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https://www.readbyqxmd.com/read/28423997/do-lipid-microemboli-induce-acute-kidney-injury-during-cardiopulmonary-bypass
#1
Richard Issitt, Tim James, Bronagh Walsh, David Voegeli
BACKGROUND: Acute kidney injury (AKI) following cardiopulmonary bypass affects 5% of patients, representing significant postoperative morbidity and mortality. Animal models have shown an increased uptake of lipid microemboli (LME) into the renal vasculature, potentially indicating ischaemic causation. This study tested a new lipid filtration system (RemoweLL) against a conventional system with no lipid-depleting capacity to determine the efficacy of the filtration system and its effects on renal function...
April 1, 2017: Perfusion
https://www.readbyqxmd.com/read/28412020/cardiac-surgery-in-patients-with-congenital-heart-disease-is-associated-with-acute-kidney-injury-and-the-risk-of-chronic-kidney-disease
#2
Nicolas L Madsen, Stuart L Goldstein, Trine Frøslev, Christian F Christiansen, Morten Olsen
Cardiac surgery associated-acute kidney injury (CS-AKI) occurs in 30-50% of patients undergoing surgery for congenital heart disease. Here we determine if CS-AKI is associated with chronic kidney disease (CKD) in patients with congenital heart disease. Using Danish regional population-based registries, our cohort study included patients with congenital heart disease born between 1990-2010 with first cardiac surgery between 2005 and 2010 (under 15 years of age). Utilizing in- and out-patient laboratory serum creatinine data, we identified individuals fulfilling KDIGO stages of AKI within 5 days of cardiac surgery...
April 12, 2017: Kidney International
https://www.readbyqxmd.com/read/28407819/-association-between-fluid-overload-and-acute-renal-injury-after-congenital-heart-disease-surgery-in-infants
#3
De-Qiang Luo, Zi-Li Chen, Wei Dai, Feng Chen
OBJECTIVE: To study the association between fluid overload and acute kidney injury (AKI) after congenital heart disease surgery in infants. METHODS: A retrospective analysis was performed on 88 infants aged less than 6 months who underwent a radical surgery for congenital heart disease. The treatment outcomes were compared between the infants with AKI after surgery and those without. The effect of cumulative fluid overload on treatment outcomes 2 days after surgery was analyzed...
April 2017: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
https://www.readbyqxmd.com/read/28406186/renin-angiotensin-system-inhibitor-is-associated-with-lower-risk-of-ensuing-chronic-kidney-disease-after-functional-recovery-from-acute-kidney-injury
#4
Yu-Hsiang Chou, Tao-Min Huang, Szu-Yu Pan, Chin-Hao Chang, Chun-Fu Lai, Vin-Cent Wu, Ming-Shiou Wu, Kwan-Dun Wu, Tzong-Shinn Chu, Shuei-Liong Lin
Acute kidney injury (AKI) is an independent risk factor for ensuing chronic kidney disease (CKD). Animal studies have demonstrated that renin-angiotensin system (RAS) inhibitor can reduce ensuing CKD after functional recovery from AKI. Here we study the association between ensuing CKD and use of RAS inhibitor including angiotensin converting enzyme inhibitor or angiotensin II type 1a receptor blocker starting after renal functional recovery in our prospectively collected observational AKI cohort. Adult patients who had cardiac surgery-associated AKI (CSA-AKI) are studied...
April 13, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28395663/renal-function-and-oxygenation-are-impaired-early-after-liver-transplantation-despite-hyperdynamic-systemic-circulation
#5
Jenny Skytte Larsson, Gudrun Bragadottir, Bengt Redfors, Sven-Erik Ricksten
BACKGROUND: Acute kidney injury (AKI) occurs frequently after liver transplantation and is associated with the development of chronic kidney disease and increased mortality. There is a lack of data on renal blood flow (RBF), oxygen consumption, glomerular filtration rate (GFR) and renal oxygenation, i.e. the renal oxygen supply/demand relationship, early after liver transplantation. Increased insight into the renal pathophysiology after liver transplantation is needed to improve the prevention and treatment of postoperative AKI...
April 11, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28389482/what-are-the-risks-and-benefits-of-temporarily-discontinuing-medications-to-prevent-acute-kidney-injury-a-systematic-review-and-meta-analysis
#6
Penny Whiting, Andrew Morden, Laurie A Tomlinson, Fergus Caskey, Thomas Blakeman, Charles Tomson, Tracey Stone, Alison Richards, Jelena Savović, Jeremy Horwood
OBJECTIVES: To summarise evidence on temporary discontinuation of medications to prevent acute kidney injury (AKI). DESIGN: Systematic review and meta-analysis of randomised and non-randomised studies. PARTICIPANTS: Adults taking diuretics, ACE inhibitors (ACEI), angiotensin receptor blockers (ARB), direct renin inhibitors, non-steroidal anti-inflammatories, metformin or sulfonylureas, experiencing intercurrent illnesses, radiological or surgical procedures...
April 7, 2017: BMJ Open
https://www.readbyqxmd.com/read/28382566/kinetics-of-the-cell-cycle-arrest-biomarkers-timp-2-igfbp-7-for-prediction-of-acute-kidney-injury-in-infants-after-cardiac-surgery
#7
Katja M Gist, Stuart L Goldstein, Julia Wrona, Jeffrey A Alten, Rajit K Basu, David S Cooper, Danielle E Soranno, Jane Duplantis, Christopher Altmann, Zhiqian Gao, Sarah Faubel
BACKGROUND: Tissue inhibitor metalloproteinase-2 (TIMP-2) and insulin-like growth factor binding protein-7 (IGFBP-7) are cell-cycle arrest biomarkers that have been shown to be predictive of acute kidney injury (AKI) in critically ill adults. AKI affects a large proportion (40%) of children following cardiac surgery. The aim of this study was to describe the kinetics of TIMP-2*IGFBP-7 and test its ability to predict AKI in infants following cardiac surgery. METHODS: A multicenter prospective study was performed in infants undergoing cardiac surgery with cardiopulmonary bypass (CPB) from October 2013 to January 2015...
April 5, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28380638/when-is-a-meta-analysis-conclusive-a-guide-to-trial-sequential-analysis-with-an-example-of-remote-ischemic-preconditioning-for-renoprotection-in-patients-undergoing-cardiac-surgery
#8
Pavel S Roshanov, Brittany B Dennis, Nicholas Pasic, Amit X Garg, Michael Walsh
Regardless of whether a randomized trial finds a statistically significant effect for an intervention or not, readers often wonder if the trial was large enough to be conclusive. To answer this question, we can estimate the required sample size for a trial by considering how commonly the outcome occurs, the smallest effect of clinical importance and the acceptable risk of falsely detecting or rejecting that effect. But when is a meta-analysis conclusive? We explain and illustrate the interpretation of Trial Sequential Analysis (TSA), a method increasingly used to answer this question...
April 1, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28371878/differences-in-acute-kidney-injury-ascertainment-for-clinical-and-preclinical-studies
#9
Marco Fiorentino, Giuseppe Castellano, John A Kellum
Background: . Acute kidney injury (AKI) is a common clinical condition directly associated with adverse outcomes. Several AKI biomarkers have been discovered, but their use in clinical and preclinical studies has not been well examined. This study aims to investigate the differences between clinical and preclinical studies on AKI biomarkers. Methods: . We performed a systematic review of clinical and preclinical interventional studies that considered AKI biomarkers in enrollment criteria and/or outcome assessment and described the main differences according to their setting, the inclusion of biomarkers in the definition of AKI and the use of biomarkers as primary or secondary end points...
March 23, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28343236/effects-of-restricting-perioperative-use-of-intravenous-chloride-on-kidney-injury-in-patients-undergoing-cardiac-surgery-the-licra-pragmatic-controlled-clinical-trial
#10
David McIlroy, Deirdre Murphy, Jessica Kasza, Dhiraj Bhatia, Lisa Wutzlhofer, Silvana Marasco
PURPOSE: The administration of chloride-rich intravenous (IV) fluid and hyperchloraemia have been associated with perioperative renal injury. The aim of this study was to determine whether a comprehensive perioperative protocol for the administration of chloride-limited IV fluid would reduce perioperative renal injury in adults undergoing cardiac surgery. METHODS: From February 2014 through to December 2015, all adult patients undergoing cardiac surgery within a single academic medical center received IV fluid according to the study protocol...
March 25, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28329336/remote-ischaemic-preconditioning-reduces-acute-kidney-injury-in-adult-patients-undergoing-cardiac-surgery-with-cardiopulmonary-bypass-a-meta-analysis
#11
Bin Yi, Xiang Chen, Han Shi, Tiao Lin, Haifeng Lin, Yi Xu, Jian Rong
This article represents the first attempt to perform a pooled analysis about remote ischaemic preconditioning (RIPC) in reduction of acute kidney injury (AKI) of adult patients undergoing cardiac surgery with cardiopulmonary bypass (CPB). A systematic search was performed using PubMed (1966-5 January 2016), the Cochrane Library (1996-5 January 2016), the Web of Science (1986-5 January 2016) and Chinese database (SinoMed) (1978-5 January 2016) to identify studies that have described the effect of RIPC on AKI in adult patients undergoing cardiac surgery with CPB...
April 1, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28303771/epidemiology-and-outcome-of-acute-kidney-injury-in-children-a-single-center-study
#12
Werner Keenswijk, Jill Vanmassenhove, Ann Raes, Evelyn Dhont, Johan VandeWalle
BACKGROUND: Information on the epidemiology of Acute Kidney Injury (AKI) in children is scarce. We performed a single center retrospective cohort study to analyze the incidence of AKI, the male/female ratio, the underlying etiology, and age at presentation. We also aimed to assess outcome measured by mortality, duration of PICU stay, and development of Chronic Kidney Disease (CKD). METHODS: Records were searched for children presenting with or developing AKI between 1st January 2008 and 1st January 2015...
March 17, 2017: Acta Clinica Belgica
https://www.readbyqxmd.com/read/28303021/age-and-surgical-complexity-impact-on-renoprotection-by-remote-ischemic-preconditioning-during-adult-cardiac-surgery-a-meta-analysis
#13
Chenghui Zhou, Heerajnarain Bulluck, Nengxin Fang, Lihuan Li, Derek J Hausenloy
We aimed to conduct an up-to-date meta-analysis to comprehensively assess the renoprotective effect of remote ischemic preconditioning (RIPC) in patients undergoing adult cardiac surgery. 21 randomized controlled trials (RCTs) with a total of 6302 patients were selected and identified. Compared with controls, RIPC significantly reduced the incidence of acute kidney injury (AKI) [odds ratio (OR) = 0.79; P = 0.02; I(2) = 38%], and in particular, AKI stage I (OR = 0.65; P = 0.01; I(2) = 55%)...
March 16, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28302078/early-serum-creatinine-accurately-predicts-acute-kidney-injury-post-cardiac-surgery
#14
Keren Grynberg, Kevan R Polkinghorne, Sharon Ford, Fiona Stenning, Thomas E Lew, Jonathan A Barrett, Shaun A Summers
BACKGROUND: Acute Kidney Injury (AKI) is a well recognized complication of cardiac surgery. It is associated with significant morbidity and mortality. The aims of our study are twofold; 1. To define the incidence of AKI post cardiac surgery. 2. To identify pre-morbid and operative risk factors for developing AKI and to determine if immediate post operative serum creatinine (IPOsCr) accurately predicts the development of AKI. METHODS: We prospectively studied 196 consecutive patients undergoing elective (on-pump) cardiac surgery...
March 16, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28271319/erratum-to-prevention-of-cardiac-surgery-associated-aki-by-implementing-the-kdigo-guidelines-in-high-risk-patients-identified-by-biomarkers-the-prevaki-randomized-controlled-trial
#15
Melanie Meersch, Christoph Schmidt, Andreas Hoffmeier, Hugo Van Aken, Carola Wempe, Joachim Gerss, Alexander Zarbock
No abstract text is available yet for this article.
March 7, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28251598/diagnosis-of-cardiac-surgery-associated-acute-kidney-injury-differential-roles-of-creatinine-chitinase-3-like-protein-1-and-neutrophil-gelatinase-associated-lipocalin-a-prospective-cohort-study
#16
Jorien De Loor, Ingrid Herck, Katrien Francois, Astrid Van Wesemael, Lieve Nuytinck, Evelyne Meyer, Eric A J Hoste
BACKGROUND: A common and serious complication of cardiac surgery prompting early detection and intervention is cardiac surgery-associated acute kidney injury (CSA-AKI). Urinary chitinase 3-like protein 1 (UCHI3L1) was found to predict AKI associated with critical illness in adults. Our aims were therefore to evaluate whether UCHI3L1 can also be used to predict AKI associated with elective cardiac surgery in adults, and to compare this predictive ability with that of urinary neutrophil gelatinase-associated lipocalin (UNGAL), more frequently assessed early serum creatinine (SCr) measurements, and various two-biomarker panels...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28243862/preoperative-exercise-capacity-is-associated-with-the-prevalence-of-postoperative-delirium-in-elective-cardiac-surgery
#17
Masato Ogawa, Kazuhiro P Izawa, Seimi Satomi-Kobayashi, Aki Kitamura, Yasunori Tsuboi, Kodai Komaki, Rei Ono, Yoshitada Sakai, Hiroshi Tanaka, Yutaka Okita
BACKGROUND: Postoperative delirium (POD) is a critical complication that is closely associated with mortality and major morbidity in elective cardiac surgery. The identification of patients at risk for POD is crucial but has not been fully explored. AIMS: The aim of this study was to determine the predictive value of the assessment of preoperative exercise capacity for POD. METHODS: We enrolled 313 consecutive patients (mean age, 68.6 ± 14...
February 28, 2017: Aging Clinical and Experimental Research
https://www.readbyqxmd.com/read/28242291/preoperative-statin-treatment-for-the-prevention-of-acute-kidney-injury-in-patients-undergoing-cardiac-surgery-a-meta-analysis-of-randomised-controlled-trials
#18
Bo Xiong, Dan Nie, Yin Cao, Yanke Zou, Yuanqing Yao, Jun Qian, Shunkang Rong, Jing Huang
BACKGROUND: The effect of preoperative statin treatment (PST) on the risk of postoperative acute kidney injury (AKI) after cardiac surgery remains controversial. We performed a meta-analysis of randomised controlled trials (RCT) to investigate whether PST could improve the renal outcomes in patients undergoing cardiac surgery. METHODS: We conducted a comprehensive search on PubMed, Embase and Cochrane Central Register of Controlled Trials. Randomised controlled trials which reported incidence of AKI and renal replacement treatment (RRT), mean change of serum creatine (SCr) and C-reactive protein (CRP), length of stay in intensive care unit (LOS-ICU) and hospital (LOS-HOS) were included...
February 13, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28237986/relationship-among-mortality-of-patients-with-acute-kidney-injury-after-cardiac-surgery-fluid-balance-and-ultrafiltration-of-renal-replacement-therapy-an-observational-study
#19
Buyun Wu, Jian Sun, Si Liu, Xiangbao Yu, Yamei Zhu, Huijuan Mao, Changying Xing
BACKGROUND/AIMS: The study aimed to investigate the relationship among mortality of patients with cardiac surgery-associated acute kidney injury (CSA-AKI), fluid balance, and ultrafiltration of renal replacement therapy (RRT). METHODS: From January 2009 to October 2015, hospitalized patients with CSA-AKI receiving continuous or prolonged intermittent RRT were screened. The effects of fluid balance and ultrafiltration of RRT on clinical outcome were analyzed. RESULTS: The 30-day mortality of all the 63 patients in the study was 58...
2017: Blood Purification
https://www.readbyqxmd.com/read/28225801/perioperative-hemoglobin-area-under-the-curve-is-an-independent-predictor-of-renal-failure-after-cardiac-surgery-results-from-a-spanish-multicenter-retrospective-cohort-study
#20
Paula Duque-Sosa, Diego Martínez-Urbistondo, Gemma Echarri, Raquel Callejas, María Josefa Iribarren, Gregorio Rábago, Pablo Monedero
Perioperative anemia is an important risk factor for cardiac surgery-associated acute kidney injury (CSA-AKI). Nonetheless, the severity of the anemia and the time in the perioperative period in which the hemoglobin level should be considered as a risk factor is conflicting. The present study introduces the concept of perioperative hemoglobin area under the curve (pHb-AUC) as a surrogate marker of the evolution of perioperative hemoglobin concentration. Through a retrospective analysis of prospectively collected data, we assessed this new variable as a risk factor for the development of acute kidney injury after cardiac surgery in 966 adult patients who underwent cardiac surgery with cardiopulmonary bypass, at twenty-three academic hospitals in Spain...
2017: PloS One
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