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pulmonary edema in aki

Zynab Karimi, Farzaneh Ketabchi, Nasim Alebrahimdehkordi, Hossein Fatemikia, Seyed Mohammad Owji, Seyed Mostafa S Moosavi
PURPOSE: Acute kidney injury (AKI) induces acute lung injury (ALI) through releasing injurious mediators or impairing clearance of systemic factors. To determine the links between AKI and ALI, pulmonary and blood variables were evaluated following induction of AKI via different experimental models of bilateral renal ischemia/reperfusion (BIR: renal ischemia with uremia), unilateral renal ischemia/reperfusion (UIR: renal ischemia without uremia), bilateral nephrectomy (BNX: uremia without renal ischemia), and unilateral nephrectomy (UNX: without uremia and renal ischemia)...
August 3, 2016: Renal Failure
Carlo Briguori, Gabriella Visconti, Michael Donahue, Francesca De Micco, Amelia Focaccio, Bruno Golia, Giuseppe Signoriello, Carmine Ciardiello, Elvira Donnarumma, Gerolama Condorelli
BACKGROUND: High urine flow rate (UFR) has been suggested as a target for effective prevention of contrast-induced acute kidney injury (CI-AKI). The RenalGuard therapy (saline infusion plus furosemide controlled by the RenalGuard system) facilitates the achievement of this target. METHODS: Four hundred consecutive patients with an estimated glomerular filtration rate ≤30 mL/min per 1.73 m(2) and/or a high predicted risk (according to the Mehran score ≥11 and/or the Gurm score >7%) treated by the RenalGuard therapy were analyzed...
March 2016: American Heart Journal
Chiao-Lin Chuang
The goal of fluid therapy in critical care medicine is to restore hemodynamic stability and vital organ perfusion while avoiding interstitial edema. Acute kidney injury (AKI) is a common complication in critically ill patients. Decisions regarding fluid management in critically ill patients with AKI are difficult, as these patients often have accompanying oliguria as well as body fluid overload. Both hypovolemia and volume overload are associated with increased morbidity and mortality in critical care patients; therefore, accurate assessment of the intravascular volume status as well as the response to fluid replacement remains one of the most challenging and important issues for clinicians in daily practice...
2016: Contributions to Nephrology
Kenneth P Chen, Susan Cavender, Joon Lee, Mengling Feng, Roger G Mark, Leo Anthony Celi, Kenneth J Mukamal, John Danziger
BACKGROUND AND OBJECTIVES: Although venous congestion has been linked to renal dysfunction in heart failure, its significance in a broader context has not been investigated. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Using an inception cohort of 12,778 critically ill adult patients admitted to an urban tertiary medical center between 2001 and 2008, we examined whether the presence of peripheral edema on admission physical examination was associated with an increased risk of AKI within the first 7 days of critical illness...
April 7, 2016: Clinical Journal of the American Society of Nephrology: CJASN
Priya Ravikumar, Liping Li, Jianfeng Ye, Mingjun Shi, Masatomo Taniguchi, Jianning Zhang, Makoto Kuro-o, Ming Chang Hu, Orson W Moe, Connie C W Hsia
αKlotho is a circulating protein that originates predominantly from the kidney and exerts cytoprotective effects in distant sites. We previously showed in rodents that the lung is particularly vulnerable to αKlotho deficiency. Because acute lung injury is a common and serious complication of acute kidney injury (AKI), we hypothesized that αKlotho deficiency in AKI contributes to lung injury. To test the hypothesis, we created AKI by renal artery ischemia-reperfusion in rats and observed the development of alveolar interstitial edema and increased pulmonary oxidative damage to DNA, protein, and lipids...
April 1, 2016: Journal of Applied Physiology
Rajniti Prasad, Om P Mishra
UNLABELLED:BACKGROUND: Acute kidney injury (AKI) in P. falciparum malaria infection is an important morbidity in children. The purpose of the present study was done to observe the renal involvement, associated morbidities and outcome. ♦ METHODS: Out of 156 patients with severe P. falciparum malaria, diagnosed on the basis of compatible clinical presentations and positive malarial parasites in the peripheral blood smear and/or histidine rich protein 2 antigen, 31 had AKI at presentation and were analyzed...
March 2016: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
Stéphane Gaudry, David Hajage, Fréderique Schortgen, Laurent Martin-Lefevre, Florence Tubach, Bertrand Pons, Eric Boulet, Alexandre Boyer, Nicolas Lerolle, Guillaume Chevrel, Dorothée Carpentier, Alexandre Lautrette, Anne Bretagnol, Julien Mayaux, Marina Thirion, Philippe Markowicz, Guillemette Thomas, Jean Dellamonica, Jack Richecoeur, Michael Darmon, Nicolas de Prost, Hodane Yonis, Bruno Megarbane, Yann Loubières, Clarisse Blayau, Julien Maizel, Benjamin Zuber, Saad Nseir, Naïke Bigé, Isabelle Hoffmann, Jean-Damien Ricard, Didier Dreyfuss
BACKGROUND: There is currently no validated strategy for the timing of renal replacement therapy (RRT) for acute kidney injury (AKI) in the intensive care unit (ICU) when short-term life-threatening metabolic abnormalities are absent. No adequately powered prospective randomized study has addressed this issue to date. As a result, significant practice heterogeneity exists and may expose patients to either unnecessary hazardous procedures or undue delay in RRT. METHODS/DESIGN: This is a multicenter, prospective, randomized, open-label parallel-group clinical trial that compares the effect of two RRT initiation strategies on overall survival of critically ill patients receiving intravenous catecholamines or invasive mechanical ventilation and presenting with AKI classification stage 3 (KDIGO 2012)...
2015: Trials
Jiao Liu, Osama Abdel-Razek, Zhiyong Liu, Fengqi Hu, Qingshan Zhou, Robert N Cooney, Guirong Wang
Sepsis is a major cause of acute kidney injury (AKI) with high rates of morbidity and mortality. Surfactant proteins A and D (SP-A, SP-D) play a critical role in host defense and regulate inflammation during infection. Recent studies indicate SP-A and SP-D are expressed in the kidney. The current study examines the role of SP-A and SP-D in the pathogenesis of sepsis-induced AKI. Wild-type (WT) and SP-A/SP-D double-knockout (KO) C57BL/6 mice were treated by cecal ligation and puncture (CLP) or sham surgery. Histological, cellular, and molecular indices of kidney injury were investigated in septic mice 6 and 24 h after CLP...
January 2015: Shock
Stéphane Gaudry, Jean-Damien Ricard, Clément Leclaire, Cédric Rafat, Jonathan Messika, Alexandre Bedet, Lucile Regard, David Hajage, Didier Dreyfuss
PURPOSE: Renal replacement therapy (RRT) is a major supportive treatment of acute kidney injury (AKI) in intensive care unit (ICU), but the timing of its initiation remains open to debate. MATERIALS AND METHODS: We retrospectively analyzed ICU patients who had AKI associated with at least one usual RRT criteria: serum creatinine concentration greater than 300 μmol/L, serum urea concentration greater than 25 mmol/L, serum potassium concentration greater than 6.5 mmol/L, severe metabolic acidosis (arterial blood pH<7...
December 2014: Journal of Critical Care
Omar Maoujoud, Yassir Zajjari, Mohammed Asseraji, Taoufiq Aatif, Samir Ahid, Zouhair Oualim
INTRODUCTION AND AIMS: In developing countries, little is known about renal replacement therapy (RRT) for acute kidney injury (AKI) in critically ill patients. The aim of this study is to describe characteristics of patients, clinical practice of renal support and outcomes in intensive care units (ICU) in a developing country. METHODS: Patients who underwent RRT for AKI from May 2003 to July 2008, in four ICUs in our institution were included in this retrospective study...
2014: Ethnicity & Disease
Malleshappa Pavan
INTRODUCTION: The aim of this study was to determine the incidence of acute renocardiac syndrome (cardiorenal syndrome type 3) and its outcome in a suburban population in India. MATERIALS AND METHODS: In an observational study, 100 patients admitted with acute kidney injury were evaluated. RESULTS: Acute renocardiac syndrome was documented in 29%. Acute gastroenteritis (46%) was the leading cause of acute kidney injury. Cardiogenic pulmonary edema (56%) was the most common cause of acute cardiac dysfunction...
January 2014: Iranian Journal of Kidney Diseases
Carlo Guastoni, Nicoletta Bellotti, Fabrizio Poletti, Patrizia Covella, Barbara Gidaro, Antonella Stasi, Giovanni Seveso, Maurizio D'Urbano, Matteo Mariani, Stefano De Servi
Continuous venovenous hemofiltration (CVVH) is a renal replacement therapy that has been successfully used in patients with severe chronic renal failure to prevent contrast-induced acute kidney injury (CI-AKI). In this study, we present a consecutive experience using a new CVVH protocol that has also been applied to patients with acute coronary syndrome (ACS). CVVH was performed in consecutive patients with estimated glomerular filtration rate <30 ml/min/1.73 m(2) (mean ± SD, 21.1 ± 7.3 ml/min/1.73 m(2)) undergoing diagnostic or interventional coronary procedures starting after the angiographic procedures...
February 15, 2014: American Journal of Cardiology
Dongyu Zang, Youzhi Shao, Xiaoming Li
Ischemic acute kidney injury (AKI) is a common complication during inpatient hospitalization, and often induces acute lung injury (ALI). A lot of studies have concentrated on the relevance between AKI and ALI, but the underlying mechanisms of AKI- associated ALI have remained unclear until now. One reason is that evidence of the ultrastructural pathology of AKI-associated ALI has been scarce and needed to be accumulated. The aims of present study are to observe ultrastructural changes, and to reveal leukocyte trafficking of ALI induced by ischemic AKI in rats...
December 2013: Ultrastructural Pathology
Zhou Yijiang, Zhu Jianhua, Lin Feili
Acute ascent to high altitudes beyond 2400 m (300 feet) can cause acute mountain sickness (AMS) and may develop into life-threatening complications such as high altitude cerebral (HACE) and pulmonary edema (HAPE). We report a case of acute kidney injury (AKI) without other organ involvement in a previously healthy young man after sudden high altitude exposure of up to 5200 m. Acute systemic hypoxia as well as prolonged renal hypoperfusion may be responsible for his kidney injury.
June 2013: High Altitude Medicine & Biology
Prakash Gore, Sanjay Srivastava
SESSION TYPE: Non Pulmonary Critical Care PostersPRESENTED ON: Wednesday, October 24, 2012 at 01:30 PM - 02:30 PMPURPOSE: To compare outcome of patients suffered from AKI due to septic and non-septic etiology.METHODS: Patients admitted to our ICU between march 2010 to march 2012 ,screened for AKI using RIFLE criteria , grade I (RISK), II (INJURY) , III (FAILURE) and divided into two groups as septic and non-septic etiologies. Two groups were compared using -mean age, icu stay , need of hemodialysis / RRT ,refractory pulmonary edema , metabolic acidosis ,uremic encephalopathy , hyperkalemia , (MODS) multiorgan dysfunction and mortality...
October 1, 2012: Chest
Antonio Carlos Seguro, Lúcia Andrade
Leptospirosis is an acute septicemic illness that affects humans in all parts of the world. Approximately 10% of patients with leptospirosis develop severe disease, the Weil syndrome, with jaundice, acute kidney injury (AKI), and pulmonary hemorrhage. Leptospirosis-induced AKI is typically nonoliguric with a high frequency of hypokalemia. Experimental and clinical studies demonstrated that tubular function alterations precede a drop in the glomerular filtration rate and are mainly in the proximal tubule. Studies in humans and animals have demonstrated a decrease in the expression of proximal sodium (NHE3) and water tubular transporter, aquaporin 1 (AQP1) together with higher renal expression of the Na-K-2Cl cotransporter NKCC2...
May 2013: Shock
Sherif Assaad, Wanda Popescu, Albert Perrino
PURPOSE OF REVIEW: This review presents the current available data to date regarding the perioperative risks associated with fluid management in thoracic surgery and its implications on the development of acute lung injury (ALI) as well as acute kidney injury (AKI). RECENT FINDINGS: The debate over the adequate fluid management during lung resection surgery has not been settled. Recent findings question the relationship between fluid administration and the development of ALI after lung resection surgery...
February 2013: Current Opinion in Anaesthesiology
Tao Ma, Zhi Liu
PURPOSE: To establish a rat model of acute ischemic kidney injury by continually occluding the bilateral renal artery and renal veins, the functions of α-epithelial Na(+) channel (α-ENaC) and aquaporin (AQP1) in lung injury induced by acute kidney injury (AKI) were examined and compared with lung injury induced by endotoxin. METHODS: Male Wistar rats were randomly divided into three groups: control group, AKI group, and sepsis group. The concentrations of AQP1 and α-ENaC in the lung tissue were detected...
August 2013: International Urology and Nephrology
B Krüger, U Benck, T Singer, B K Krämer
Acute kidney injury (AKI) of any origin is a common complication/disease in hospitalized patients, going along with significantly increased mortality and morbidity, as well as hospitalization duration and expenses. Drug-induced AKI is usually seen in patients with concurrent risk factors such as existing kidney disease, dehydration with or without hypotension, older age or diabetes mellitus. In cases with multiple risk factors or therapies the triggering drug is often impossible to define. Hemodynamic alterations, intrinsic tubulointerstitial damages and intrarenal (i...
September 2012: Deutsche Medizinische Wochenschrift
Gudrun Bragadottir, Bengt Redfors, Sven-Erik Ricksten
INTRODUCTION: Acute kidney injury (AKI), which is a major complication after cardiovascular surgery, is associated with significant morbidity and mortality. Diuretic agents are frequently used to improve urine output and to facilitate fluid management in these patients. Mannitol, an osmotic diuretic, is used in the perioperative setting in the belief that it exerts reno-protective properties. In a recent study on uncomplicated postcardiac-surgery patients with normal renal function, mannitol increased glomerular filtration rate (GFR), possibly by a deswelling effect on tubular cells...
2012: Critical Care: the Official Journal of the Critical Care Forum
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