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diuretic and aki

Tracey Ying, Samantha Chan, Stephen Lane, Christine Somerville
AIM: To identify risk factors for acute kidney injury following major orthopaedic surgery. METHODS: We included all patients undergoing major orthopaedic surgery at University Hospital Geelong between 2008 and 2014 in the study. Out of 2188 surgeries audited, we identified cases of acute kidney injury using the RIFLE criteria and matched those to controls 2:1 for age, sex, procedure and chronic kidney disease stage. We reviewed their records for risk factors of postoperative acute kidney injury, including medications such as gentamicin, diuretics, non-steroidal anti-inflammatory drugs and angiotensin-converting enzyme inhibitor or angiotensin receptor blocker use...
October 5, 2016: Nephrology
Wenxue Hu, Wenna He, Wei Liu, Xiaowu Fang, Yanhua Wu, Feng Yu, Wenke Hao
BACKGROUND/AIMS: Cardiorenal syndrome type 1 (CRS1) is a syndrome characterized by a rapid worsening of cardiac function leading to acute kidney injury (AKI). The aims of this study were to investigate the risk factors and the prognosis of CRS1 in elderly patients. METHODS: A total of 312 elderly patients (≥60 years old) with acute heart failure (AHF) were studied. They were assigned as CRS1 (suffered from in-hospital AKI) or NCRS1 (without AKI) group. Clinical and laboratory data were recorded...
September 28, 2016: Kidney & Blood Pressure Research
Hannelore Sprenger-Mähr, Emanuel Zitt, Karl Lhotta
INTRODUCTION: The number of patients suffering from acute kidney injury requiring dialysis (AKI-D) is increasing. Whereas causes and outcome of AKI-D in the intensive care unit (ICU) are described extensively, few data exist about AKI-D patients treated outside the ICU. Aim of this study was to identify the causes of AKI-D, determine in-depth the comorbid conditions and outcome of this particular patient group and identify possibilities for its prevention. METHODS: We retrospectively studied all AKI-D patients treated outside the ICU in a single nephrology referral center between January 2010 and June 2015...
2016: PloS One
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
Roseli Aparecida Matheus do Nascimento, Murillo Santucci Cesar Assunção, João Manoel Silva, Cristina Prata Amendola, Taysa Martindo de Carvalho, Emerson Quintino Lima, Suzana Margareth Ajeje Lobo
OBJECTIVE: To evaluate the knowledgeof nurses on early identification of acute kidney injury (AKI) in intensive care, emergency and hospitalization units. METHOD: A prospective multi-center study was conducted with 216 nurses, using a questionnaire with 10 questions related to AKI prevention, diagnosis, and treatment. RESULTS: 57.2% of nurses were unable to identify AKI clinical manifestations, 54.6% did not have knowledge of AKI incidence in patients admitted to the ICU, 87...
May 2016: Revista da Escola de Enfermagem da U S P
Benjamin I Silbert, Kwok M Ho, Jeffrey Lipman, Jason A Roberts, Tomas B Corcoran, David J Morgan, Warren Pavey, Emilie Mas, Anne E Barden, Trevor A Mori
Furosemide, a loop diuretic, is used to increase urine output in patients with acute kidney injury (AKI). It remains uncertain whether the benefits of furosemide in AKI outweigh its potential harms. We investigated if furosemide influenced oxidative stress in 30 critically ill patients with AKI by measuring changes in F2-isoprostanes (F2-IsoPs), markers of in vivo oxidative stress, in plasma and urine following intravenous furosemide. Urine F2-IsoPs were higher in sepsis (p = 0.001) and increased in proportion to urine furosemide (p = 0...
September 15, 2016: Antioxidants & Redox Signaling
Laura Prieto-García, Miguel Pericacho, Sandra M Sancho-Martínez, Ángel Sánchez, Carlos Martínez-Salgado, José Miguel López-Novoa, Francisco J López-Hernández
Pre-renal acute kidney injury (AKI) results from glomerular haemodynamic alterations leading to reduced glomerular filtration rate (GFR) with no parenchymal compromise. Renin-angiotensin system inhibitors, such as angiotensin-converting enzyme inhibitors (ACEIs), angiotensin receptor antagonists (ARAs), non-steroidal anti-inflammatory drugs (NSAIDs) and diuretics, are highly prescribed drugs that are frequently administered together. Double and triple associations have been correlated with increased pre-renal AKI incidence, termed "double whammy" and "triple whammy", respectively...
August 1, 2016: Pharmacology & Therapeutics
Yan-Bei Sun, Bi-Cheng Liu, Yun Zou, Jia-Rong Pan, Yuan Tao, Min Yang
OBJECTIVES: To study the risk factors for acute kidney injury (AKI) in-patients with acute myocardial infarction (AMI). METHODS: A total of 1371 cases of adult in-patients with AMI in the First People's Hospital of Changzhou from January 2008 to December 2012 were retrospectively analyzed. Based on the occurrence of AKI diagnosed according to the 2012 KDIGO AKI criteria, they were divided into AKI group and non-AKI group and further into conservative treatment groups, coronary angiography (CAG) groups, and coronary artery bypass grafting (CABG) groups based on the timing of AKI occurrence, respectively...
June 14, 2016: Renal Failure
Joanna P Simpson, Andrew Taylor, Nazneen Sudhan, David K Menon, Andrea Lavinio
BACKGROUND: High-volume fluid resuscitation and the administration of sodium bicarbonate and diuretics have a theoretical renoprotective role in patients at high risk of acute kidney injury (AKI) following rhabdomyolysis. Abnormally elevated creatine kinase has previously been used as a biological marker for the identification of patients at high risk of AKI following rhabdomyolysis. OBJECTIVE: To assess the sensitivity and specificity of plasma creatine kinase (admission and peak values) for the prediction of AKI requiring renal replacement therapy (RRT) or of death in patients with confirmed rhabdomyolysis...
June 2, 2016: European Journal of Anaesthesiology
Yong Liu, Hualong Li, Shiqun Chen, Jiyan Chen, Ning Tan, Yingling Zhou, Yuanhui Liu, Piao Ye, Peng Ran, Chongyang Duan, Pingyan Chen
BACKGROUND: No well-defined protocols currently exist regarding the optimal rate and duration of normal saline administration to prevent contrast-induced acute kidney injury (CI-AKI) in patients with renal insufficiency. METHODS AND RESULTS: Hydration volume ratios (hydration volume/weight; HV/W) were calculated in 1406 patients with renal insufficiency (estimated glomerular filtration rate [eGFR], <90 mL/min per 1.73 m(2)) undergoing percutaneous coronary intervention (PCI) with routine speed hydration (1 or 0...
June 2016: Journal of the American Heart Association
U Janssens, M Joannidis
Heart and kidney are closely interacting organs which function interdependently. Organ crosstalk between these two organs is based on humoral regulation and by inflammatory mediators, which are similar to those dominating systemic inflammation syndrome. The close interaction between heart and kidney results in organ dysfunction following both chronic and acute functional impairment of the respective counterpart. These changes are summarized under the term cardiorenal syndrome (CRS) which is subdivided into 5 types...
May 2016: Medizinische Klinik, Intensivmedizin und Notfallmedizin
Rohit J Kate, Ruth M Perez, Debesh Mazumdar, Kalyan S Pasupathy, Vani Nilakantan
BACKGROUND: Acute Kidney Injury (AKI) occurs in at least 5 % of hospitalized patients and can result in 40-70 % morbidity and mortality. Even following recovery, many subjects may experience progressive deterioration of renal function. The heterogeneous etiology and pathophysiology of AKI complicates its diagnosis and medical management and can add to poor patient outcomes and incur substantial hospital costs. AKI is predictable and may be avoidable if early risk factors are identified and utilized in the clinical setting...
2016: BMC Medical Informatics and Decision Making
Hisayo Fujita, Masayoshi Shinjoh, Tomohiro Ishii, Midori Awazu
INTRODUCTION: The fractional excretion of sodium (FENa) has been used as an index for the differential diagnosis of acute tubular necrosis (ATN) and prerenal acute kidney injury (AKI). The reliability of this index, however, decreases with the use of the diuretic agent furosemide. The fractional excretion of urea nitrogen (FEUN) has been shown to be useful in such settings in adults. The objective of this study was to examine whether FEUN is also useful in these settings in children. METHODS: We assessed 102 episodes of AKI in 74 children, classifying these into three groups based on history, physical examination, urine examination and subsequent clinical course: (1) prerenal AKI without furosemide (N = 37), (2) prerenal AKI with furosemide (N = 32) and (3) ATN (N = 33)...
August 2016: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
Chia-Hung Yang, Chih-Hsiang Chang, Tien-Hsing Chen, Pei-Chun Fan, Su-Wei Chang, Chun-Chi Chen, Pao-Hsien Chu, Yi-Ting Chen, Huang-Yu Yang, Chih-Wei Yang, Yung-Chang Chen
BACKGROUND: Acute kidney injury (AKI) is associated with morality and repeated hospitalization, and is frequently encountered in patients with acute decompensated heart failure (ADHF). However, few effective tools exist for early AKI identification and risk stratification. METHODS AND RESULTS: This was a prospective observational study conducted in the coronary care unit (CCU) of a tertiary care university hospital. Patients with a diagnosis of ADHF and who were using diuretics were enrolled...
2016: Circulation Journal: Official Journal of the Japanese Circulation Society
Eun Seok Kim, Hyun Jeong Kim, Yong Jun Kim, Su Mi Lee, Ho Jin Lee, Duk Song Cho, Young Ki Son, Seong Eun Kim, Ki Hyun Kim, Won Suk An
BACKGROUND: Angiotensin converting enzyme (ACE) inhibitor and angiotensin receptor blocker (ARB) may induce acute kidney injury (AKI). The aim of this study was to evaluate the role of the resistive index (RI), which reflects renal artery resistance on renal duplex ultrasonography, as a predictor of AKI in chronic kidney disease (CKD) patients who are prescribed an ACE inhibitor or ARB. METHODS: We screened 105 CKD patients evaluated with renal duplex ultrasonography from 2008 to 2012...
December 2013: Kidney Research and Clinical Practice
Kenneth P Chen, Susan Cavender, Joon Lee, Mengling Feng, Roger G Mark, Leo Anthony Celi, Kenneth J Mukamal, John Danziger
BACKGROUND AND OBJECTIVES: Although venous congestion has been linked to renal dysfunction in heart failure, its significance in a broader context has not been investigated. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Using an inception cohort of 12,778 critically ill adult patients admitted to an urban tertiary medical center between 2001 and 2008, we examined whether the presence of peripheral edema on admission physical examination was associated with an increased risk of AKI within the first 7 days of critical illness...
April 7, 2016: Clinical Journal of the American Society of Nephrology: CJASN
Patrick M Honore, Rita Jacobs, Inne Hendrickx, Sean M Bagshaw, Olivier Joannes-Boyau, Willem Boer, Elisabeth De Waele, Viola Van Gorp, Herbert D Spapen
Sepsis-induced acute kidney injury (SAKI) remains an important challenge in critical care medicine. We reviewed current available evidence on prevention and treatment of SAKI with focus on some recent advances and developments. Prevention of SAKI starts with early and ample fluid resuscitation preferentially with crystalloid solutions. Balanced crystalloids have no proven superior benefit. Renal function can be evaluated by measuring lactate clearance rate, renal Doppler, or central venous oxygenation monitoring...
December 2015: Annals of Intensive Care
O Goren, I Matot
Perioperative acute kidney injury (AKI) is not uncommon and is associated with considerable morbidity and mortality. Recently, several definition systems for AKI were proposed, incorporating both small changes of serum creatinine and urinary output reduction as diagnostic criteria. Novel biomarkers are under investigation as fast and accurate predictors of AKI. Several special considerations regarding the risk of AKI are of note in the surgical patient. Co-morbidities are important risk factors for AKI. The surgery in itself, especially emergency and major surgery in the critically ill, is associated with a high incidence of AKI...
December 2015: British Journal of Anaesthesia
A I Safina, M A Daminova, G A Abdullina
BACKGROUND: The incidence of acute kidney injury (AKI) in neonates in the intensive care units and neonatal intensive care (NICU) according Plotz et al. ranges from 8% to 22% [3]. According to Andreoli, neonatal death due to AKI in NICU amounts up to 10-61% [1]. It should be in the reasons of AKI emphasize.The role of certain drugs, which are widely used in modern neonatology: nonsteroidal anti-inflammatory drugs (NSAIDs), antibiotics (aminoglycosides, glycopeptides, carbapenems, 3rd generation cephalosporins), furosemide, enalapril, in contributing to AKI should be emphasized [2]...
2015: International Journal of Risk & Safety in Medicine
Shin-Yi Lin, Sung-Chun Tang, Li-Kai Tsai, Shin-Joe Yeh, Li-Jiuan Shen, Fe-Lin Lin Wu, Jiann-Shing Jeng
Mannitol, an osmotic diuretic, is commonly used to treat patients with acute brain edema, but its use also increases the risk of developing acute kidney injury (AKI). In this study, we investigated the incidence and risk factors of mannitol-related AKI in acute stroke patients.A total of 432 patients (ischemic stroke 62.3%) >20 years of age who were admitted to the neurocritical care center in a tertiary hospital and received mannitol treatment were enrolled in this study. Clinical parameters including the scores of National Institutes of Health Stroke Scale (NIHSS) at admission, vascular risk factors, laboratory data, and concurrent nephrotoxic medications were registered...
November 2015: Medicine (Baltimore)
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