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Renal injury in cardiac surgery

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https://www.readbyqxmd.com/read/29672418/perioperative-use-of-levosimendan-improves-clinical-outcomes-in-patients-post-cardiac-surgery-a-systematic-review-and-meta-analysis
#1
Hua Qiang, Xiu Luo, Jian-Hua Huo, Zhi-Quan Wang
Severe postoperative complications can affect cardiac surgery patients. Levosimendan is a novel calcium sensitizer commonly administered after cardiac surgery. However, the patient benefits are controversial. PubMed, Embase, and the Cochrane library were systematically searched for randomized controlled trials (RCTs) comparing levosimendan with control in adult cardiac surgery patients. Twenty-five studies (3247 patients) were included. Pooled data indicated that levosimendan reduced mortality after cardiac surgery (OR 0...
April 3, 2018: Journal of Cardiovascular Pharmacology
https://www.readbyqxmd.com/read/29628586/postoperative-cardiac-surgery-outcomes-in-a-statin-native-population
#2
Sameh Aboulnaga, Ahmed Mahfouz, Hesham A Ewila, Alejandro Kohn Tuli, Rajvir Singh, Amr S Omar, Abdulaziz Al Khualifi
Background: Statin utilization had been associated with improved survival after cardiac surgery. We aim to study whether perioperative treatment with statin could be associated with increased postoperative complications. Design: This was a retrospective, descriptive, single-center study. Settings: We analyzed morbidity after cardiac surgery as well as the outcome related to statin therapy in a tertiary cardiac center. Patients: A total of 202 consecutive patients were enrolled over 1 year after cardiac surgery...
January 2018: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29614507/renoprotective-postoperative-monitoring-what-is-the-best-method-for-computing-renal-perfusion-pressure-an-observational-prospective-multicentre-study
#3
Csaba Kopitko, Laszlo Medve, Tibor Gondos
BACKGROUND: Low mean arterial pressure (MAP) is a well-known risk factor for postoperative acute kidney injury (AKI), but probably it is not the sole hemodynamic parameter that can influence the development of renal failure. There are data in cardiac patients supporting the role of renal venous congestion in the development of AKI. The aim of our study was to determine a combination of factors best predicting the development of AKI. METHODS: Data were collected prospectively for adult patients admitted after major abdominal surgery to 9 Hungarian intensive care units...
April 3, 2018: Nephron
https://www.readbyqxmd.com/read/29613817/acute-kidney-injury-after-non-cardiovascular-surgery-risk-factors-and-impact-on-development-of-chronic-kidney-disease-and-long-term-mortality
#4
Leili Pourafkari, Pradeep Arora, Jahan Porhomayon, Hasan H Dosluoglu, Preksha Arora, Nader D Nader
OBJECTIVE: To identify factors associated with acute kidney injury (AKI) and its progression to chronic kidney disease (CKD) in a non-cardiac/non-vascular surgery setting. METHODS: We examined Veterans Affairs Surgical Quality database for surgical entries between 2000-2014. Demographics, comorbidities, laboratory findings and hospital outcomes were assessed. Primary endpoint was occurrence of AKI defined as increase of ≥0.3 mg/dL, 48 hours postoperatively...
April 3, 2018: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/29601328/statin-loading-in-cardiovascular-surgery-never-too-early-to-treat
#5
Niki Katsiki, Filippos Triposkiadis, Athanasios D Giannoukas, Dimitri P Mikhailidis
PURPOSE OF REVIEW: The effects of statin loading before, during or after vascular interventions on cardiovascular and renal outcomes are discussed. Furthermore, the selection of optimal statin type and dose, according to current evidence or guidelines, is considered. The importance of treating statin intolerance and avoiding statin discontinuation is also discussed. RECENT FINDINGS: Statin loading has been shown to beneficially affect cardiovascular outcomes, total mortality and/or contrast-induced acute kidney injury, in patients undergoing vascular procedures such as percutaneous coronary intervention (PCI), coronary artery bypass grafting (CABG), carotid endarterectomy (CEA), carotid artery stenting, endovascular aneurysm repair, open abdominal aortic aneurysms (AAA) repair and lower extremities vascular interventions...
March 29, 2018: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/29581218/ripheart-remote-ischemic-preconditioning-for-heart-surgery-study-myocardial-dysfunction-postoperative-neurocognitive-dysfunction-and-1-year-follow-up
#6
Patrick Meybohm, Madeline Kohlhaas, Christian Stoppe, Matthias Gruenewald, Jochen Renner, Berthold Bein, Martin Albrecht, Jochen Cremer, Mark Coburn, Gereon Schaelte, Andreas Boening, Bernd Niemann, Michael Sander, Jan Roesner, Frank Kletzin, Haitham Mutlak, Sabine Westphal, Rita Laufenberg-Feldmann, Marion Ferner, Ivo F Brandes, Martin Bauer, Sebastian N Stehr, Andreas Kortgen, Maria Wittmann, Georg Baumgarten, Tanja Meyer-Treschan, Peter Kienbaum, Matthias Heringlake, Julika Schoen, Sascha Treskatsch, Thorsten Smul, Ewa Wolwender, Thomas Schilling, Georg Fuernau, Holger Bogatsch, Oana Brosteanu, Dirk Hasenclever, Kai Zacharowski
BACKGROUND: Remote ischemic preconditioning (RIPC) has been suggested to protect against certain forms of organ injury after cardiac surgery. Previously, we reported the main results of RIPHeart (Remote Ischemic Preconditioning for Heart Surgery) Study, a multicenter trial randomizing 1403 cardiac surgery patients receiving either RIPC or sham-RIPC. METHODS AND RESULTS: In this follow-up paper, we present 1-year follow-up of the composite primary end point and its individual components (all-cause mortality, myocardial infarction, stroke and acute renal failure), in a sub-group of patients, intraoperative myocardial dysfunction assessed by transesophageal echocardiography and the incidence of postoperative neurocognitive dysfunction 5 to 7 days and 3 months after surgery...
March 26, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29580796/effect-of-levosimendan-on-renal-outcome-in-cardiac-surgery-patients-with-chronic-kidney-disease-and-perioperative-cardiovascular-dysfunction-a-substudy-of-a-multicenter-randomized-trial
#7
Alberto Zangrillo, Gabriele Alvaro, Alessandro Belletti, Antonio Pisano, Luca Brazzi, Maria G Calabrò, Fabio Guarracino, Tiziana Bove, Evgeny V Grigoryev, Fabrizio Monaco, Vladimir A Boboshko, Valery V Likhvantsev, Anna M Scandroglio, Gianluca Paternoster, Rosalba Lembo, Samuele Frassoni, Marco Comis, Vadim V Pasyuga, Paolo Navalesi, Vladimir V Lomivorotov
OBJECTIVE: Acute kidney injury (AKI) occurs frequently after cardiac surgery. Levosimendan might reduce the incidence of AKI in patients undergoing cardiac surgery. The authors investigated whether levosimendan administration could reduce AKI incidence in a high-risk cardiac surgical population. DESIGN: Post hoc analysis of a multicenter randomized trial. SETTING: Cardiac surgery operating rooms and intensive care units of 14 centers in 3 countries...
February 26, 2018: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29576405/a-propensity-matched-comparison-of-fenestrated-endovascular-aneurysm-repair-and-open-surgical-repair-of-pararenal-and-paravisceral-aortic-aneurysms
#8
Giovanni Tinelli, Maria Antonietta Crea, Chiara de Waure, Gian Luca Di Tanna, Jean-Pierre Becquemin, Jonathan Sobocinski, Francesco Snider, Stéphan Haulon
OBJECTIVE: This study investigated the outcomes of a current series of patients treated with fenestrated and branched endovascular aneurysm repair (F-BEVAR) or open surgical repair (OSR) for pararenal abdominal aortic aneurysms (pr-AAAs), including juxtarenal, suprarenal, and type IV thoracoabdominal aneurysms. This study compares the outcomes of these procedures from two high-volume centers without the bias induced by a learning curve. METHODS: All patients with pr-AAAs undergoing repair at two centers between January 2010 and June 2016 were included in a prospective database...
March 22, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29559751/circulating-and-urinary-mir-210-and-mir-16-increase-during-cardiac-surgery-using-cardiopulmonary-bypass-a-pilot-study
#9
Annette L Mazzone, Robert A Baker, Kym McNicholas, Richard J Woodman, Michael Z Michael, Jonathan M Gleadle
A pilot study to measure and compare blood and urine microRNAs miR-210 and miR-16 in patients undergoing cardiac surgery with cardiopulmonary bypass (CPB) and off-pump coronary artery bypass grafting surgery. Frequent serial blood and urine samples were taken from patients undergoing cardiac surgery with CPB (n = 10) and undergoing off-pump cardiac surgery (n = 5) before, during, and after surgery. Circulating miR-210 and miR-16 levels were determined by relative quantification real-time polymerase chain reaction...
March 2018: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/29548590/predicting-kidney-disease-progression-in-patients-with-acute-kidney-injury-after-cardiac-surgery
#10
K Annette Mizuguchi, Chuan-Chin Huang, Ian Shempp, Justin Wang, Prem Shekar, Gyorgy Frendl
OBJECTIVE: The study objective was to identify patients who are likely to develop progressive kidney dysfunction (acute kidney disease) before their hospital discharge after cardiac surgery, allowing targeted monitoring of kidney function in this at-risk group with periodic serum creatinine measurements. METHODS: Risks of progression to acute kidney disease (a state in between acute kidney injury and chronic kidney disease) were modeled from acute kidney injury stages (Kidney Disease: Improving Global Outcomes) in patients undergoing cardiac surgery...
February 17, 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29547923/urinary-hypoxia-an-intraoperative-marker-of-risk-of-cardiac-surgery-associated-acute-kidney-injury
#11
Michael Z L Zhu, Andrew Martin, Andrew D Cochrane, Julian A Smith, Amanda G Thrift, Gerard K Harrop, Jennifer P Ngo, Roger G Evans
Background: Acute kidney injury (AKI) is common after cardiac surgery and profoundly affects postoperative mortality and morbidity. There are no validated methods to assess risk of AKI intraoperatively. Methods: We determined the association between postoperative AKI and intraoperative urinary oxygen tension (PO2), measured via a fiber optic probe in the tip of the urinary catheter, in 65 patients undergoing high-risk cardiac surgery requiring cardiopulmonary bypass (CPB)...
March 14, 2018: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/29540648/acute-kidney-injury-in-a-case-of-purpura-fulminans-developing-secondary-to-antithrombin-3-deficiency
#12
Gülsüm Özkan, Gaye Kübra Emeksiz, Reşit Volkan Atar, Samet Sedef, Pınar Sonat Kara, Meltem Öznur, Burhan Turgut
Purpura fulminans associated with antithrombin 3 (AT 3) deficiency is very rare in adults and neonates. It can be categorized into three principal forms - neonatal, idiopathic and acute infectious. Purpura fulminans has been reported to cause cardiac, pulmonary and renal damage in rare cases. We describe an adult case of purpura fulminans developing in association with AT 3 deficiency without infection following a surgical procedure, and acute kidney injury (AKI) developing secondary to rhabdomyolysis and disseminated intravascular coagulation (DIC)...
2018: Journal of Nippon Medical School, Nippon Ika Daigaku Zasshi
https://www.readbyqxmd.com/read/29535139/preoperative-short-term-calorie-restriction-for-prevention-of-acute-kidney-injury-after-cardiac-surgery-a-randomized-controlled-open-label-pilot-trial
#13
Franziska Grundmann, Roman-Ulrich Müller, Annika Reppenhorst, Lennart Hülswitt, Martin R Späth, Torsten Kubacki, Maximilian Scherner, Michael Faust, Ingrid Becker, Thorsten Wahlers, Bernhard Schermer, Thomas Benzing, Volker Burst
BACKGROUND: Acute kidney injury is a frequent complication after cardiac surgery and is associated with adverse outcomes. Although short-term calorie restriction (CR) has proven protective in rodent models of acute kidney injury, similar effects have not yet been demonstrated in humans. METHODS AND RESULTS: CR_KCH (Effect of a Preoperative Calorie Restriction on Renal Function After Cardiac Surgery) is a randomized controlled trial in patients scheduled for cardiac surgery...
March 13, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29529338/pre-operative-anaemia-intra-operative-hepcidin-concentration-and-acute-kidney-injury-after-cardiac-surgery-a-retrospective-observational-study
#14
K Karkouti, P Yip, C Chan, L Chawla, V Rao
Acute kidney after cardiac surgery is more common in anaemic patients, whereas haemolysis during cardiopulmonary bypass may lead to iron-induced renal injury. Hepcidin promotes iron sequestration by macrophages: hepcidin concentration is reduced by anaemia and increased by inflammation. We analysed the associations in 525 patients between pre-operative anaemia (haemoglobin < 130 g.l-1 in men and < 120 g.l-1 in women), intra-operative hepcidin concentration and acute kidney injury (dialysis or > 26...
March 12, 2018: Anaesthesia
https://www.readbyqxmd.com/read/29517549/renal-blood-flow-glomerular-filtration-rate-and-renal-oxygenation-in-early-clinical-septic-shock
#15
Jenny Skytte Larsson, Vitus Krumbholz, Anders Enskog, Gudrun Bragadottir, Bengt Redfors, Sven-Erik Ricksten
OBJECTIVE: Data on renal hemodynamics, function, and oxygenation in early clinical septic shock are lacking. We therefore measured renal blood flow, glomerular filtration rate, renal oxygen consumption, and oxygenation in patients with early septic shock. DESIGN: Prospective comparative study. SETTING: General and cardiothoracic ICUs. PATIENTS: Patients with norepinephrine-dependent early septic shock (n = 8) were studied within 24 hours after arrival in the ICU and compared with postcardiac surgery patients without acute kidney injury (comparator group, n = 58)...
March 6, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29511889/kidney-injury-biomarkers-5-years-after-aki-due-to-pediatric-cardiac-surgery
#16
Jason H Greenberg, Prasad Devarajan, Heather R Thiessen-Philbrook, Catherine Krawczeski, Chirag R Parikh, Michael Zappitelli
BACKGROUND: We previously reported that children undergoing cardiac surgery are at high risk for long-term chronic kidney disease (CKD) and hypertension, although postoperative acute kidney injury (AKI) is not a risk factor for worse long-term kidney outcomes. We report here our evaluation of renal injury biomarkers 5 years after cardiac surgery to determine whether they are associated with postoperative AKI or long-term CKD and hypertension. METHODS: Children aged 1 month to 18 years old undergoing cardiopulmonary bypass were recruited to this prospective cohort study...
March 6, 2018: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
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
#17
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
#18
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
#19
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
#20
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
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