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Renal injury in cardiac surgery

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https://www.readbyqxmd.com/read/29464581/urinary-neutrophil-gelatinase-associated-lipocalin-ngal-and-serum-cystatin-c-measurements-for-early-diagnosis-of-acute-kidney-injury-in-children-admitted-to-picu
#1
Jameela Abdulaziz Kari, Mohamed Ahmed Shalaby, Kholoud Sofyani, Ahmad Saleh Sanad, Albaraa Fuad Ossra, Rayan Smeer Halabi, Maha Hassan Aljuhani, Wael Mohammad Toffaha, Feras Aymen Moria, Samar Sabry, Hanan AbdelAziz Ahmed, Khalid Abdulaziz Alhasan, Sara Sharief, Osama Safdar
BACKGROUND: Acute kidney injury (AKI) is common in critically ill children with significant mortality and morbidity. Serum creatinine is an insensitive and late biomarker compared to newly proposed AKI biomarkers. METHODS: Prospective study in pediatric intensive care unit (PICU) over three months to compare between serum cystatin-C (s-Cys-C) and urinary neutrophil gelatinase-associated lipocalin (uNGAL) as AKI biomarkers at multiple time points with pediatric risk, injury, failure, loss, end-stage renal disease (pRIFLE) classification in diagnosing AKI...
February 20, 2018: World Journal of Pediatrics: WJP
https://www.readbyqxmd.com/read/29459617/ngal-neutrophil-gelatinase-associated-lipocalin-is-an-early-predictor-of-acute-kidney-injury-after-cardiac-surgery-and-variation-of-ngal-values-in-homogenous-study-subject
#2
O F Miah, F A Dowel, A Latif, A N Hai, M A Mahmud, M A Razzak, T Ahammod
Isolated CABG (coronary artery bypass grafting) has the lowest incidence of AKI (Acute Kidney Injury), followed by valvular surgery and then, combined CABG with valvular surgery. Due to the difference in baseline characteristics and in surgery type, the range of incidence is between 8.9 and 39% based on RIFLE (Risk Injury failure loss end stage kidney disease) or AKIN (Acute Kidney Injury Network) criteria. The advent of novel biomarkers of kidney injury has opened a new era of early detection and prognosis prediction for AKI...
January 2018: Mymensingh Medical Journal: MMJ
https://www.readbyqxmd.com/read/29459111/a-trial-of-two-anesthetic-regimes-for-minimally-invasive-mitral-valve-repair
#3
Marco Moscarelli, Nora Terrasini, Anna Nunziata, Prakash Punjabi, Gianni Angelini, Marco Solinas, Alba Buselli, Paolo Del Sarto, Dorela Haxhiademi
OBJECTIVE: Minimally invasive mitral valve repair may be associated with prolonged cardioplegic arrest times and ischemic reperfusion injury. Intravenous (propofol) and volatile (sevoflurane) anesthesia are used routinely during cardiac surgery and are thought to provide cardioprotection; however, the individual contribution of each regimen to cardioprotection is unknown. Therefore, the authors sought to compare the cardioprotective effects of propofol and sevoflurane anesthesia in patients undergoing minimally invasive mitral valve repair...
January 31, 2018: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29452878/combining-novel-renal-injury-markers-with-delta-serum-creatinine-early-after-cardiac-surgery-and-risk-stratification-for-serious-adverse-outcomes-an-exploratory-analysis
#4
David R McIlroy, David Farkas, Kun Pan, John W Pickering, H Thomas Lee
OBJECTIVE: To evaluate the prognostic utility of multiple novel urinary biomarkers of renal injury when used alone, in pair-wise combination with an early delta serum creatinine (ΔSCr ) term, and combined as a broad biomarker panel for the prediction of serious adverse outcomes that may reflect AKI in patients undergoing cardiac surgery. DESIGN: Post-hoc analysis of prospective observational study. SETTING: Academic medical center. PARTICIPANTS: 603 adults undergoing cardiac surgery...
December 30, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29451341/validation-of-acute-kidney-injury-according-to-the-modified-kdigo-criteria-in-infants-after-cardiac-surgery-for-congenital-heart-disease
#5
Kentaro Ueno, Shunji Seki, Naohiro Shiokawa, Tomoyuki Matsuba, Akinori Miyazono, Daisuke Hazeki, Yutaka Imoto, Yoshifumi Kawano
AIM: We aimed to validate the incidence of, risk factors for, and postoperative outcomes of acute kidney injury (AKI) according to the modified Kidney Disease Improving Global Outcomes (m-KDIGO) criteria and compare this criteria with both the pediatric Risk, Injury, Failure, Loss, End-stage disease (pRIFLE) and Acute Kidney Injury Network (AKIN) criteria in infants after cardiac surgery. METHODS: We retrospectively enrolled 145 consecutive infants who underwent open-heart surgery at Kagoshima University Hospital...
February 16, 2018: Nephrology
https://www.readbyqxmd.com/read/29433878/the-effect-of-resident-involvement-on-bariatric-surgical-outcomes-an-acs-nsqip-analysis
#6
Ivy N Haskins, Jihad Kudsi, Kathleen Hayes, Richard L Amdur, Paul P Lin, Khashayar Vaziri
BACKGROUND: Surgical residency training programs in the United States are modeled on the principle of graduated responsibility. Residents are given greater responsibility and autonomy in the operating room and during perioperative care as they gain surgical skills and progress through their training. The impact of this method of surgical training on patient outcomes remains unknown. The purpose of this study is to compare early patient morbidity and mortality after bariatric surgery in cases with and without resident participation using the American College of Surgeons National Surgical Quality Improvement Program database...
March 2018: Journal of Surgical Research
https://www.readbyqxmd.com/read/29432378/low-perfusion-pressure-is-associated-with-renal-tubular-injury-in-infants-undergoing-cardiac-surgery-with-cardiopulmonary-bypass-a-secondary-analysis-of-an-observational-study
#7
Mirela Bojan, Maria C Basto Duarte, Vanessa Lopez, Laurent Tourneur, Stephanie Vicca, Marc Froissart
BACKGROUND: Earlier work on adults undergoing surgery with cardiopulmonary bypass suggests that there is a close relationship between the lower limit of the cerebral and renal autoregulation pressures. Although cerebral autoregulation during bypass in infants has been extensively investigated, the impact of bypass on kidney function is not well known. It is, nevertheless, acknowledged that the main pathophysiological process involved in cardiac surgery-related kidney damage is tubular injury, and that urine neutrophil gelatinase-associated lipocaline (uNGAL) is a reliable biomarker of injury...
February 9, 2018: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29427619/the-association-of-aortic-valve-pathology-with-renal-resistive-index-as-a-kidney-injury-biomarker
#8
Benjamin Y Andrew, Anne D Cherry, Jennifer N Hauck, Alina Nicoara, Cory D Maxwell, Ryan M Konoske, Annemarie Thompson, Lakshmi D Kartha, Madhav Swaminathan, Mark Stafford-Smith
BACKGROUND: Acute kidney injury (AKI) is a common serious complication following cardiac surgery. Doppler-determined renal resistive index (RRI) is a promising early AKI biomarker in this population. However, the relationship between aortic valve pathology (insufficiency and/or stenosis) and RRI is unknown. This study aimed to investigate RRI variability related to aortic valve pathology. METHODS: In a retrospective review of cardiac surgery patients, RRI and aortic valve pathology were assessed prior to cardiopulmonary bypass using transesophageal echocardiography...
February 7, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29408241/major-adverse-renal-and-cardiac-events-following-coronary-angiography-and-cardiac-surgery
#9
Kristen M Tecson, David Brown, James W Choi, Georges Feghali, Gonzalo V Gonzalez-Stawinski, Baron L Hamman, Robert Hebeler, Stuart R Lander, Brian Lima, Srini Potluri, Jeffrey M Schussler, Robert C Stoler, Carlos Velasco, Peter A McCullough
BACKGROUND: Patients at high risk for developing post-procedural complications may receive iodixanol, an iso-osmolar contrast, during coronary angiography to minimize the risk of renal toxicity. For those who additionally require cardiac surgery, the wait-time between angiography and surgery may be a modifiable factor capable of mitigating poor surgical outcomes; however, there have been inconsistsent reports regarding the optimal wait-time. We sought to determine the effects of wait time between angiogram and cardiac surgery, as well as contrast induced acute injury (CI-AKI) on the development of major adverse renal and cardiac events (MARCE)...
February 2, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29399365/urinary-hepcidin-25-is-elevated-in-patients-that-avoid-acute-kidney-injury-following-cardiac-surgery
#10
Nora Choi, Claudio Rigatto, Michael Zappitelli, Ang Gao, Simon Christie, Brett Hiebert, Rakesh C Arora, Julie Ho
Background: Acute kidney injury (AKI) following cardiac surgery leads to increased morbidity and mortality. Characterization and validation of early biomarkers of AKI may ultimately facilitate early therapeutic intervention. We have previously identified that elevated urinary hepcidin-25 is inversely and independently associated with the development of AKI in adult cardiac surgery patients. Hepcidin-25 is an antimicrobial peptide that sequesters iron intracellularly, and its elevation following human ischemia reperfusion injury may represent a renoprotective response to minimize renal injury...
2018: Canadian Journal of Kidney Health and Disease
https://www.readbyqxmd.com/read/29382510/preoperative-renal-functional-reserve-predicts-risk-of-acute-kidney-injury-after-cardiac-surgery
#11
Faeq Husain-Syed, Fiorenza Ferrari, Aashish Sharma, Tommaso Hinna Danesi, Pércia Bezerra, Salvador Lopez-Giacoman, Sara Samoni, Massimo de Cal, Valentina Corradi, Grazia Maria Virzì, Silvia De Rosa, María Jimena Muciño Bermejo, Carla Estremadoyro, Gianluca Villa, Jose J Zaragoza, Carlotta Caprara, Alessandra Brocca, Horst-Walter Birk, Hans-Dieter Walmrath, Werner Seeger, Federico Nalesso, Monica Zanella, Alessandra Brendolan, Davide Giavarina, Loris Salvador, Rinaldo Bellomo, Mitchell H Rosner, John A Kellum, Claudio Ronco
BACKGROUND: Although acute kidney injury (AKI) frequently complicates cardiac surgery, methods to determine AKI risk in patients without underlying kidney disease are lacking. Renal functional reserve (RFR) can be used to measure the capacity of the kidney to increase glomerular filtration rate under conditions of physiological stress and may serve as a functional marker that assesses susceptibility to injury. We sought to determine whether preoperative RFR predicts postoperative AKI...
January 27, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29369890/cyclosporine-before-coronary-artery-bypass-grafting-does-not-prevent-postoperative-decreases-in-renal-function-a-randomized-clinical-trial
#12
Per Ederoth, Alain Dardashti, Edgars Grins, Björn Brondén, Carsten Metzsch, André Erdling, Shahab Nozohoor, Arash Mokhtari, Magnus J Hansson, Eskil Elmér, Lars Algotsson, Stefan Jovinge, Henrik Bjursten
BACKGROUND: Acute kidney injury is a common complication after cardiac surgery, leading to increased morbidity and mortality. One suggested cause for acute kidney injury is extracorporeal circulation-induced ischemia-reperfusion injury. In animal studies, cyclosporine has been shown to reduce ischemia-reperfusion injury in the kidneys. We hypothesized that administering cyclosporine before extracorporeal circulation could protect the kidneys in patients undergoing cardiac surgery. METHODS: The Cyclosporine to Protect Renal Function in Cardiac Surgery (CiPRICS) study was an investigator-initiated, double-blind, randomized, placebo-controlled, single-center study...
January 25, 2018: Anesthesiology
https://www.readbyqxmd.com/read/29366580/urinary-biomarkers-may-provide-prognostic-information-for-subclinical-acute-kidney-injury-after-cardiac-surgery
#13
Christian Albert, Annemarie Albert, Johanna Kube, Rinaldo Bellomo, Nicholas Wettersten, Hermann Kuppe, Sabine Westphal, Michael Haase, Anja Haase-Fielitz
OBJECTIVE: This study aimed to determine the biomarker-specific outcome patterns and short-and long-term prognosis of cardiac surgery-asoociated acute kidney injury (AKI) identified by standard criteria and/or urinary kidney biomarkers. METHODS: Patients enrolled (N = 200), originated a German multicenter study (NCT00672334). Standard risk injury, failure, loss, and end-stage renal disease classification (RIFLE) criteria (including serum creatinine and urine output) and urinary kidney biomarker test result (neutrophil gelatinase-associated lipocalin, midkine, interleukin 6, and proteinuria) were used for diagnosis of postoperative AKI...
December 22, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29358013/perioperative-care-of-the-obese-cardiac-surgical-patient
#14
REVIEW
M Megan Chacon, Sreekanth R Cheruku, Peter J Neuburger, Laeben Lester, Sasha K Shillcutt
Morbid obesity is associated with impairment of cardiovascular, pulmonary, gastrointestinal, and renal physiology with significant perioperative consequences and has been linked with higher morbidity and mortality after cardiac surgery. Cardiac surgery patients have a higher incidence of difficult airway and difficult laryngoscopy than general surgery patients do, and obesity is associated with difficult mask ventilation and direct laryngoscopy. Positioning injuries occur more frequently because obese patients are at greater risk of pressure injury, such as rhabdomyolysis and compartment syndrome...
December 13, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29357431/vascular-endothelial-cell-changes-in-post-cardiac-surgery-acute-kidney-injury
#15
Saqib H Qureshi, Nishith N Patel, Gavin J Murphy
BACKGROUND: Acute Kidney Injury (AKI) is common complication of cardiac surgery however the phenotype of this condition is poorly defined. The aim of this study was to characterize changes in endothelial structure and function that underlie post cardiopulmonary bypass (CPB) AKI. METHODS: Adult pigs (N=16) were randomised to undergo following procedures; (n=8 per group); Group 1: sham operation-neck dissection with 2.5hr of general anesthesia and Group 2: CPB-2.5hr of cardiopulmonary bypass...
December 20, 2017: American Journal of Physiology. Renal Physiology
https://www.readbyqxmd.com/read/29344022/role-of-body-mass-index-in-acute-kidney-injury-patients-after-cardiac-surgery
#16
Zhouping Zou, Yamin Zhuang, Lan Liu, Bo Shen, Jiarui Xu, Zhe Luo, Jie Teng, Chunsheng Wang, Xiaoqiang Ding
Background/Aims: To explore the association of body mass index (BMI) with the risk of developing acute kidney injury after cardiac surgery (CS-AKI) and for AKI requiring renal replacement therapy (AKI-RRT) after cardiac surgery. Methods: Clinical data of 8,455 patients undergoing cardiac surgery, including demographic preoperative, intraoperative, and postoperative data were collected. Patients were divided into underweight (BMI <18.5), normal weight (18.5≤ BMI <24), overweight (24≤ BMI <28), and obese (BMI ≥28) groups...
December 2017: Cardiorenal Medicine
https://www.readbyqxmd.com/read/29336390/long-term-quality-of-life-postacute-kidney-injury-in-cardiac-surgery-patients
#17
Pankaj Kumar Mishra, Heyman Luckraz, Jayanta Nandi, Alan Nevill, Ramesh Giri, Andrew Panayiotou, Johann Nicholas
BACKGROUND: Acute renal failure after cardiac surgery is known to be associated with significant short-term morbidity and mortality. There have as yet been no major reports on long-term quality of life (QOL). This study assessed the impact of acute kidney injury (AKI) and renal replacement therapy (RRT) on long-term survival and QOL after cardiac surgery. The need for long-term RRT is also assessed. MATERIALS AND METHODS: Patients who underwent cardiac surgery between 2005 and 2011 (n = 6087) and developed AKI (RIFLE criteria, n = 570) were included...
January 2018: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/29334927/dexmedetomidine-prevents-acute-kidney-injury-after-adult-cardiac-surgery-a-meta-analysis-of-randomized-controlled-trials
#18
Yang Liu, Bo Sheng, Suozhu Wang, Feiping Lu, Jie Zhen, Wei Chen
BACKGROUND: Dexmedetomidine has been shown to confer direct renoprotection by stabilizing the sympathetic system, exerting anti-inflammatory effects and attenuating ischemia/reperfusion (I/R) injury in preclinical studies. Results from clinical trials of dexmedetomidine on acute kidney injury (AKI) following adult cardiac surgery are controversial. METHODS: We searched EMBASE, PubMed, and Cochrane CENTRAL databases for randomized controlled trials (RCTs) comparing the renal effect of dexmedetomidine versus placebo or other anesthetic drugs in adult patients undergoing cardiac surgery...
January 15, 2018: BMC Anesthesiology
https://www.readbyqxmd.com/read/29310552/prevention-of-acute-kidney-injury-in-children-undergoing-cardiac-surgery-a-narrative-review
#19
Esther Huimin Leow, Yoke Hwee Chan, Yong Hong Ng, Joel Kian Boon Lim, Masakazu Nakao, Jan Hau Lee
Children undergoing cardiac surgery are at risk of developing acute kidney injury (AKI). Preventing cardiac surgery-associated AKI (CS-AKI) is important as it is associated with increased early- and long-term mortality and morbidity. Targeting modifiable risk factors (eg, avoiding poor renal perfusion, nephrotoxic drugs, and fluid overload) reduces the risk of CS-AKI. There is currently no strong evidence for the routine use of pharmacological approaches (eg, aminophylline, dexmedetomidine, fenoldopam, and steroids) to prevent CS-AKI...
January 2018: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/29248147/sequelae-of-aki
#20
REVIEW
Samir S Patel, Carlos E Palant, Vrinda Mahajan, Lakhmir S Chawla
Large epidemiologic studies in a variety of patient populations reveal increased morbidity and mortality that occur months to years after an episode of acute kidney injury (AKI). Even milder forms of AKI have increased associated morbidity and mortality. Residual confounding may account for these findings, but considering the huge number of individuals afflicted with AKI, the sequelae of AKI may be a very large public health burden. AKI may simply be a marker for increased risk, but there is increasing evidence that it is part of the causal pathway to chronic kidney disease...
September 2017: Best Practice & Research. Clinical Anaesthesiology
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