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AKI assessment

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https://www.readbyqxmd.com/read/28629397/optimal-timing-of-renal-replacement-therapy-initiation-in-acute-kidney-injury-the-elephant-felt-by-the-blindmen
#1
Chih-Chung Shiao, Tao-Min Huang, Herbert D Spapen, Patrick M Honore, Vin-Cent Wu
Renal replacement therapy (RRT) is a key component in the management of severe acute kidney injury (AKI) in critically ill patients. Many cohort studies, meta-analyses, and two recent large randomized prospective trials which evaluated the relationship between the timing of RRT initiation and patient outcome remain inconclusive due to substantial differences in study design, patient population, AKI definition, and RRT indication. A cause-specific diagnosis of AKI based on current staging criteria plus a sensitive biomarker (panel) that allows creating a homogeneous study population is definitely needed to assess the impact of early versus late initiation of RRT on patient outcome...
June 20, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28625177/iron-deficiency-without-anaemia-is-a-potential-cause-of-fatigue-meta-analyses-of-randomised-controlled-trials-and-cross-sectional-studies
#2
Katsuhiko Yokoi, Aki Konomi
Fe deficiency is a prevalent nutritional disease, and fatigue is a common complaint in the general and patient population. The association between Fe deficiency without anaemia (IDNA) and fatigue is unclear. Here, we performed a meta-analysis to evaluate the therapeutic effect of Fe on fatigue in patients with IDNA and the association between IDNA and fatigue in the population. Articles from the PubMed database up to 19 January 2016 were systematically searched. A total of six relevant randomised controlled trials (RCT) and six relevant cross-sectional studies were identified...
June 19, 2017: British Journal of Nutrition
https://www.readbyqxmd.com/read/28619541/can-renal-resistive-index-predict-acute-kidney-injury-after-acute-type-a-aortic-dissection-repair
#3
Hai-Bo Wu, Huai Qin, Wei-Guo Ma, Hong-Lei Zhao, Jun Zheng, Jian-Rong Li, Li-Zhong Sun
BACKGROUND: This study sought to determine whether assessment of the renal resistive index (RRI) can predict the short-term reversibility of acute kidney injury (AKI) after repair of acute type A aortic dissection (TAAD). METHODS: This prospective study included 62 patients undergoing repair of acute TAAD. Doppler-based RRIs were obtained preoperatively, immediately after the surgical procedure, and 6, 24, and 48 hours postoperatively. The occurrence of AKI was evaluated daily according to Acute Kidney Injury Network criteria...
June 13, 2017: Annals of Thoracic Surgery
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/28616656/accuracy-of-neutrophil-gelatinase-associated-lipocalin-for-acute-kidney-injury-diagnosis-in-children-systematic-review-and-meta-analysis
#5
REVIEW
Luís Taddeo Filho, Antonio Jose Grande, Tamy Colonetti, Éverton Simon Possamai Della, Maria Inês da Rosa
OBJECTIVE: To estimate the accuracy of Neutrophil Gelatinase-Associated Lipocalin (NGAL) as a biomarker for acute kidney injury (AKI) in children. METHODS: A systematic review of the literature was performed. The review protocol was registered at PROSPERO (CRD 42015024153). We conducted searches in the following databases: Medline (PubMed), LILACS (BVS), SCOPUS (Elsevier), Embase (OVID), Cochrane Central Register of Controlled Trials (CENTRAL), Biomed Central, and ISI Web of Science, from January 1990 to October 2016...
June 14, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
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
#6
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/28616212/hypophosphatemia-in-critically-ill-patients-with-acute-kidney-injury-treated-with-hemodialysis-is-associated-with-adverse-events
#7
Cynthia Lim, Han Khim Tan, Manish Kaushik
Background. Hypophosphatemia in critically ill patients may be exacerbated by renal replacement therapy (RRT). We aimed to identify risk factors and adverse outcomes associated with hypophosphatemia in intensive care patients treated with RRT for acute kidney injury (AKI). Methods. This was a secondary analysis of data from a single-center prospective cohort study of medical and surgical intensive care patients with RRT for AKI between 18 December 2010 and 3 April 2013. Demographic, comorbidity, laboratory and RRT data were retrieved from patient case notes and electronic medical records...
June 2017: Clinical Kidney Journal
https://www.readbyqxmd.com/read/28616211/acute-kidney-injury-in-patients-with-severe-sepsis-or-septic-shock-a-comparison-between-the-risk-injury-failure-loss-of-kidney-function-end-stage-kidney-disease-rifle-acute-kidney-injury-network-akin-and-kidney-disease-improving-global-outcomes-kdigo-classifications
#8
Marta Pereira, Natacha Rodrigues, Iolanda Godinho, Joana Gameiro, Marta Neves, João Gouveia, Zélia Costa E Silva, José António Lopes
PURPOSE: Using the Risk, Injury, Failure, Loss of kidney function, End-stage kidney disease (RIFLE), Acute Kidney Injury Network (AKIN) and Kidney Disease: Improving Global Outcomes (KDIGO) systems, the incidence of acute kidney injury (AKI) and their ability to predict in-hospital mortality in severe sepsis or septic shock was compared. MATERIALS AND METHODS: We performed a retrospective analysis of 457 critically ill patients with severe sepsis or septic shock hospitalized between January 2008 and December 2014...
June 2017: Clinical Kidney Journal
https://www.readbyqxmd.com/read/28614837/renal-oxygenation-and-hemodynamics-in-kidney-injury
#9
Alexander Bullen, Zhi Zhao Liu, Mark Hepokoski, Ying Li, Prabhleen Singh
Acute kidney injury (AKI) continues to be a major therapeutic challenge. Despite significant advances made in cellular and molecular pathophysiology of AKI, major gaps in knowledge exist regarding the changes in renal hemodynamics and oxygenation in the early stages and through the continuum of AKI. Particular features of renal hemodynamics and oxygenation increase the susceptibility of the kidney to sustain injury due to oxygen demand-supply mismatch and also play an important role in the recovery and repair from AKI as well as the transition of AKI to chronic kidney disease...
June 15, 2017: Nephron
https://www.readbyqxmd.com/read/28614696/clinical-utility-of-single-molecule-counting-technology-for-quantification-of-kim-1-in-patients-with-heart-failure-and-chronic-kidney-disease
#10
Jennifer Miao, Eitan Friedman, Alan H B Wu, John A Todd, Joel Estis, Xiaomei Xu, Niamh Nolan, Jeffrey J Bishop, Daniel J Lenihan
BACKGROUND: Acute kidney injury (AKI) is associated with high morbidity and mortality, and may lead to chronic kidney disease (CKD). Traditional serum biomarkers for acute and chronic renal dysfunction are insensitive and nonspecific. While urinary kidney injury molecule-1 (KIM-1) is a sensitive and specific measure of kidney tubular injury, it is difficult to obtain in acute settings. Thus, our objective was to develop a highly sensitive immunoassay for plasma KIM-1. METHODS: A novel plasma KIM-1 immunoassay was developed using Single Molecule Counting technology (SMC)...
June 11, 2017: Clinical Biochemistry
https://www.readbyqxmd.com/read/28611154/cytoresistance-after-acute-kidney-injury-is-limited-to-the-recovery-period-of-proximal-tubule-integrity-and-possibly-involves-hippo-yap-signaling
#11
Takamasa Iwakura, Yoshihide Fujigaki, Tomoyuki Fujikura, Takayuki Tsuji, Naro Ohashi, Akihiko Kato, Hideo Yasuda
Rat proximal tubule (PT) cells that have recovered from severe acute kidney injury induced by uranyl acetate (UA) develop cytoresistance to subsequent UA treatments. We reported that enhanced G1 arrest might contribute to cytoresistance. Herein, we examined these mechanisms by investigating Yes-associated protein (YAP), a regulator of cell number, and survivin, a downstream mediator of YAP that inhibits apoptosis. Rats pretreated with saline (vehicle group) or UA (AKI group) were injected with UA 2 weeks, 2 months, or 6 months after treatment...
June 2017: Physiological Reports
https://www.readbyqxmd.com/read/28607684/a-multifaceted-quality-improvement-programme-to-improve-acute-kidney-injury-care-and-outcomes-in-a-large-teaching-hospital
#12
Leonard Ebah, Prasanna Hanumapura, Deryn Waring, Rachael Challiner, Katharine Hayden, Jill Alexander, Robert Henney, Rachel Royston, Cassian Butterworth, Marc Vincent, Susan Heatley, Ged Terriere, Robert Pearson, Alastair Hutchison
Acute kidney injury (AKI) is now widely recognised as a serious health care issue, occurring in up to 25% of hospital in-patients, often with worsening of outcomes. There have been several reports of substandard care in AKI. This quality improvement (QI) programme aimed to improve AKI care and outcomes in a large teaching hospital. Areas of documented poor AKI care were identified and specific improvement activities implemented through sequential Plan-Do-Study-Act (PDSA) cycles. An electronic alert system (e-alert) for AKI was developed, a Priority Care Checklist (PCC) was tested with the aid of specialist nurses whilst targeted education activities were carried out and data on care processes and outcomes monitored...
2017: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/28602971/new-developments-in-hepatorenal-syndrome
#13
Ayse L Mindikoglu, Stephen C Pappas
Hepatorenal Syndrome (HRS) continues to be one of the major complications of decompensated cirrhosis leading to death in the absence of liver transplantation. Challenges in precisely evaluating renal function in the patient with cirrhosis remain due to the limitations of serum creatinine (Cr) alone in estimating glomerular filtration rate (GFR); current GFR estimating models appear to underestimate renal function. Newer models incorporating renal biomarkers, such as the Cr-Cystatin C GFR Equation for Cirrhosis appear to more accurately estimate true GFR...
June 7, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28597505/renal-effects-of-an-emergency-department-chloride-restrictive-intravenous-fluid-strategy-in-patients-admitted-to-hospital-for-more-than-48-hours
#14
Nor'azim Mohd Yunos, Rinaldo Bellomo, David McD Taylor, Simon Judkins, Fergus Kerr, Harvey Sutcliffe, Colin Hegarty, Michael Bailey
OBJECTIVE: Patients commonly receive i.v. fluids in the ED. It is still unclear whether the choice of i.v. fluids in this setting influences renal or patient outcomes. We aimed to assess the effects of restricting i.v. chloride administration in the ED on the incidence of acute kidney injury (AKI). METHODS: We conducted a before-and-after trial with 5008 consecutive ED-treated hospital admissions in the control period and 5146 consecutive admissions in the intervention period...
June 8, 2017: Emergency Medicine Australasia: EMA
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
#15
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/28596472/dipeptidyl-peptidase-4-inhibitor-use-is-associated-with-a-lower-risk-of-incident-acute-kidney-injury-in-patients-with-diabetes
#16
Chia-Ter Chao, Jui Wang, Hon-Yen Wu, Kuo-Liong Chien, Kuan-Yu Hung
OBJECTIVES: Dipeptidyl peptidase 4 inhibitor (DPP4i) use potentially slows the progression of diabetic kidney disease, but its effects on the risk of acute kidney injury (AKI) are unclear. We aimed to assess the association between DPP4i use and incident AKI episodes from a nationally representative cohort in Taiwan. MATERIALS AND METHODS: All patients newly diagnosed with diabetes mellitus (DM) between 2008, when DPP4i use was first approved in Taiwan, and mid-2013 were enrolled...
May 23, 2017: Oncotarget
https://www.readbyqxmd.com/read/28591706/predictors-of-acute-kidney-injury-after-paraquat-intoxication
#17
Cheng-Hao Weng, Hui-Hsiang Chen, Ching-Chih Hu, Wen-Hung Huang, Ching-Wei Hsu, Jen-Fen Fu, Wey-Ran Lin, I-Kwan Wang, Tzung-Hai Yen
Paraquat intoxication is characterized by multi-organ failure, causing substantial mortality and morbidity. Many paraquat patients experience acute kidney injury (AKI), sometimes requiring hemodialysis. We observed 222 paraquat-intoxicated patients between 2000 and 2012, and divided them into AKI (n = 103) and non-AKI (n = 119) groups. The mortality rate was higher for AKI than non-AKI patients (70.1% vs. 40.0%, P < 0.001). Patients with AKI had a longer time to hospital arrival (P = 0.003), lower PaO2 (P = 0...
May 18, 2017: Oncotarget
https://www.readbyqxmd.com/read/28586767/quantification-and-dosing-of-renal-replacement-therapy-in-acute-kidney-injury-a-reappraisal
#18
William R Clark, Martine Leblanc, Zaccaria Ricci, Claudio Ronco
BACKGROUND/AIMS: Delivered dialysis therapy is routinely measured in the management of patients with end-stage renal disease; yet, the quantification of renal replacement prescription and delivery in acute kidney injury (AKI) is less established. While continuous renal replacement therapy (CRRT) is widely understood to have greater solute clearance capabilities relative to intermittent therapies, neither urea nor any other solute is specifically employed for CRRT dose assessments in clinical practice at present...
2017: Blood Purification
https://www.readbyqxmd.com/read/28586635/tin-protoporphyrin-activates-the-oxidant-dependent-nrf2-cytoprotective-pathway-and-mitigates-acute-kidney-injury
#19
Ali C M Johnson, Jeff J Delrow, Richard A Zager
Tin protoporphyrin (SnPP), a heme oxygenase (HO) inhibitor, can paradoxically protect against diverse forms of acute kidney injury (AKI). This study sought potential underlying mechanisms. CD-1 mice received intravenous SnPP, followed 4-18 hours later by a variety of renal biochemical, histologic, and genomic assessments. Renal resistance to ischemic-reperfusion injury (IRI) was also sought. SnPP was rapidly taken up by kidney and was confined to proximal tubules. Transient suppression of renal heme synthesis (decreased δ aminolevulinic acid synthase expression), a 2...
May 19, 2017: Translational Research: the Journal of Laboratory and Clinical Medicine
https://www.readbyqxmd.com/read/28580076/postoperative-acute-kidney-injury
#20
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
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