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Aki cardiac surgery

Arne Ring, Tom Morris, Marcin Wozniak, Nikol Sullo, William Dott, Veerle Verheyden, Tracy Kumar, Nigel Brunskill, Rakesh Vaja, Gavin J Murphy
BACKGROUND: Acute kidney injury (AKI) is a common and severe complication of cardiac surgery. There is no effective prevention or treatment. Sildenafil citrate (Revatio®, Pfizer Inc), a phosphodiesterase type 5 inhibitor, prevents post cardiac surgery AKI in pre-clinical studies, however its use is contraindicated in patients with symptomatic cardiovascular disease. METHODS: To assess the safety and pharmacokinetics of intravenous sildenafil in cardiac surgery patients we conducted an open label, dose escalation study with 6 patients per dose level...
October 25, 2016: British Journal of Clinical Pharmacology
Shurong Li, Shufang Fu, Yichen Xiao, Gaosi Xu
Acute kidney injury (AKI) is a common and severe complication of cardiac surgery, and related rates of both hospitalization and long-term mortality are increasing. A number of studies have explored the preventive effects of perioperative pharmacological therapy on AKI after cardiac surgery. However, the mechanisms of AKI are multifaceted, and no universal treatment has been confirmed as beneficial. We review and analyze several current perioperative pharmacological therapies for AKI after cardiac surgery to identify promising preventive strategies...
October 22, 2016: American Journal of Cardiovascular Drugs: Drugs, Devices, and Other Interventions
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
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
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
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
Henrique Palomba, Isac Castro, Luis Yu, Emmanuel A Burdmann
BACKGROUND: Acute kidney injury (Dasta et al., Nephrol Dial Transplant 23(6):1970-1974, 2008) following cardiac surgery is associated with higher perioperative morbidity and mortality, but its impact on long term development of chronic kidney disease (CKD) is uncertain. METHODS: A total of 350 patients submitted to elective cardiac surgery were evaluated for AKI, defined as an increase in serum creatinine (SCr) ≥ 0.3 mg/dL over baseline value. Univariate and multivariate analysis were used to study pre, intra and postoperative parameters associated with occurrence CKD after 12 months of follow-up...
October 4, 2016: Journal of Nephrology
T Velasquez, G Mackey, J Lusk, U G Kyle, T Fontenot, P Marshall, L S Shekerdemian, J A Coss-Bu, A Nishigaki, T Yatabe, T Tamura, K Yamashita, M Yokoyama, J C Ruiz-Rodriguez, B Encina, R Belmonte, I Troncoso, P Tormos, M Riveiro, J Baena, A Sanchez, J Bañeras, J Cordón, N Duran, A Ruiz, J Caballero, X Nuvials, J Riera, J Serra, A M F Rutten, S N M van Ieperen, E P H M Der Kinderen, T Van Logten, L Kovacikova, P Skrak, M Zahorec, U G Kyle, A Akcan-Arikan, J C Silva, G Mackey, J Lusk, M Goldsworthy, L S Shekerdemian, J A Coss-Bu, D Wood, D Harrison, R Parslow, P Davis, J Pappachan, S Goodwin, P Ramnarayan, S Chernyshuk, H Yemets, V Zhovnir, S M Pulitano', S De Rosa, A Mancino, G Villa, F Tosi, P Franchi, G Conti, B Patel, H Khine, A Shah, D Sung, L Singer, S Haghbin, S Inaloo, Z Serati, M Idei, T Nomura, N Yamamoto, Y Sakai, T Yoshida, Y Matsuda, Y Yamaguchi, S Takaki, O Yamaguchi, T Goto, N Longani, S Medar, I R Abdel-Aal, A S El Adawy, H M E H Mohammed, A N Mohamed, S M Parry, L D Knight, L Denehy, N De Morton, C E Baldwin, D Sani, G Kayambu, V Z M da Silva, P Phongpagdi, Z A Puthucheary, C L Granger, J E Rydingsward, C M Horkan, K B Christopher, D McWilliams, C Jones, E Reeves, G Atkins, C Snelson, L M Aitken, J Rattray, J Kenardy, A M Hull, A Ullman, R Le Brocque, M Mitchell, C Davis, B Macfarlane, J C Azevedo, L L Rocha, F F M De Freitas, A M Cavalheiro, N M Lucinio, M S Lobato, G Ebeling, A Kraegpoeth, E Laerkner, I De Brito-Ashurst, C White, S Gregory, L G Forni, E Flowers, A Curtis, C A Wood, K Siu, K Venkatesan, J B H Muhammad, L Ng, E Seet, N Baptista, A Escoval, E Tomas, R Agrawal, R Mathew, A Varma, E Dima, E Charitidou, E Perivolioti, M Pratikaki, C Vrettou, A Giannopoulos, S Zakynthinos, C Routsi, E Atchade, S Houzé, S Jean-Baptiste, G Thabut, C Genève, S Tanaka, B Lortat-Jacob, P Augustin, M Desmard, P Montravers, F J González de Molina, S Barbadillo, R Alejandro, F Álvarez-Lerma, J Vallés, R M Catalán, E Palencia, A Jareño, R M Granada, M L Ignacio, N Cui, D Liu, H Wang, L Su, H Qiu, R Li, K Jaffal, A Rouzé, J Poissy, B Sendid, S Nseir, E Paramythiotou, M Rizos, F Frantzeskaki, A Antoniadou, S Vourli, L Zerva, A Armaganidis, J Riera, J Gottlieb, M Greer, O Wiesner, M Martínez, M Acuña, J Rello, T Welte, E Atchade, T Mignot, S Houzé, S Jean-Baptiste, G Thabut, B Lortat-Jacob, S Tanaka, P Augustin, M Desmard, P Montravers, S Soussi, E Dudoignon, A Ferry, M Chaussard, M Benyamina, A Alanio, S Touratier, M Chaouat, M Lafaurie, M Mimoun, A Mebazaa, M Legrand, M A Sheils, C Patel, L Mohankumar, N Akhtar, S K Pacheco Noriega, N Navarrete Aldana, J L Ávila León, J Durand Baquero, F Fernández Bernal, E Ahmadnia, J S Hadley, M Millar, D Hall, H Hewitt, H Yasuda, M Sanui, T Komuro, S Kawano, K Andoh, H Yamamoto, E Noda, J Hatakeyama, N Saitou, H Okamoto, A Kobayashi, T Takei, S Matsukubo, H B Rotzel, A Serrano Lázaro, D Aguillón Prada, M Rodriguez Gimillo, O Diaz Barinas, M L Blasco Cortes, J Ferreres Franco, J M Segura Roca, A Carratalá, B Gonçalves, R Turon, A Mendes, F Miranda, P J Mata, D Cavalcanti, N Melo, P Lacerda, P Kurtz, C Righy, L E de la Cruz Rosario, S P Gómez Lesmes, J C García Romero, A N García Herrera, E D Díaz Pertuz, M J Gómez Sánchez, E Regidor Sanz, J Barado Hualde, A Ansotegui Hernández, J M Guergué Irazabal, V Spatenkova, O Bradac, P Suchomel, T Urli, E Heusch Lazzeri, R Aspide, M Zanello, L Perez-Borrero, J M Garcia-Alvarez, M D Arias-Verdu, E Aguilar-Alonso, R Rivera-Fernandez, J Mora-Ordoñez, C De La Fuente-Martos, E Castillo-Lorente, F Guerrero-Lopez, S P Gómez Lesmes, L E De la Cruz Rosario, E D Díaz Pertuz, A Ansotegui Hernández, J C García Romero, M J Gómez Sánchez, A N García Herrera, J Roldán Ramírez, E Regidor Sanz, J Barado Hualde, J P Tirapu León, L Navarro-Guillamón, S Cordovilla-Guardia, A Iglesias-Santiago, F Guerrero-López, E Fernández-Mondéjar, A Vidal, M Perez, A Juez, N Arias, L Colino, J L Perez, H Pérez, P Calpe, M A Alcala, D Robaglia, C Perez, S K Lan, M M Cunha, T Moreira, F Santos, E Lafuente, M J Fernandes, J G Silva, L E de la Cruz Rosario, S P Gómez Lesmes, A N García Herrera, J C García Romero, E D Díaz Pertuz, M J Gómez Sánchez, E Regidor Sanz, J G Armando Echeverría, A Ansotegui Hernández, J Barado Hualde, V Podlepich, E Sokolova, E Alexandrova, K Lapteva, P Kurtz, C Shuinotsuka, L Rabello, G Vianna, A Reis, C Cairus, J Salluh, F Bozza, J C Barrios Torres, N J Fernández Araujo, P García-Olivares, E Keough, M Dalorzo, L K Tang, I De Sousa, M Díaz, L J Marcos-Zambrano, J E Guerrero, S E Zamora Gomez, G D Hernandez Lopez, A I Vazquez Cuellar, O R Perez Nieto, J A Castanon Gonzalez, D Bhasin, S Rai, H Singh, O Gupta, M K Bhattal, S Sampley, K Sekhri, R Nandha, F A Aliaga, F Olivares, F Appiani, P Farias, F Alberto, A Hernández, S Pons, R Sonneville, L Bouadma, M Neuville, E Mariotte, A Radjou, J Lebut, S Chemam, G Voiriot, M P Dilly, B Mourvillier, R Dorent, P Nataf, M Wolff, J F Timsit, O Ediboglu, S Ataman, H Ozkarakas, C Kirakli, A Vakalos, V Avramidis, O Obukhova, I A Kurmukov, S Kashiya, E Golovnya, V N Baikova, T Ageeva, T Haritydi, E V Kulaga, J J Rios-Toro, L Perez-Borrero, E Aguilar-Alonso, M D Arias-Verdu, J M Garcia-Alvarez, C Lopez-Caler, C De La Fuente-Martos, S Rodriguez-Fernandez, M Gomez Sanchez-Orézzoli, F Martin-Gallardo, J Nikhilesh, V Joshi, E Villarreal, J Ruiz, M Gordon, A Quinza, J Gimenez, M Piñol, A Castellanos, P Ramirez, Y D Jeon, W Y Jeong, M H Kim, I Y Jeong, M Y Ahn, J Y Ahn, S H Han, J Y Choi, Y G Song, J M Kim, N S Ku, H Shah, F Kellner, F Rezai, N Mistry, P Yodice, V Ovnanian, K Fless, E Handler, R Martínez Alejos, J D Martí Romeu, D González Antón, A Quinart, A Torres Martí, M Llaurado-Serra, A Lobo-Civico, A Ventura-Rosado, A Piñol-Tena, M Pi-Guerrero, C Paños-Espinosa, M Peralvo-Bernat, J Marine-Vidal, R Gonzalez-Engroba, N Montesinos-Cerro, M Treso-Geira, A Valeiras-Valero, L Martinez-Reyes, A Sandiumenge, M F Jimenez-Herrera, S Helyar, P Riozzi, A Noon, G Hallows, H Cotton, J Keep, P A Hopkins, A Taggu, S Renuka, S Sampath, P J T Rood, T Frenzel, R Verhage, M Bonn, P Pickkers, J G van der Hoeven, M van den Boogaard, F Corradi, L Melnyk, F Moggia, R Pienovi, G Adriano, C Brusasco, L Mariotti, M Lattuada, M J Bloomer, M Coombs, K Ranse, R Endacott, B Maertens, K Blot, S Blot, M P van Nieuw Amerongen, E S van der Heiden, J W R Twisk, A R J Girbes, J J Spijkstra, P Riozzi, S Helyar, H Cotton, G Hallows, A Noon, C Bell, K Peters, A Feehan, J Keep, P A Hopkins, K Churchill, K Hawkins, R Brook, N Paver, R Endacott, N Maistry, A van Wijk, N Rouw, T van Galen, S Evelein-Brugman, A Taggu, B Krishna, S Sampath, A Putzu, M Fang, M Boscolo Berto, A Belletti, T Cassina, L Cabrini, M Mistry, Y Alhamdi, I Welters, S T Abrams, C H Toh, H S Han, E M Gil, D S Lee, C M Park, S Winder-Rhodes, R Lotay, J Doyle, M W Ke, W C Huang, C H Chiang, W T Hung, C C Cheng, K C Lin, S C Lin, K R Chiou, S R Wann, C W Shu, P L Kang, G Y Mar, C P Liu, S Dubó, A Aquevedo, M Jibaja, D Berrutti, C Labra, R Lagos, M F García, V Ramirez, M Tobar, F Picoita, C Peláez, D Carpio, L Alegría, C Hidalgo, K Godoy, J Bakker, G Hernández, Y Sadamoto, K Katabami, T Wada, Y Ono, K Maekawa, M Hayakawa, A Sawamura, S Gando, H Marin-Mateos, J L Perez-Vela, R Garcia-Gigorro, M A Corres Peiretti, M J Lopez-Gude, S Chacon-Alves, E Renes-Carreño, J C Montejo-González, K L Parlevliet, H R W Touw, M Beerepoot, C Boer, P W G Elbers, P R Tuinman, S A Abdelmonem, T A Helmy, I El Sayed, S Ghazal, S H Akhlagh, M Masjedi, K Hozhabri, E Kamali, I Zýková, B Paldusová, P Sedlák, D Morman, A M Youn, Y Ohta, M Sakuma, D Bates, T Morimoto, P L Su, W Y Chang, W C Lin, C W Chen, F Facchin, F Zarantonello, G Panciera, A De Cassai, A Venrdramin, A Ballin, T Tonetti, P Persona, C Ori, L Del Sorbo, S Rossi, G Vergani, M Cressoni, D Chiumello, C Chiurazzi, M Brioni, I Algieri, T Tonetti, M Guanziroli, A Colombo, I Tomic, A Colombo, F Crimella, E Carlesso, V Gasparovic, L Gattinoni, A Serpa Neto, M Schmidt, T Pham, A 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J P Frat, A Constan, J M Chrétien, J Mancebo, A Mercat, J C M Richard, L Brochard, E Soilemezi, E Koco, S Savvidou, C Nouris, D Matamis, R Di Mussi, S Spadaro, C A Volta, M Mariani, A Colaprico, C Antonio, F Bruno, S Grasso, A Rodriguez, I Martín-Loeches, E Díaz, J R Masclans, F Gordo, J Solé-Violán, M Bodí, F X Avilés-Jurado, S Trefler, M Magret, L F Reyes, J Marín-Corral, J C Yebenes, A Esteban, A Anzueto, S Aliberti, M I Restrepo, J Skytte Larsson, B Redfors, S E Ricksten, R Haines, J Powell-Tuck, H Leonard, M Ostermann, R E Berthelsen, T S Itenov, A Perner, J U Jensen, M Ibsen, A E K Jensen, M H Bestle, T Bucknall, J Dixon, F Boa, I MacPhee, B J Philips, J Doyle, F Saadat, T Samuels, S Huddart, B McCormick, R DeBrunnar, J Preece, M Swart, C Peden, S Richardson, L Forni, P Kalfon, K Baumstarck, P Estagnasie, M A Geantot, A Berric, G Simon, B Floccard, T Signouret, M Boucekine, M Fromentin, M Nyunga, A Sossou, M Venot, R Robert, A Follin, A Renault, M Garrouste, O Collange, Q Levrat, I Villard, D Thévenin, J Pottecher, R G Patrigeon, N Revel, C Vigne, O Mimoz, P Auquier, S Pawar, T Jacques, K Deshpande, R Pusapati, B Wood, R A Pulham, J Wray, K Brown, C Pierce, S Nadel, P Ramnarayan, J R Azevedo, W S Montenegro, D P Rodrigues, S C Sousa, V F Araujo, A L Leitao, P H Prazeres, A V Mendonca, M P Paula, A Das Neves, C I Loudet, M Busico, D Vazquez, D Villalba, A Lischinsky, M Veronesi, M Emmerich, E Descotte, A Juliarena, M Carboni Bisso, M Grando, A Tapia, M Camargo, D Villani Ulla, L Corzo, H Placido Dos Santos, A Ramos, J A Doglia, E Estenssoro, M Carbonara, S Magnoni, C L Mac Donald, J S Shimony, V Conte, F Triulzi, F Stretti, M Macrì, A Z Snyder, N Stocchetti, D L Brody, V Podlepich, V Shimanskiy, I Savin, K Lapteva, A Chumaev, M C Tjepkema-Cloostermans, J Hofmeijer, A Beishuizen, H Hom, M J Blans, M J A M van Putten, L Longhi, B Frigeni, M Curinga, D Mingone, S Beretta, A Patruno, L Gandini, A Vargiolu, F Ferri, R Ceriani, M R Rottoli, L Lorini, G Citerio, S 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No abstract text is available yet for this article.
September 2016: Intensive Care Medicine Experimental
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)
Tomoko S Kato, Hiroshi Nakamura, Mai Murata, Kishio Kuroda, Hitoshi Suzuki, Yasutaka Yokoyama, Akie Shimada, Satoshi Matsushita, Taira Yamamoto, Atsushi Amano
BACKGROUND: Adequate fluid management is an important component of patient care following cardiac surgery. Our aim in this study was to determine the benefits of tolvaptan, an oral selective vasopressin-2 receptor antagonist that causes electrolyte-free water diuresis, in postoperative fluid management. We prospectively examined the effect of tolvaptan on renal excretion of electrolytes and urea nitrogen in cardiac surgery patients. METHODS: Patients undergoing coronary artery bypass surgery were randomized to receive conventional loop diuretics (Group C, n = 30) or conventional loop diuretic therapy plus tolvaptan (Group T, n = 27)...
2016: BMC Cardiovascular Disorders
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
Adriana D Oprea, Frederick W Lombard, Wen-Wei Liu, William D White, Jörn A Karhausen, Yi-Ju Li, Timothy E Miller, Solomon Aronson, Tong J Gan, Manuel L Fontes, Miklos D Kertai
BACKGROUND: Increased pulse pressure (PP) is an important independent predictor of cardiovascular outcome and acute kidney injury (AKI) after cardiac surgery. The objective of this study was to determine whether elevated baseline PP is associated with postoperative AKI and 30-day mortality after noncardiac surgery. METHODS: We evaluated 9125 adult patients who underwent noncardiac surgery at Duke University Medical Center between January 2006 and December 2009. Baseline arterial blood pressure was defined as the mean of the first 5 measurements recorded by the automated record keeping system before inducing anesthesia...
September 7, 2016: Anesthesia and Analgesia
David E Leaf, Sushrut S Waikar
Acute kidney injury (AKI) is an increasingly common and feared complication in hospitalized patients. The selection of appropriate primary and secondary end points is critical to the design and eventual success of clinical trials aimed at preventing and treating AKI. In this article, we provide an overview of AKI definitions and suggestions on the rational selection of end points for clinical trials in various settings, including the prevention of contrast-induced AKI, prevention of cardiac surgery-associated AKI, treatment of established AKI, and treatment of dialysis-requiring AKI...
September 3, 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Bixiao Zhao, Qiongshi Lu, Yuwei Cheng, Justin M Belcher, Edward D Siew, David E Leaf, Simon C Body, Amanda A Fox, Sushrut W Waikar, Charles D Collard, Heather Thiessen-Philbrook, T Alp Ikizler, Lorraine B Ware, Charles L Edelstein, Amit X Garg, Murim Choi, Jennifer A Schaub, Hongyu Zhao, Richard P Lifton, Chirag R Parikh
RATIONALE: Acute kidney injury is a common and severe complication of critical illness and cardiac surgery. Despite significant attempts at developing treatments, therapeutic advances to attenuate acute kidney injury and expedite recovery have largely failed. OBJECTIVES: Identifying genetic loci associated with increased risk of acute kidney injury may reveal novel pathways for therapeutic development. METHODS: We conducted an exploratory genome-wide association study to identify single-nucleotide polymorphisms associated with genetic susceptibility to in-hospital acute kidney injury...
August 30, 2016: American Journal of Respiratory and Critical Care Medicine
Heyman Luckraz, Kumaresan Nagarajan, Akis Chnaris, Parminderjit Kaur Jayia, Israr Muhammed, Sophia Mahboob, Alan Nevill
Cardiac surgery has become established in octogenarians over the past decade. This study assessed the quality of life (QOL) and survival in patients undergoing various cardiac procedures at various time intervals postoperative. Patients older than 80 years at the time of their cardiac procedure were initially included (n = 427). Patients were grouped according to the time interval from their operations namely as within 3 years postoperative (Group A), 3-5 years postoperative (Group B), and older than 5 years postoperative (Group C)...
2016: Seminars in Thoracic and Cardiovascular Surgery
Zaccaria Ricci, Stefano Romagnoli, Luca Di Chiara
The association between pediatric cardiac surgery, acute kidney injury (AKI), and clinical outcomes has been studied several times in the recent literature. In this issue of Critical Care an interesting and original study analyzed the path from causal AKI entities to clinical AKI consequences through the application of structural equation modeling. The authors described the complex connections linking duration of cardiopulmonary bypass, cross clamp-time, and descriptors of low cardiac output syndrome to AKI modeled as a complex variable composed of post-operative serum creatinine increase of 50 % over baseline, urine output <0...
2016: Critical Care: the Official Journal of the Critical Care Forum
Peter A McCullough, Elliott Bennett-Guerrero, Lakhmir S Chawla, Thomas Beaver, Ravindra L Mehta, Bruce A Molitoris, Ann Eldred, Greg Ball, Ho-Jin Lee, Mark T Houser, Samina Khan
BACKGROUND: Patients undergoing cardiac surgeries with cardiopulmonary bypass (on-pump) have a high risk for acute kidney injury (AKI). We tested ABT-719, a novel α-melanocyte-stimulating hormone analog, for prevention of AKI in postoperative cardiac surgery patients. METHODS AND RESULTS: This phase 2b randomized, double-blind, placebo-controlled trial included adult patients with stable renal function undergoing high-risk on-pump cardiac surgery in the United States and Denmark...
2016: Journal of the American Heart Association
Yin Zongyi, Li Baifeng, Zou Funian, Li Hao, Wang Xin
This article has been withdrawn at the request of the author(s) and/or editor. The Publisher apologizes for any inconvenience this may cause. The full Elsevier Policy on Article Withdrawal can be found at
August 5, 2016: EBioMedicine
Steven G Coca, Girish N Nadkarni, Amit X Garg, Jay Koyner, Heather Thiessen-Philbrook, Eric McArthur, Michael G Shlipak, Chirag R Parikh
BACKGROUND: We previously demonstrated that assessment of the duration of AKI, in addition to magnitude of rise in creatinine alone, adds prognostic information for long-term survival. We evaluated whether post-operative kidney injury biomarkers in urine collected immediately after cardiac surgery associate with duration of serum creatinine elevation. METHODS: We studied 1199 adults undergoing cardiac surgery in a prospective cohort study (TRIBE-AKI) and examined the association between the levels of five urinary biomarkers individually at 0-6 hours after surgery: interleukin-18 (IL-18), neutrophil gelatinase-associated lipocalin (NGAL), kidney injury molecule-1 (KIM-1), liver fatty acid binding protein (L-FABP) and albumin with duration of serum creatinine-based AKIN criteria for AKI (0 (no AKI), 1-2, 3-6, ≥7 days)...
2016: PloS One
Jahan Che Penny-Dimri, Andrew D Cochrane, Luke A Perry, Julian A Smith
BACKGROUND: The role of perioperative erythropoietin (EPO) for preventing cardiac surgery associated acute kidney injury (CSA-AKI) remains uncertain with published trials producing conflicting results. Perspective into the factors at work is needed, due to ongoing uncertainty. METHODS: We undertook the systematic review and meta-analysis of randomised-controlled trials (RCTs) using random-effects modelling. The primary outcome was safety and efficacy of perioperative EPO to prevent CSA-AKI and the secondary outcomes were change in serum creatinine, urinary neutrophil gelatinase-associated lipocalin, time in ICU, rates of postoperative transfusions, haemodialysis, and mortality...
November 2016: Heart, Lung & Circulation
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