that late recognition of the syndrome may lead to delayed interventions with increased morbidity and mortality. Early diagnosis and timely therapeutic strategies may be the cornerstone of future improvement in outcomes. The purpose of this article is to provide a practical model to identify patients at high risk for AKI in different environments, with the goal to prevent AKI...
2017: Blood Purification
https://www.readbyqxmd.com/read/27900940/acute-kidney-injury-in-allopurinol-induced-dress-syndrome-a-case-report-of-concurrent-tubulointerstitial-nephritis-and-kidney-limited-necrotizing-vasculitis%C3%A2
#14
Anthony J Esposito, Ryan C Murphy, Mirna N Toukatly, Osama W Amro, Bryan R Kestenbaum, Behzad Najafian
Drug reaction with eosinophilia and systemic symptoms (DRESS) is a rare but potentially fatal adverse drug reaction with variable renal involvement. We report the case of a man who presented with allopurinol-induced DRESS and acute kidney injury (AKI) requiring hemodialysis. Kidney biopsy revealed eosinophilic tubulointerstitial nephritis and necrotizing vasculitis of the intralobular arteries without systemic markers of vasculitis. After cyclophosphamide and glucocorticoids, his symptoms and AKI resolved. To our knowledge, this is the first case of kidney-limited necrotizing vasculitis, questioning whether a biopsy should be routinely performed in patients with DRESS accompanied by severe AKI...
November 30, 2016: Clinical Nephrology
https://www.readbyqxmd.com/read/27851800/expression-and-function-of-interleukin-1%C3%AE-induced-neutrophil-gelatinase-associated-lipocalin-in-renal-tubular-cells
#15
Tadayoshi Konno, Rei Nakano, Ryo Mamiya, Hisashi Tsuchiya, Taku Kitanaka, Shinichi Namba, Nanako Kitanaka, Ken Okabayashi, Takanori Narita, Hiroshi Sugiya
Acute kidney injury (AKI) is characterized by a sudden loss of renal function. Early recognition of AKI, especially in critically ill patients, is essential for adequate therapy. Currently, neutrophil gelatinase-associated lipocalin (NGAL) is considered to be an effective biomarker of AKI; however, the regulation of its expression and function in renal tubular cells remains unclear. In this study, we investigated the regulation of the expression and function of NGAL in IL-1β-treated Madin-Darby canine kidney (MDCK) cells as a model of renal tubular cells...
2016: PloS One
https://www.readbyqxmd.com/read/27822078/acute-kidney-injury-adjusted-to-volume-status-in-critically-ill-patients-recognition-of-delayed-diagnosis-restaging-and-associated-outcomes
#16
Harout Yacoub, Leen Khoury, Youssef El Douaihy, Chadi Salmane, Jeanne Kamal, Marc Saad, Patricia Nasr, Jared Radbel, Elie El-Charabaty, Suzanne El-Sayegh
Critically ill patients receive a significant amount of fluids leading to a positive fluid balance; this dilutes serum creatinine resulting in an overestimated glomerular filtration rate. The goal of our study is to identify undiagnosed or underestimated acute kidney injury (AKI) in the intensive care unit (ICU). It will also identify the morbidity and mortality associated with an underestimated AKI. We reviewed records of patients admitted to our institution (Staten Island University Hospital) between 2012 and 2013 for more than 2 days...
2016: International Journal of Nephrology and Renovascular Disease
https://www.readbyqxmd.com/read/27820742/epidemiology-and-pathophysiology-of-cardiac-surgery-associated-acute-kidney-injury
#17
Dana Y Fuhrman, John A Kellum
PURPOSE OF REVIEW: Acute kidney injury (AKI) remains a serious complication of cardiac surgery. An understanding of the epidemiology and pathophysiology of AKI in cardiac surgery patients is crucial to early recognition and proper management. RECENT FINDINGS: The article will review the current criteria used for defining AKI and the most recently published incidence rates of AKI in the cardiac surgery population. Variables associated with AKI will be reviewed. The cause of cardiac surgery-associated AKI is multifactorial involving genetic factors as well as insults because of nephrotoxins, ischemia and reperfusion, cardiac dysfunction, venous congestion, inflammation, and oxidative stress...
February 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/27784284/case-report-severe-bradycardia-a-reversible-cause-of-cardio-renal-cerebral-syndrome
#18
Mabel Aoun, Randa Tabbah
BACKGROUND: Cardio-Renal Syndromes were first classified in 2008 and divided into five subtypes. The type 1 Cardio-Renal Syndrome (CRS) is characterized by acute decompensation of heart failure leading to acute kidney injury (AKI). Bradyarrhythmia was not mentioned in the classification as a cause for low cardiac output (CO) in type 1 CRS. Besides, CRS was not previously associated with central nervous system (CNS) injury despite the fact that cardiac, renal and neurological diseases can coexist...
October 26, 2016: BMC Nephrology
https://www.readbyqxmd.com/read/27736815/acute-kidney-injury-electronic-alert-for-nephrologist-reactive-versus-proactive
#19
COMMENT
Kianoush Kashani, Claudio Ronco
Acute kidney injury (AKI) is a common complication of acute illnesses with significant impact on the mortality and morbidity. Early recognition of AKI allows clinicians to provide prophylactic interventions and to improve the outcomes of this deadly syndrome. Growing utilization and capabilities of electronic health records allow AKI risk stratification and early recognition with a potential effect on the processes of care and outcomes. We evaluate the current level of evidence on the impact of the AKI e-alert on the processes of care and outcomes...
2016: Blood Purification
https://www.readbyqxmd.com/read/27704389/the-duration-of-acute-kidney-injury-after-cardiac-surgery-increases-the-risk-of-long-term-chronic-kidney-disease
#20
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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