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https://www.readbyqxmd.com/read/28527049/early-rise-in-postoperative-creatinine-for-identification-of-acute-kidney-injury-after-cardiac-surgery
#1
Keyvan Karkouti, Vivek Rao, Christopher T Chan, Duminda N Wijeysundera
PURPOSE: Acute kidney injury (AKI) is a potentially serious complication of cardiac surgery. Treatment strategies are unlikely to prove efficacious unless patients are identified and treated soon after the onset of injury. In this observational study, we determined and validated the ability of an early rise in postoperative serum creatinine to identify patients who suffer AKI during cardiac surgery. METHODS: The relationship between an early rise in creatinine (immediate postoperative / preoperative creatinine) and AKI (> 50% increase in creatinine by postoperative calendar days 1or 2) was determined by logistic regression modelling...
May 19, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/28525506/haptoglobin-administration-in-cardiovascular-surgery-patients-its-association-with-the-risk-of-postoperative-acute-kidney-injury
#2
Kenta Kubota, Moritoki Egi, Satoshi Mizobuchi
BACKGROUND: Acute kidney injury (AKI) often occurs after cardiac surgery. During cardiac surgery, plasma free hemoglobin (fHb) would increase due to hemolysis. Since plasma fHb is thought to be nephrotoxic, haptoglobin, which is an fHb scavenger, may have the potential to prevent postoperative AKI (pAKI). However, there have been few studies in which the association of intraoperative administration of haptoglobin with the incidence of AKI after cardiac surgery was assessed. METHODS: This study was a retrospective observational study to assess the independent association of intraoperative administration of haptoglobin with the incidence pAKI in cardiac surgery patients...
June 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28515370/acute-kidney-injury-following-cardiopulmonary-bypass-in-children%C3%A3-risk-factors-and-outcomes
#3
Seon Hwa Lee, Soo-Jin Kim, Hyung Joong Kim, Jae Sung Son, Ran Lee, Tae Gyoon Yoon
BACKGROUND: Acute kidney injury (AKI) is the most common and most serious complication following heart surgery. We aimed to determine the prevalence of, and risk factors for, AKI following pediatric cardiac surgery.Methods and Results:We retrospectively analyzed 135 patients aged ≤18 years who underwent cardiac surgery for congenital heart defects; by RACHS-1 category, 58 patients (43%) had an operative risk score ≥3. AKI was defined and classified using the pediatric pRIFLE criteria (Pediatric Risk, Injury, Failure, Loss, and End-stage Kidney Disease); 19 patients (14...
May 17, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28509399/association-of-renin-angiotensin-antagonists-with-adverse-perioperative-events-in-patients-undergoing-elective-orthopaedic-surgery-a-case-control-study
#4
Amith Zainudheen, Ian A Scott, Xenia Caney
BACKGROUND: Renin angiotensin antagonists (RAAs) may block protective vasopressor responses during surgery. Evidence linking RAAs with intraoperative hypotension and perioperative adverse events is conflicting. METHODS: Retrospective case-control study of 258 consecutive patients who underwent elective total knee or hip replacement between January 1(st) 2013 and August 31(st) 2016, and who were chronically prescribed a single blood pressure lowering agent up to the time of surgery...
May 16, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28499652/lack-of-furosemide-responsiveness-predicts-acute-kidney-injury-in-infants-after-cardiac-surgery
#5
Aadil Kakajiwala, Ji Young Kim, John Z Hughes, Andrew Costarino, John Ferguson, J William Gaynor, Susan L Furth, Joshua J Blinder
BACKGROUND: This was a retrospective study to determine whether lack of furosemide responsiveness (LFR) predicts acute kidney injury (AKI) after cardiopulmonary bypass surgery in infants. METHODS: Infants (less than 1 year of age) undergoing cardiopulmonary bypass surgery, receiving routine postoperative furosemide (0.8 to 1.2 mg/kg per dose between 8 and 24 hours after surgery) were included. Urine output was measured 2 and 6 hours after furosemide dose. Lack of furosemide responsiveness was defined a priori as urine output less than 1 mL · kg(-1) · h(-1) after furosemide...
May 9, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28489791/effect-of-perioperative-statin-therapy-on-renal-outcome-in-patients-undergoing-cardiac-surgery-a-meta-analysis-of-randomized-controlled-trials
#6
Siyang Wang, Huan Yao, Hong Yu, Chan Chen, Ronghua Zhou, Rurong Wang, Hai Yu, Bin Liu
BACKGROUND: Acute renal injury (AKI) is a common renal complication after cardiac surgery. The aim of this study was to determine the effect of perioperative statin therapy (PST) on postoperative renal outcome in patients undergoing cardiac procedures. METHODS: We searched for the reports that evaluating the effect of PST on renal outcomes after cardiac surgery between March 1983 and June 2016 in the electronic database Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE/PubMed, and EMBASE/OVID...
May 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28472145/preoperative-aspirin-use-and-acute-kidney-injury-after-cardiac-surgery-a-propensity-score-matched-observational-study
#7
Min Hur, Chang-Hoon Koo, Hyung-Chul Lee, Sun-Kyung Park, Minkyung Kim, Won Ho Kim, Jin-Tae Kim, Jae-Hyon Bahk
BACKGROUND: The association between preoperative aspirin use and postoperative acute kidney injury (AKI) in cardiovascular surgery is unclear. We sought to evaluate the effect of preoperative aspirin use on postoperative AKI in cardiac surgery. METHODS: A total of 770 patients who underwent cardiovascular surgery under cardiopulmonary bypass were reviewed. Perioperative clinical parameters including preoperative aspirin administration were retrieved. We matched 108 patients who took preoperative aspirin continuously with patients who stopped aspirin more than 7 days or did not take aspirin for the month before surgery...
2017: PloS One
https://www.readbyqxmd.com/read/28443376/remote-ischemic-conditioning-and-renal-protection
#8
Georgios Giannopoulos, Dimitrios A Vrachatis, Vasiliki Panagopoulou, Manolis Vavuranakis, Michael W Cleman, Spyridon Deftereos
Over the course of the last 2 decades, the concept of remote ischemic conditioning (RIC) has attracted considerable research interest, because RIC, in most of its embodiments offers an inexpensive way of protecting tissues against ischemic damage inflicted by a number of medical conditions or procedures. Acute kidney injury (AKI) is a common side effect in the context of various medical procedures, and RIC has been suggested as a means of reducing its incidence. Outcomes regarding kidney function have been reported in numerous studies that evaluated the effects of RIC in a variety of settings (eg, cardiac surgery, interventions requiring intravenous administration of contrast media)...
January 1, 2017: Journal of Cardiovascular Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/28423997/do-lipid-microemboli-induce-acute-kidney-injury-during-cardiopulmonary-bypass
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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