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Renal injury in cardiac surgery

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https://www.readbyqxmd.com/read/28095822/hyperuricemia-increases-the-risk-of-acute-kidney-injury-a-systematic-review-and-meta-analysis
#1
Xialian Xu, Jiachang Hu, Nana Song, Rongyi Chen, Ting Zhang, Xiaoqiang Ding
BACKGROUND: Mounting evidence indicated that the elevated serum uric acid level was associated with an increased risk of acute kidney injury (AKI). Our goal was to systematically evaluate the correlation of serum uric acid (SUA) level and incidence of AKI by longitudinal cohort studies. METHODS: We searched electronic databases and the reference lists of relevant articles. 18 cohort studies with 75,200 patients were analyzed in this random-effect meta-analysis. Hyperuricemia was defined as SUA levels greater than 360-420 μmol/L (6-7 mg/dl), which was various according to different studies...
January 17, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28089174/neonatal-acute-kidney-injury-severity-and-recovery-prediction-and-the-role-of-serum-and-urinary-biomarkers
#2
Deirdre U Sweetman
Neonatal acute kidney injury is common, in part due to incomplete renal maturation and also due to frequent exposure to risk factors for acute kidney injury such as perinatal asphyxia, extracorporeal-membrane-oxygenation, cardiac surgery, sepsis, prematurity and nephrotoxicity. However the current method by which acute kidney injury is diagnosed is sub-optimal and not universally accepted which impairs the accurate estimation of the true incidence of neonatal acute kidney injury. Serum Cystatin-C, urinary NGAL, KIM-1 and IL-18 are promising neonatal acute kidney injury biomarkers however the diagnosis of acute kidney injury remains serum creatinine/urine output-based in many studies...
January 11, 2017: Early Human Development
https://www.readbyqxmd.com/read/28077532/modern-hydroxyethyl-starch-and-acute-kidney-injury-after-cardiac-surgery-a-prospective-multicentre-cohort
#3
M Vives, R Callejas, P Duque, G Echarri, D N Wijeysundera, A Hernandez, A Sabate, M Bes-Rastrollo, P Monedero
BACKGROUND: Recent trials have shown hydroxyethyl starch (HES) solutions increase the risk of acute kidney injury (AKI) in critically ill patients. It is uncertain whether these adverse effects also affect surgical patients. We sought to determine the renal safety of modern tetrastarch (6% HES 130/0.4) use in cardiac surgical patients. METHODS: In this multicentre prospective cohort study, 1058 consecutive patients who underwent cardiac surgery from 15th September 2012 to 15th December 2012 were recruited in 23 Spanish hospitals...
October 2016: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28077530/impact-of-balanced-tetrastarch-raw-material-on-perioperative-blood-loss-a-randomized-double-blind-controlled-trial
#4
A Joosten, R Tircoveanu, S Arend, P Wauthy, P Gottignies, P Van der Linden
BACKGROUND: As 6% hydroxyethyl starch (HES) 130/0.40 or 130/0.42 can originate from different vegetable sources, they might have different clinical effects. The purpose of this prospective, randomized, double-blind controlled trial was to compare two balanced tetrastarch solutions, one maize-derived and one potato-derived, on perioperative blood loss in patients undergoing cardiac surgery with cardiopulmonary bypass (CPB). METHODS: We randomly assigned 118 patients undergoing elective cardiac surgery into two groups, to receive either a maize- or a potato-derived HES solution...
October 2016: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28074703/early-surgery-after-angiography-in-patients-scheduled-for-valve-replacement
#5
Victor Dayan, Roberto Stanham, Gerardo Soca, Fernando Genta, Jorge Mariño, Alvaro Lorenzo
Background There are limited data regarding the risks of cardiac surgery early after coronary angiography in patients scheduled for isolated aortic and/or mitral valve replacement. Our aim was to evaluate the risk of early surgery after coronary angiography in these patients. Methods We retrospectively analyzed data of 1044 patients who underwent isolated aortic and/or mitral valve replacement from 2006 to 2014. Baseline, operative, and postoperative variables were collected. The patients were divided into 3 groups based on the interval between coronary angiography and surgery: ≤3 days ( n = 216), 4-7 days ( n = 109), and ≥8 days ( n = 719)...
January 2017: Asian Cardiovascular & Thoracic Annals
https://www.readbyqxmd.com/read/28057030/effect-of-perioperative-sodium-bicarbonate-administration-on-renal-function-following-cardiac-surgery-for-infective-endocarditis-a-randomized-placebo-controlled-trial
#6
Jin Sun Cho, Sarah Soh, Jae-Kwang Shim, Sanghwa Kang, Haegi Choi, Young-Lan Kwak
BACKGROUND: Patients with infective endocarditis (IE) have an elevated risk of renal dysfunction because of extensive systemic inflammation and use of nephrotoxic antibiotics. In this randomized, placebo-controlled trial, we investigated whether perioperative sodium bicarbonate administration could attenuate postoperative renal dysfunction in patients with IE undergoing cardiac surgery. METHODS: Seventy patients randomly received sodium chloride (n = 35) or sodium bicarbonate (n = 35)...
January 5, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28035621/implications-of-dynamic-changes-in-mir-192-expression-in-ischemic-acute-kidney-injury
#7
Lulu Zhang, Yuan Xu, Song Xue, Xudong Wang, Huili Dai, Jiaqi Qian, Zhaohui Ni, Yucheng Yan
PURPOSE: Ischemia-reperfusion injury (IRI) is a major cause of acute kidney injury (AKI) with poor outcomes. While many important functions of microRNAs (miRNAs) have been identified in various diseases, few studies reported miRNAs in acute kidney IRI, especially the dynamic changes in their expression and their implications during disease progression. METHODS: The expression of miR-192, a specific kidney-enriched miRNA, was assessed in both the plasma and kidney of IRI rats at different time points after kidney injury and compared to renal function and kidney histological changes...
December 29, 2016: International Urology and Nephrology
https://www.readbyqxmd.com/read/28024933/a-preoperative-multimarker-approach-to-evaluate-acute-kidney-injury-after-cardiac-surgery
#8
Tone B Enger, Hilde Pleym, Roar Stenseth, Guri Greiff, Alexander Wahba, Vibeke Videm
OBJECTIVE: To investigate whether a multimarker strategy combining preoperative biomarkers representing distinct pathophysiologic pathways enhances preoperative risk assessment of acute kidney injury after cardiac surgery (CSA-AKI) and increases knowledge of underlying pathogenesis. DESIGN: Prospective, cohort study. SETTING: Single-center tertiary referral hospital. PARTICIPANTS: The study comprised 1,015 adults undergoing cardiac surgery with cardiopulmonary bypass...
October 11, 2016: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28017677/preoperative-renal-resistive-index-predicts-risk-of-acute-kidney-injury-in-patients-undergoing-cardiac-surgery
#9
Daniel Hertzberg, Simon L Ceder, Ulrik Sartipy, Kent Lund, Martin J Holzmann
OBJECTIVE: To investigate whether an elevated preoperative renal resistive index (RRI) predicts acute kidney injury (AKI) in patients undergoing cardiac surgery. DESIGN: Prospective cohort study. SETTING: University hospital. PARTICIPANTS: Cohort of 96 adult cardiac surgical patients. INTERVENTIONS: Resistive index was measurement the day before surgery. MEASUREMENTS AND MAIN RESULTS: Renal Doppler was used to measure the resistive index in renal cortical or arcuate arteries the day before surgery...
October 11, 2016: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28000751/suppression-of-nlrp3-inflammasome-activation-ameliorates-chronic-kidney-disease-induced-cardiac-fibrosis-and-diastolic-dysfunction
#10
Antoinette Bugyei-Twum, Armin Abadeh, Kerri Thai, Yanling Zhang, Melissa Mitchell, Golam Kabir, Kim A Connelly
Cardiac fibrosis is a common finding in patients with chronic kidney disease. Here, we investigate the cardio-renal effects of theracurmin, a novel formulation of the polyphenolic compound curcumin, in a rat model of chronic kidney disease. Briefly, Sprague-Dawley rats were randomized to undergo sham or subtotal nephrectomy (SNx) surgery. At 3 weeks post surgery, SNx animals were further randomized to received theracurmin via once daily oral gavage or vehicle for 5 consecutive weeks. At 8 weeks post surgery, cardiac function was assessed via echocardiography and pressure volume loop analysis, followed by LV and renal tissue collection for analysis...
December 21, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27997877/effects-of-low-dose-atrial-natriuretic-peptide-infusion-on-cardiac-surgery-associated-acute-kidney-injury-a-multicenter-randomized-controlled-trial
#11
Chieko Mitaka, Tetsu Ohnuma, Takanori Murayama, Fumio Kunimoto, Michio Nagashima, Tetsuhiro Takei, Naoya Iguchi, Makoto Tomita
PURPOSE: To evaluate the effects of atrial natriuretic peptide (ANP) on renal function and medical costs in patients with acute kidney injury (AKI) associated with cardiac surgery. MATERIALS AND METHODS: The Japanese trial for AKI in Post-cardiovascular surgery patients by ANP (JAPAN) was a prospective, multicenter, randomized, double-blind, placebo-controlled study conducted in 11 hospitals in Japan. Acute kidney injury was defined as an increase in serum creatinine of at least 0...
December 11, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/27984332/external-validation-of-predictive-models-for-acute-kidney-injury-following-cardiac-surgery-a-prospective-multicentre-cohort-study
#12
Gemma Echarri, Paula Duque-Sosa, Raquel Callejas, Nuria Garcia-Fernandez, Jorge M Nunez-Cordoba, Maria J Iribarren, Pablo Monedero
BACKGROUND: Four predictive models for acute kidney injury associated with cardiac surgery were developed by Demirjian in the United States in 2012. However, the usefulness of these models in clinical practice needs to be established in different populations independent of that used to develop the models. OBJECTIVES: Our aim was to evaluate the predictive performance of these models in a Spanish population. DESIGN: A multicentre, prospective observational study...
February 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/27979834/ciclosporin-to-protect-renal-function-in-cardiac-surgery-ciprics-a-study-protocol-for-a-double-blind-randomised-placebo-controlled-proof-of-concept-study
#13
Per Ederoth, Edgars Grins, Alain Dardashti, Björn Brondén, Carsten Metzsch, André Erdling, Shahab Nozohoor, Arash Mokhtari, Magnus J Hansson, Eskil Elmér, Lars Algotsson, Stefan Jovinge, Henrik Bjursten
INTRODUCTION: Acute kidney injury (AKI) after cardiac surgery is common and results in increased morbidity and mortality. One possible mechanism for AKI is ischaemia-reperfusion injury caused by the extracorporeal circulation (ECC), resulting in an opening of the mitochondrial permeability transition pore (mPTP) in the kidneys, which can lead to cell injury or cell death. Ciclosporin may block the opening of mPTP if administered before the ischaemia-reperfusion injury. We hypothesised that ciclosporin given before the start of ECC in cardiac surgery can decrease the degree of AKI...
December 15, 2016: BMJ Open
https://www.readbyqxmd.com/read/27965964/pulmonary-perfusion-and-ventilation-during-cardiopulmonary-bypass-are-not-associated-with-improved-postoperative-outcomes-after-cardiac-surgery
#14
Yiliam F Rodriguez-Blanco, Angela Gologorsky, Tomas Antonio Salerno, Kaming Lo, Edward Gologorsky
OBJECTIVES: Clinical trials of either pulmonary perfusion or ventilation during cardiopulmonary bypass (CBP) are equivocal. We hypothesized that to achieve significant improvement in outcomes both interventions had to be concurrent. DESIGN: Retrospective case-control study. SETTINGS: Major academic tertiary referral medical center. PARTICIPANTS: Two hundred seventy-four consecutive patients who underwent open heart surgery with CBP 2009-2013...
2016: Frontiers in Cardiovascular Medicine
https://www.readbyqxmd.com/read/27956671/defining-oliguria-during-cardiopulmonary-bypass-and-its-relationship-with-cardiac-surgery-associated-acute-kidney-injury
#15
D Hori, N M Katz, D M Fine, M Ono, V M Barodka, L C Lester, G Yenokyan, C W Hogue
BACKGROUND: While urine flow rate ≤0.5 ml kg(-1) h(-1) is believed to define oliguria during cardiopulmonary bypass (CPB), it is unclear whether this definition identifies risk for acute kidney injury (AKI) . The purpose of this retrospective study was to evaluate if urine flow rate during CPB is associated with AKI. METHODS: Urine flow rate was calculated in 503 patients during CPB. AKI in the first 48 h after surgery was defined by the Kidney Disease: Improving Global Outcomes classification...
December 2016: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/27941063/prognostic-implications-of-adding-urine-output-to-serum-creatinine-measurements-for-staging-of-acute-kidney-injury-after-major-surgery-a-cohort-study
#16
Samuel Quan, Neesh Pannu, Todd Wilson, Chad Ball, Zhi Tan, Marcello Tonelli, Brenda R Hemmelgarn, Elijah Dixon, Matthew T James
BACKGROUND: Current guidelines recommend staging acute kidney injury (AKI) according to the serum creatinine (SCr) or urine output (UO) criteria that achieve the highest stage. There is little information about the implications of adding UO to SCr measurements for staging AKI outside intensive care units and after cardiac surgery. METHODS: We performed a cohort study of all adults without end-stage renal disease who underwent major noncardiac surgery between January 2005 and March 2011 in Calgary, AB, Canada...
December 2016: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/27930561/meta-analysis-for-outcomes-of-acute-kidney-injury-after-cardiac-surgery
#17
Qiankun Shi, Liang Hong, Xinwei Mu, Cui Zhang, Xin Chen
This study aimed to investigate the outcomes of acute kidney injury (AKI) after cardiac surgery by the meta-analysis.Electronic databases PubMed and Embase were searched for relative studies from December 2008 to June 2015. For eligible studies, the R software was conducted to meta-analyze outcomes of AKI patients (AKI group) and none-AKI patients after cardiac surgery (NO AKI group). The chi-square-based Q test and I statistic were used for heterogeneity analysis. P < 0.1 or I > 50% revealed significant heterogeneity among studies, and then a random effects model was used; otherwise a fixed effect model was performed...
December 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27906706/effects-of-cardiopulmonary-bypass-on-renal-perfusion-filtration-and-oxygenation-in-patients-undergoing-cardiac-surgery
#18
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...
February 2017: 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
#19
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
#20
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
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