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acute kidney injury mortality

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https://www.readbyqxmd.com/read/28440305/acute-kidney-injury-in-cirrhosis-baseline-serum-creatinine-predicts-patient-outcomes
#1
F Wong, J G O'Leary, K R Reddy, G Garcia-Tsao, M B Fallon, S W Biggins, R M Subramanian, P J Thuluvath, P S Kamath, H Patton, B Maliakkal, P Tandon, H Vargas, L Thacker, J S Bajaj
OBJECTIVES: The International Ascites Club (IAC) recently defined Stage 1 acute kidney injury (AKI) for cirrhosis as an acute increase in serum creatinine (SCr) by ≥0.3 mg/dl or by ≥50% in <48 h from a stable value within 3 months. The baseline SCr may influence AKI risk and patient outcomes. The objective of this study is to determine in cirrhosis whether the baseline SCr has any effect on the in-hospital AKI course and patient survival. METHODS: North American Consortium for the Study of End-Stage Liver Disease is a consortium of tertiary-care hepatology centers prospectively enroling non-elective cirrhotic inpatients...
April 25, 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/28439485/treatment-of-atypical-hemolytic-uremic-syndrome-in-the-era-of-eculizumab
#2
Rawaa Ebrahem, Salam Kadhem, Quoc Truong
Hemolytic-uremic syndrome (HUS) is the triad of microangiopathic hemolytic anemia (MAHA), thrombocytopenia, and acute kidney injury (AKI); the main cause of multi-organ failure is related to thrombotic microangiopathy (TMA). Atypical HUS (aHUS) is a disease of uncontrolled complement activation associated with a high mortality rate and most cases progress to end-stage renal disease. About 50% of patients with this syndrome carry mutations in genes that encode complement proteins. Also, aHUS constitutes an over-activation of the complement pathway which is either inherited, acquired, or both...
March 23, 2017: Curēus
https://www.readbyqxmd.com/read/28438182/forced-fluid-removal-versus-usual-care-in-intensive-care-patients-with-high-risk-acute-kidney-injury-and-severe-fluid-overload-ffaki-study-protocol-for-a-randomised-controlled-pilot-trial
#3
Rasmus E Berthelsen, Theis Itenov, Anders Perner, Jens-Ulrik Jensen, Michael Ibsen, Andreas Emil Kryger Jensen, Morten Bestle
BACKGROUND: Intravenous administration of fluids is an essential part of critical care. While some fluid administration is likely beneficial, there is increasing observational evidence that the development of fluid overload is associated with increased mortality. There are no randomised trials to confirm this association in patients with acute kidney injury. We aim to perform a pilot trial to test the feasibility of forced fluid removal compared to standard care in patients with acute kidney injury and severe fluid overload, the FFAKI trial...
April 24, 2017: Trials
https://www.readbyqxmd.com/read/28437375/both-positive-and-negative-fluid-balance-may-be-associated-with-reduced-long-term-survival-in-the-critically-ill
#4
Vikram Balakumar, Raghavan Murugan, Florentina E Sileanu, Paul Palevsky, Gilles Clermont, John A Kellum
OBJECTIVES: Among critically ill patients with acute kidney injury, exposure to positive fluid balance, compared with negative fluid balance, has been associated with mortality and impaired renal recovery. However, it is unclear whether positive and negative fluid balances are associated with poor outcome compared to patients with even fluid balance (euvolemia). In this study, we examined the association between exposure to positive or negative fluid balance, compared with even fluid balance, on 1-year mortality and renal recovery...
April 21, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28437374/icu-patients-requiring-renal-replacement-therapy-initiation-fewer-survivors-and-more-dialysis-dependents-from-80-years-old
#5
Morgane Commereuc, Emmanuel Guérot, Anais Charles-Nelson, Adrien Constan, Sandrine Katsahian, Frédérique Schortgen
OBJECTIVES: To assess the role of advanced age on survival and dialysis dependency after initiation of renal replacement therapy for acute kidney injury. DESIGN: Retrospective pooled analysis of prospectively collected data. SETTING: ICUs of two teaching hospitals in Paris area, France. SUBJECTS: One thousand five hundred thirty adult patients who required renal replacement therapy initiation in the ICU. INTERVENTIONS: None...
April 21, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28437373/resuscitation-with-balanced-fluids-is-associated-with-improved-survival-in-pediatric-severe-sepsis
#6
Elizabeth T Emrath, James D Fortenberry, Curtis Travers, Courtney E McCracken, Kiran B Hebbar
OBJECTIVE: To evaluate outcomes in patients receiving balanced fluids for resuscitation in pediatric severe sepsis. DESIGN: Observational cohort review of prospectively collected data from a large administrative database. SETTING: PICUs from 43 children's hospitals. PATIENTS: PICU patients diagnosed with severe sepsis. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: We reviewed data from the Pediatric Health Information System database from 2004 to 2012...
April 21, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28437243/impact-of-pulmonary-hypertension-on-in-hospital-outcome-after-surgical-or-transcatheter-aortic-valve-replacement
#7
Anja Gutmann, Klaus Kaier, Holger Reinecke, Lutz Frankenstein, Andreas Zirlik, Wolfgang Bothe, Constantin von Zur Mühlen, Manfred Zehender, Jochen Reinöhl, Christoph Bode, Peter Stachon
AIMS: The impact of pulmonary hypertension (PH) on in-hospital outcome of either surgical (SAVR) or transcatheter aortic valve replacement (TAVR) was analyzed. METHODS AND RESULTS: Data from all 107,057 patients undergoing isolated SAVR or TAVR in Germany between 2007 and 2014 was provided by the German Federal Bureau of Statistics. About 18% of patients with aortic valve stenosis suffered from PH. Patients with PH had more co- morbidities with consequently increased EuroSCORE (TAVR without PH: 12...
April 25, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28435306/pediatric-acute-kidney-injury-prevalence-impact-and-management-challenges
#8
REVIEW
Eileen Ciccia, Prasad Devarajan
The incidence of pediatric acute kidney injury (AKI) is increasing globally, as are the associated morbidities and mortality. A recent standardization of the definition of AKI has allowed for a more accurate assessment of the epidemiology of pediatric AKI. Recent advances in leveraging electronic medical health record systems have allowed for real-time risk stratification and prevention of pediatric AKI in the hospital setting. Newly developed and validated clinical scores have improved our ability to predict AKI and provide a rational context for biomarker utilization in hospitalized children...
2017: International Journal of Nephrology and Renovascular Disease
https://www.readbyqxmd.com/read/28434550/renal-failure-after-cardiac-operations-not-all-acute-kidney-injury-is-the-same
#9
Todd C Crawford, J Trent Magruder, Joshua C Grimm, Shin-Rong Lee, Alejandro Suarez-Pierre, David Lehenbauer, Christopher M Sciortino, Robert S Higgins, Duke E Cameron, John V Conte, Glenn J Whitman
BACKGROUND: The Society of Thoracic Surgeons (STS) database does not distinguish between a decline in creatinine clearance vs new hemodialysis (HD) when qualifying acute renal failure (ARF) after a cardiac operation. We hypothesized that patients requiring HD experience significantly greater postoperative morbidity and death. METHODS: We included all patients who underwent STS index cardiac operations at our institution from 2008 to March 2015 and did not have preexisting renal failure (creatinine >4...
April 20, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28433221/c-reactive-protein-predicts-acute-kidney-injury-and-death-after-coronary-artery-bypass-grafting
#10
Seung Seok Han, Dong Ki Kim, Sejoong Kim, Ho Jun Chin, Dong-Wan Chae, Ki Young Na
BACKGROUND: A better prediction of postoperative acute kidney injury (AKI) is worthwhile in patients undergoing coronary artery bypass grafting (CABG) because AKI is associated with high rates of morbidity and mortality. The present study was performed to investigate whether preoperative C-reactive protein (CRP) predicted AKI and the long-term rate of mortality in CABG. METHODS: This retrospective cohort study included 1,656 patients whose high-sensitivity CRPs were measured before CABG at two tertiary referral centers from 2004 to 2010...
April 19, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28433199/glycoprotein-non-metastatic-melanoma-protein-b-gpnmb-is-highly-expressed-in-macrophages-of-acute-injured-kidney-and-promotes-m2-macrophages-polarization
#11
Letian Zhou, Hui Zhuo, Huiyu Ouyang, Yexin Liu, Fang Yuan, Lin Sun, Fuyou Liu, Hong Liu
Acute kidney injury (AKI) is an increasingly common disorder that is strongly linked to short- and long-term morbidity and mortality. During AKI process, macrophages, one of the important immune response cells, can polarize into M1 and M2 subtype from M0 subtype. It is well-known that M1 macrophages play a pro inflammatory role while M2 macrophages play an anti-inflammatory role. Glycoprotein non-metastatic melanoma protein b (Gpnmb) is a glycosylated transmembrane protein highly expressed in numerous cells, including osteoblasts, dendritic cells and macrophages...
March 31, 2017: Cellular Immunology
https://www.readbyqxmd.com/read/28432312/growth-differentiation-factor-15-deficiency-augments-inflammatory-response-and-exacerbates-septic-heart-and-renal-injury-induced-by-lipopolysaccharide
#12
Palida Abulizi, Neruja Loganathan, Duo Zhao, Tina Mele, Yixin Zhang, Terry Zwiep, Kexiang Liu, Xiufen Zheng
Septic acute kidney injury (AKI) and myocardial dysfunction are leading causes of mortality with no accepted method of therapy. In this study we demonstrate the role of growth differentiating factor 15 (GDF15) in septic AKI and myocardial dysfunction using a murine lipopolysaccharide (LPS)-induced sepsis model and an in vitro cell culture system. Data show that GDF15 deficiency augments inflammatory response and exacerbates renal and cardiac injury induced by LPS, while over-expression of GDF15 protects the kidney and heart from LPS-induced organ dysfunction...
April 21, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28431991/molecular-mechanisms-of-trauma-induced-acute-kidney-injury-inflammatory-and-metabolic-insights-from-animal-models
#13
David M Burmeister, Belinda I Gómez, Michael A Dubick
Trauma-induced acute kidney injury (AKI), such as after hemorrhagic shock (HS) or burn, remains a significant problem in the intensive care unit and is associated with increased mortality. The pathophysiology that drives AKI post-trauma is multi factorial, and includes both inflammatory and metabolic alterations. Identifying the systemic profile that contributes to AKI is crucial not only for early diagnosis, but also for identifying treatments that improve kidney function and maintaining long-term patient health...
April 18, 2017: Biochimica et Biophysica Acta
https://www.readbyqxmd.com/read/28427574/acute-noncardiovascular-illness-in-the-cardiac-intensive-care-unit
#14
Eric M Holland, Travis J Moss
BACKGROUND: Fifty years after the inception of the cardiac intensive care unit (CICU), noncardiovascular illnesses have become more prevalent and may contribute to morbidity and mortality. OBJECTIVES: The authors performed multivariate statistical analyses to determine the association of acute noncardiovascular illnesses with outcomes, including length of stay (LOS), mortality, and hospital readmission. METHODS: We studied 1,042 admissions between October 12, 2013 and November 28, 2014 to the CICU at the University of Virginia Health System, a tertiary-care academic medical center...
April 25, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28427496/mortality-risk-factors-in-intensive-care-unit-patients-with-acute-kidney-injury-requiring-renal-replacement-therapy-a-retrospective-cohort-study%C3%A2
#15
Michael Schmitz, Frank P Tillmann, Ausra Paluckaite, Erich A Laufer, Brian Rayner, Lars C Rump, Peter J Heering
BACKGROUND: Mortality of critically-ill patients with acute kidney injury (AKI) requiring renal replacement therapy (RRT) in an intensive-care setting continues to remain high. There is still uncertainty as to which factors should guide clinical judgement. METHODS: A cohort of 155 patients admitted to an intensive-care unit and necessitating RRT due to AKI were retrospectively analyzed. Demographic and clinical parameters at the time of RRT initiation were retrieved...
April 21, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28427138/-advances-in-the-research-of-treatment-of-burns-in-the-elderly
#16
Z Y Jiang, D H Min, G H Guo
With our country going into the aging society, burns in the elderly often occur. Studies have shown that the number of elderly burn patients has reached 13% to 20% of the total number of burn patients. As the sensory and cognitive functions are low, skin is thinning, the functions of heart, lung, and kidney are reduced, the immunity is impaired, and other physiological characteristics exist in the elderly, the wounds of elderly burn patients often heal slowly, and the mortality is high. At present, there is still a lack of enough attention to the elderly burn patients...
April 20, 2017: Zhonghua Shao Shang za Zhi, Zhonghua Shaoshang Zazhi, Chinese Journal of Burns
https://www.readbyqxmd.com/read/28426835/outcomes-from-a-cohort-of-patients-with-acute-kidney-injury-subjected-to-continuous-venovenous-hemodiafiltration-the-role-of-negative-fluid-balance
#17
Thais Oliveira Claizoni Dos Santos, Marisa Aparecida de Souza Oliveira, Julio Cesar Martins Monte, Marcelo Costa Batista, Virgilio Gonçalves Pereira Junior, Bento Fortunato Cardoso Dos Santos, Oscar Fernando Pavão Santos, Marcelino de Souza Durão Junior
BACKGROUND: Several factors influence the outcomes in acute kidney injury (AKI), especially in intensive care unit (ICU) patients. In this scenario, continuous renal replacement therapies (CRRT) are used to control metabolic derangements and blood volume. Knowing this fact, it may be possible to change the course of the disease and decrease the high mortality rate observed. Thus, we aimed to evaluate the main risk factors for death in AKI patients needing CRRT. RESULTS: This was a prospective, observational cohort study of ICU patients (N = 183) with AKI who underwent continuous venovenous hemodiafiltration (CVVHDF) as their initial dialysis modality choice...
2017: PloS One
https://www.readbyqxmd.com/read/28426831/representation-and-reporting-of-kidney-disease-in-cerebrovascular-disease-a-systematic-review-of-randomized-controlled-trials
#18
Ioannis Konstantinidis, Shanti Patel, Marianne Camargo, Achint Patel, Priti Poojary, Steven G Coca, Girish N Nadkarni
Patients with kidney disease (KD) are at increased risk for cerebrovascular disease (CVD) and CVD patients with KD have worse outcomes. We aimed to determine the representation of KD patients in major randomized controlled trials (RCTs) of CVD interventions. We searched MEDLINE for reports of major CVD trials published through February 9, 2017. We excluded trials that did not report mortality outcomes, enrolled fewer than 100 participants, or were subgroup, follow-up, or post-hoc analyses. Two independent reviewers performed study selection and data extraction...
2017: PloS One
https://www.readbyqxmd.com/read/28426743/acute-kidney-injury-can-predict-in-hospital-and-long-term-mortality-in-elderly-patients-undergoing-hip-fracture-surgery
#19
Seong Eun Hong, Tae-Young Kim, Je-Hyun Yoo, Jwa-Kyung Kim, Sung Gyun Kim, Hyung Jik Kim, Young Rim Song
BACKGROUND: Hip fracture is a common health problem in the elderly that is associated with increased mortality. Acute kidney injury (AKI) is a frequent complication in elderly patients undergoing surgery and is associated with the clinical outcome. We evaluated the incidence and risk factors of AKI in elderly patients undergoing hip fracture surgery and the impact of AKI on short- and long-term clinical outcomes. METHODS: We performed a retrospective cohort study of 450 elderly patients who underwent hip fracture surgery between January 2010 and December 2012...
2017: PloS One
https://www.readbyqxmd.com/read/28426384/a-2-year-old-boy-with-circulatory-failure-owing-to-streptococcal-toxic-shock-syndrome-case-report
#20
Werner Keenswijk, Johan Vande Walle
A 2-year-old boy presented with severe hypotension and acute kidney injury after a prodrome of non-bloody diarrhoea and fever in the preceding 3 days. He had a mild Ebstein cardiac anomaly but otherwise a normal past history and growth. On examination, he looked ill, his temperature was 37.5 °C, circulation was poor, and there were several purpuric lesions on the face, hands and scrotum. Haemoglobin was 7.8 g/dL (11-14), total white cell count 27 × 10(9)/L, platelets 62 × 10(9)/L, blood urea nitrogen 20...
April 20, 2017: Paediatrics and International Child Health
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