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Renal injury in cardiac surgery

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https://www.readbyqxmd.com/read/27906706/effects-of-cardiopulmonary-bypass-on-renal-perfusion-filtration-and-oxygenation-in-patients-undergoing-cardiac-surgery
#1
Lukas Lannemyr, Gudrun Bragadottir, Vitus Krumbholz, Bengt Redfors, Johan Sellgren, Sven-Erik Ricksten
BACKGROUND: Acute kidney injury is a common complication after cardiac surgery with cardiopulmonary bypass. The authors evaluated the effects of normothermic cardiopulmonary bypass on renal blood flow, glomerular filtration rate, renal oxygen consumption, and renal oxygen supply/demand relationship, i.e., renal oxygenation (primary outcome) in patients undergoing cardiac surgery. METHODS: Eighteen patients with a normal preoperative serum creatinine undergoing cardiac surgery procedures with normothermic cardiopulmonary bypass (2...
December 1, 2016: Anesthesiology
https://www.readbyqxmd.com/read/27862029/creatinine-neutrophil-gelatinase-associated-lipocalin-and-cystatin-c-in-determining-acute-kidney-injury-after-heart-operations-using-cardiopulmonary-bypass
#2
Jurij Matija Kališnik, Eva Hrovat, Alenka Hrastovec, Janez Žibert, Aleš Jerin, Milan Skitek, Giuseppe Santarpino, Tomislav Klokocovnik
Acute kidney injury (AKI) represents frequent complication after cardiac surgery using cardiopulmonary bypass (CPB). In the hope to enhance earlier more reliable characterization of AKI, we tested the utility of neutrophil gelatinase-associated lipocalin (NGAL) and cystatin C (CysC) in addition to standard creatinine for early determination of AKI after cardiac surgery using CPB. Forty-one patients met the inclusion criteria. Arterial blood samples collected after induction of general anesthesia were used as baseline, further sampling occurred at CPB termination, 2 h after CPB, on the first and second day after surgery...
November 8, 2016: Artificial Organs
https://www.readbyqxmd.com/read/27853882/the-protective-effect-of-human-atrial-natriuretic-peptide-on-renal-damage-during-cardiac-surgery
#3
Takahiro Moriyama, Shintaro Hagihara, Toko Shiramomo, Misaki Nagaoka, Shohei Iwakawa, Yuichi Kanmura
PURPOSE: Acute kidney injury (AKI) is one of the critical complications after cardiac surgery. In the kidney, angiotensin II (Ang II) is formed by independent mechanisms, and activity of the intrarenal renin-angiotensin-aldosterone (RAAS) system contributes to the progression of kidney damage. Although atrial natriuretic peptide (ANP) exerts protective effects against renal injury by inhibiting the RAAS, the mechanisms of this effect have not been completely clarified. We investigated how human ANP (hANP) could prevent renal damage induced by cardiopulmonary bypass...
November 16, 2016: Journal of Anesthesia
https://www.readbyqxmd.com/read/27833481/cardiac-and-renal-protective-effects-of-dexmedetomidine-in-cardiac-surgeries-a-randomized-controlled-trial
#4
A S Ammar, K M Mahmoud, Z A Kasemy, M A Helwa
BACKGROUND: Cardiac and renal injuries are common insults after cardiac surgeries that contribute to perioperative morbidity and mortality. Dexmedetomidine has been shown to protect several organs against ischemia/reperfusion-(I/R) induced injury. We performed a randomized controlled trial to assess the effect of dexmedetomidine on cardiac and renal I/R injury in patients undergoing cardiac surgeries. MATERIALS AND METHODS: Fifty patients scheduled for elective cardiac surgeries were randomized to dexmedetomidine group that received a continuous infusion of dexmedetomidine initiated 5 min before cardiopulmonary bypass (1 μg/kg over 15 min, followed by 0...
October 2016: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/27833089/effects-of-continuous-renal-replacement-therapy-on-serum-cytokines-neutrophil-gelatinase-associated-lipocalin-and-prognosis-in-patients-with-severe-acute-kidney-injury-after-cardiac-surgery
#5
Heng-Jin Wang, Pei Wang, Nan Li, Cheng Wan, Chun-Ming Jiang, Jing-Song He, Dong-Jin Wang, Miao Zhang, Ling-Yun Sun
The aim of our study was to evaluate the effect of continuous renal replacement therapy (CRRT) on serum cytokines, neutrophil gelatinase-associated lipocalin (NGAL), and prognosis in patients with severe acute kidney injury (AKI) following cardiac surgery. A total number of 153 patients with severe AKI following cardiac surgery were treated with CRRT. They were divided into the survival and non-survival groups. Clinical data from these two groups before and after CRRT were recorded and analyzed. It was found that the number of impaired organs, MODS and APACHE II scores were significantly higher in the non-survival group than those in the survival group before CRRT...
November 9, 2016: Oncotarget
https://www.readbyqxmd.com/read/27832187/risk-factors-for-acute-kidney-injury-after-congenital-cardiac-surgery-in-infants-and-children-a-retrospective-observational-study
#6
Sun-Kyung Park, Min Hur, Eunhee Kim, Won Ho Kim, Jung Bo Park, Youngwon Kim, Ji-Hyuk Yang, Tae-Gook Jun, Chung Su Kim
Acute kidney injury (AKI) after pediatric cardiac surgery is associated with high morbidity and mortality. Modifiable risk factors for postoperative AKI including perioperative anesthesia-related parameters were assessed. The authors conducted a single-center, retrospective cohort study of 220 patients (aged 10 days to 19 years) who underwent congenital cardiac surgery between January and December 2012. The incidence of AKI within 7 days postoperatively was determined using the Kidney Disease: Improving Global Outcomes (KDIGO) criteria...
2016: PloS One
https://www.readbyqxmd.com/read/27799177/non-invasive-measurement-of-renal-perfusion-and-oxygen-metabolism-to-predict-postoperative-acute-kidney-injury-in-neonates-and-infants-after-cardiopulmonary-bypass-surgery
#7
F Neunhoeffer, M Wiest, K Sandner, H Renk, E Heimberg, C Haller, M Kumpf, C Schlensak, M Hofbeck
BACKGROUND: The pathophysiology of acute kidney injury (AKI) after cardiopulmonary bypass surgery for congenital heart disease is not completely understood. The aim of this study was to carry out a prospective analysis of the diagnostic value of non-invasive monitoring of renal oxygenation and microcirculation by combining laser Doppler flowmetry and tissue spectrometry. METHODS: In 50 neonates and infants who underwent repair (n = 31) or neonatal palliation (n = 19) of congenital heart disease with cardiopulmonary bypass, renal oxygenation, and microcirculatory flow, the approximate renal metabolic rate of oxygen and Doppler-based renal resistive index were determined after surgery...
November 2016: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/27759760/validity-of-klotho-cyr61-and-ykl-40-as-ideal-predictive-biomarkers-for-acute-kidney-injury-review-study
#8
Osama Mosa, Milan Skitek, Ales Jerin
CONTEXT AND OBJECTIVE: Acute kidney injury (AKI) is still a headache for clinicians and scientists as a possible reason for increased death among intensive care unit (ICU) patients after invasive cardiac surgery. Furthermore, the diagnostic process for AKI using conventional biomarkers is not sufficient to ensure early warning of this condition because of the morbid influence of non-renal factors that definitively delay the time for the prognosis. These imposed limitations have led to significant amounts of research targeted towards identifying novel biomarkers for AKI with a sustained degree of sensitivity and specificity...
October 13, 2016: São Paulo Medical Journal, Revista Paulista de Medicina
https://www.readbyqxmd.com/read/27755064/rapid-occurrence-of-chronic-kidney-disease-in-patients-experiencing-reversible-acute-kidney-injury-after-cardiac-surgery
#9
David Legouis, Pierre Galichon, Aurélien Bataille, Sylvie Chevret, Sophie Provenchère, Anne Boutten, Dimitrios Buklas, Jean-Luc Fellahi, Jean-Luc Hanouz, Alexandre Hertig
BACKGROUND: There is recent evidence to show that patients suffering from acute kidney injury are at increased risk of developing chronic kidney disease despite the fact that surviving tubular epithelial cells have the capacity to fully regenerate renal tubules and restore renal function within days or weeks. The aim of the study was to investigate the impact of acute kidney injury on de novo chronic kidney disease. METHODS: The authors conducted a retrospective population-based cohort study of patients initially free from chronic kidney disease who were scheduled for elective cardiac surgery with cardiopulmonary bypass and who developed an episode of acute kidney injury from which they recovered...
October 17, 2016: Anesthesiology
https://www.readbyqxmd.com/read/27748669/congenital-heart-surgery-and-acute-kidney-injury
#10
Tennille N Webb, Stuart L Goldstein
PURPOSE OF REVIEW: The incidence of cardiac surgery-associated acute kidney injury (CS-AKI) continues to increase and is associated with significant morbidity and mortality. Early diagnosis and identification of patients at risk are extremely important. Therefore, identifying associated risk factors, biomarkers for earlier detection, prevention and therapeutic options for CS-AKI warrant special attention. RECENT FINDINGS: The current diagnosis of acute kidney injury (AKI) largely depends upon the functional biomarkers serum creatinine and oliguria leading to delays in diagnosis and worsening outcomes...
September 29, 2016: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/27717384/preoperative-plasma-growth-differentiation-factor-15-for-prediction-of-acute-kidney-injury-in-patients-undergoing-cardiac-surgery
#11
Matthias Heringlake, Efstratios I Charitos, Kira Erber, Astrid Ellen Berggreen, Hermann Heinze, Hauke Paarmann
BACKGROUND: Growth-differentiation factor-15 (GDF-15) is an emerging humoral marker for risk stratification in cardiovascular disease. Cardiac-surgery-associated acute kidney injury (CSA-AKI), an important complication in patients undergoing cardiac surgery, is associated with poor prognosis. The present secondary analysis of an observational cohort study aimed to determine the role of GDF-15 in predicting CSA-AKI compared with the Cleveland-Clinic Acute Renal Failure (CC-ARF) score and a logistic regression model including variables associated with renal dysfunction...
October 8, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27716701/cardiac-surgery-associated-acute-kidney-injury
#12
Christian Ortega-Loubon, Manuel Fernández-Molina, Yolanda Carrascal-Hinojal, Enrique Fulquet-Carreras
Cardiac surgery-associated acute kidney injury (CSA-AKI) is a well-recognized complication resulting with the higher morbid-mortality after cardiac surgery. In its most severe form, it increases the odds ratio of operative mortality 3-8-fold, length of stay in the Intensive Care Unit and hospital, and costs of care. Early diagnosis is critical for an optimal treatment of this complication. Just as the identification and correction of preoperative risk factors, the use of prophylactic measures during and after surgery to optimize renal function is essential to improve postoperative morbidity and mortality of these patients...
October 2016: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/27704535/the-association-between-pre-operative-variables-including-blood-pressure-and-postoperative-kidney-function
#13
S M Kendale, P N Lapis, S M Melhem, J D Blitz
We used multivariate analyses to assess the association of pre-operative variables with kidney function in 41,523 adults after scheduled surgery in a single large academic hospital. Eight variables were independently associated with a reduction in postoperative estimated glomerular filtration rate: pre-operative renal function; age; ASA physical status; cardiac failure; anaemia; cancer; type of surgery; and the lowest quartile of pre-operative mean arterial blood pressure (< 71 mmHg). The estimated glomerular filtration rate fell by a mean (95% CI) of 2...
December 2016: Anaesthesia
https://www.readbyqxmd.com/read/27684548/levosimendan-administration-in-limb-ischemia-multicomponent-signaling-serving-kidney-protection
#14
Peter Onody, Peter Aranyi, Zsolt Turoczi, Rita Stangl, Andras Fulop, Emese Dudas, Gabor Lotz, Attila Szijarto
AIMS AND OBJECTIVES: Acute renal failure is a severe complication of lower extremity major arterial reconstructions, which could even be fatal. Levosimendan is a dual-acting positive inotropic and vasodilatory agent, which is suspected to have protective effects against cardiac ischemia. However, there is no data available on lower limb or remote organ ischemic injuries therefore the aim of the study was to investigate the effect of levosimendan on lower limb ischemia-reperfusion injury and the corollary renal dysfunction...
2016: PloS One
https://www.readbyqxmd.com/read/27682213/the-management-of-neonatal-acute-and-chronic-renal-failure-a-review
#15
Malcolm G Coulthard
Most babies with chronic renal failure are identified antenatally, and over half that are treated with peritoneal dialysis receive kidney transplants before school age. Most infants that develop acute renal failure have hypotension following cardiac surgery, or multiple organ failure. Sometimes the falls in glomerular filtration and urine output are physiological and reversible, and sometimes due to kidney injury, but (illogically) it is now common to define them all as having 'acute kidney injury'. Contrary to widespread opinion, careful interpretation of the plasma creatinine concentrations can provide sensitive evidence of early acute renal failure...
September 25, 2016: Early Human Development
https://www.readbyqxmd.com/read/27648014/evaluation-of-nephroprotective-efficacy-of-hypoxic-preconditioning-in-patients-undergoing-coronary-artery-bypass-surgery
#16
Zhaneta V Vesnina, Yury B Lishmanov, Ekaterina A Alexandrova, Evgeniy A Nesterov
BACKGROUND: Nonpulsatile blood flow plays an important role in the pathogenesis of renal dysfunction in patients with extracorporeal circulation. In our opinion, hypoxic preconditioning (HP) can be used to protect kidneys from postsurgical dysfunction. The aim of this study was to evaluate nephroprotective efficacy of HP in myocardial revascularization with extracorporeal circulation. METHODS: The randomized, controlled trial was performed in 63 patients undergoing coronary artery bypass grafting (CABG)...
August 2016: Cardiorenal Medicine
https://www.readbyqxmd.com/read/27631199/remote-ischemic-preconditioning-for-prevention-of-acute-kidney-injury-in-patients-undergoing-on-pump-cardiac-surgery-a-systematic-review-and-meta-analysis
#17
Yabing Zhang, Xiyang Zhang, Dongmei Chi, Siyang Wang, Hua Wei, Hong Yu, Qian Li, Bin Liu
Remote ischemic preconditioning (RIPC) may attenuate acute kidney injury (AKI). However, results of studies evaluating the effect of RIPC on AKI after cardiac surgery have been controversial and contradictory.The aim of this meta-analysis is to examine the association between RIPC and AKI after on-pump cardiac surgery.The authors searched relevant studies in PubMed, EMBASE, and the Cochrane Library through December 2015.We considered for inclusion all randomized controlled trials that the role of RIPC in reducing AKI and renal replacement therapy (RRT) among patients underwent on-pump cardiac surgical procedures...
September 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27618162/kidney-outcomes-5-years-after-pediatric-cardiac-surgery-the-tribe-aki-study
#18
Jason H Greenberg, Michael Zappitelli, Prasad Devarajan, Heather R Thiessen-Philbrook, Catherine Krawczeski, Simon Li, Amit X Garg, Steve Coca, Chirag R Parikh
Importance: Acute kidney injury (AKI) after pediatric cardiac surgery is associated with high short-term morbidity and mortality; however, the long-term kidney outcomes are unclear. Objective: To assess long-term kidney outcomes after pediatric cardiac surgery and to determine if perioperative AKI is associated with worse long-term kidney outcomes. Design, Setting, and Participants: This prospective multicenter cohort study recruited children between ages 1 month to 18 years who underwent cardiopulmonary bypass for cardiac surgery and survived hospitalization from 3 North American pediatric centers between July 2007 and December 2009...
September 12, 2016: JAMA Pediatrics
https://www.readbyqxmd.com/read/27578577/-protective-effects-of-high-dose-ulinastatin-on-vital-organs-in-patients-receiving-total-arch-replacement-for-type-a-aortic-dissection
#19
Xian-Yue Wang, Wen-Peng Dong, Guang Tong, Sheng-Hui Bi, Ben Zhang, Hua Lu, Xiao-Wu Wang, Wei-da Zhang
OBJECTIVE: To investigate the protective effects of high-dose ulinastatin on the vital organs in patients undergoing total arch replacement for type A aortic dissection. METHODS: Between September 2014 and March 2016, 66 patients with type A aortic dissection underwent total arch replacement at our center. Thirty-six of the patients received ulinastatin treatment at 300 000 U/8 h from admission to 3 days postoperatively and at 300 000 U/2 h during cardiopulmonary bypass surgery (UTI group), and the other 30 patients did not receive perioperative ulinastatin treatment (control group)...
August 20, 2016: Nan Fang Yi Ke da Xue Xue Bao, Journal of Southern Medical University
https://www.readbyqxmd.com/read/27575274/the-role-of-blood-transfusion-in-the-development-of-atrial-fibrillation-after-coronary-artery-bypass-grafting
#20
Athanasia Vlahou, Konstantinos Diplaris, Fotini Ampatzidou, Lampos Karagounnis, George Drossos
Objectives Atrial fibrillation (AF) is the most common complication after coronary artery bypass grafting (CABG). It is associated with prolonged hospital stay and increased cost. The aim of this study is to investigate the relationship between transfusion of blood derivatives and occurrence of postoperative paroxysmal AF. Materials and Methods From June 2012 to February 2014, 446 patients undergoing CABG with cardiopulmonary bypass (CPB) were prospectively evaluated for occurrence of postoperative AF. Patients and procedural variables were recorded and were associated with the development of new-onset AF with logistic regression analysis...
August 30, 2016: Thoracic and Cardiovascular Surgeon
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