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https://www.readbyqxmd.com/read/28900861/acute-kidney-injury-caused-by-decompression-illness-successfully-treated-with-hyperbaric-oxygen-therapy-and-temporary-dialysis
#1
Arata Hibi, Keisuke Kamiya, Takahisa Kasugai, Keisuke Kamiya, Satoru Kominato, Chiharu Ito, Toshiyuki Miura, Katsushi Koyama
A 52-year-old Japanese male professional diver was referred to our hospital for decompression illness (DCI). After 1 h of diving operation at 20 m below sea level, he complained of dyspnea, chest pain, and abdominal pain. He dove again, intending to ease the symptoms, but the symptoms were never relieved. He dove for a total of 4 h. No neurological abnormalities were observed. Computed tomography images revealed portal venous gas and mesenteric venous gas, in addition to bubbles in the femoral veins, pelvis, lumbar canal, intracranial sinuses, and joints...
September 12, 2017: CEN Case Reports
https://www.readbyqxmd.com/read/28836115/management-of-ascites-and-hepatorenal-syndrome
#2
REVIEW
Salvatore Piano, Marta Tonon, Paolo Angeli
Ascites represents the most common decompensating event in patients with liver cirrhosis. The appearance of ascites is strongly related to portal hypertension, which leads to splanchnic arterial vasodilation, reduction of the effective circulating volume, activation of endogenous vasoconstrictor systems, and avid sodium and water retention in the kidneys. Bacterial translocation further worsens hemodynamic alterations of patients with cirrhosis and ascites. The first-line treatment of uncomplicated ascites is a moderate sodium-restricted diet combined with diuretic treatment...
August 23, 2017: Hepatology International
https://www.readbyqxmd.com/read/28747177/acute-coronary-syndrome-and-acute-kidney-injury-role-of-inflammation-in-worsening-renal-function
#3
Jorge Ortega-Hernández, Rashidi Springall, Fausto Sánchez-Muñoz, Julio-C Arana-Martinez, Héctor González-Pacheco, Rafael Bojalil
BACKGROUND: Acute Kidney Injury (AKI), a common complication of acute coronary syndromes (ACS), is associated with higher mortality and longer hospital stays. The role of cytokines and other mediators is unknown in AKI induced by an ACS (ACS-AKI), leading to several unanswered questions. The worsening of renal function is usually seen as a dichotomous phenomenon instead of a dynamic change, so evaluating changes of the renal function in time may provide valuable information in the ACS-AKI setting...
July 26, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28732755/two-cases-of-acute-kidney-injury-due-to-multiple-wasp-stings
#4
Sanjay Vikrant, Anupam Parashar
Acute kidney injury (AKI) is an unusual complication of wasp stings. Treatment of established AKI is largely supportive but the preventive strategies are not well documented. This is a report of 2 human cases that developed AKI after multiple wasp stings (Vespa magnifica). Each patient reached the hospital early in their clinical course and was treated with intravenous hydration and urine alkalization. In both the cases the severity of AKI, morbidity, and duration of hospitalization were reduced. The requirement of dialysis therapy was avoided...
July 18, 2017: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/28647690/acute-kidney-injury-after-primary-angioplasty-is-contrast-induced-nephropathy-the-culprit
#5
Oren Caspi, Manhal Habib, Yuval Cohen, Arthur Kerner, Ariel Roguin, Eitan Abergel, Monther Boulos, Michael R Kapeliovich, Rafael Beyar, Eugenia Nikolsky, Doron Aronson
BACKGROUND: Acute kidney injury (AKI) following primary percutaneous coronary intervention (pPCI) is frequently interpreted as contrast-induced AKI but may result from other insults. We aimed to determine the causal association of contrast material exposure and the incidence of AKI following pPCI using a control group of propensity score-matched patients with ST-segment-elevation myocardial infarction who were not exposed to contrast material. METHODS AND RESULTS: We studied 2025 patients with ST-segment-elevation myocardial infarction who underwent pPCI and 1025 patients receiving fibrinolysis or no reperfusion who were not exposed to contrast material during the first 72 hours of hospital stay (control group)...
June 24, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28602971/new-developments-in-hepatorenal-syndrome
#6
Ayse L Mindikoglu, Stephen C Pappas
Hepatorenal syndrome (HRS) continues to be one of the major complications of decompensated cirrhosis, leading to death in the absence of liver transplantation. Challenges in precisely evaluating renal function in the patient with cirrhosis remain because of the limitations of serum creatinine (Cr) alone in estimating glomerular filtration rate (GFR); current GFR estimating models appear to underestimate renal function. Newer models incorporating renal biomarkers, such as the Cr-Cystatin C GFR Equation for Cirrhosis appear to estimate true GFR more accurately...
June 7, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28577069/prevention-of-acute-kidney-injury-and-protection-of-renal-function-in-the-intensive-care-unit-update-2017-expert-opinion-of-the-working-group-on-prevention-aki-section-european-society-of-intensive-care-medicine
#7
M Joannidis, W Druml, L G Forni, A B J Groeneveld, P M Honore, E Hoste, M Ostermann, H M Oudemans-van Straaten, M Schetz
BACKGROUND: Acute kidney injury (AKI) in the intensive care unit is associated with significant mortality and morbidity. OBJECTIVES: To determine and update previous recommendations for the prevention of AKI, specifically the role of fluids, diuretics, inotropes, vasopressors/vasodilators, hormonal and nutritional interventions, sedatives, statins, remote ischaemic preconditioning and care bundles. METHOD: A systematic search of the literature was performed for studies published between 1966 and March 2017 using these potential protective strategies in adult patients at risk of AKI...
June 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28543803/predictive-value-of-inflammatory-factors-on-contrast-induced-acute-kidney-injury-in-patients-who-underwent-an-emergency-percutaneous-coronary-intervention
#8
Ying Yuan, Hong Qiu, Xiaoying Hu, Tong Luo, Xiaojin Gao, Xueyan Zhao, Jun Zhang, Yuan Wu, Shubin Qiao, Yuejin Yang, Runlin Gao
BACKGROUND: Contrast-induced acute kidney injury (CI-AKI) is one of the most serious complications in patients who undergo percutaneous coronary intervention (PCI), especially in those with acute coronary syndrome. It has been shown that inflammation may play an important role in the pathophysiology of CI-AKI. HYPOTHESIS: Inflammatory factors may play a predominant role in the prediction of CI-AKI in patients who undergo emergency PCI. METHODS: Patients who underwent emergency PCI from 2013 to 2015 were consecutively enrolled and were divided into CI-AKI and non-CI-AKI groups...
May 19, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28499652/lack-of-furosemide-responsiveness-predicts-acute-kidney-injury-in-infants-after-cardiac-surgery
#9
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/28389482/what-are-the-risks-and-benefits-of-temporarily-discontinuing-medications-to-prevent-acute-kidney-injury-a-systematic-review-and-meta-analysis
#10
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/28245728/risk-factors-for-acute-kidney-injury-associated-with-the-treatment-of-bacterial-endocarditis-at-a-tertiary-academic-medical-center
#11
Brianne M Ritchie, Beth A Hirning, Craig A Stevens, Steven A Cohen, Jeremy R DeGrado
BACKGROUND: Acute kidney injury (AKI) is a common complication of endocarditis. OBJECTIVE: To determine risk factors for the development of AKI in patients treated for endocarditis. METHODS: This single centre, retrospective univariate and multivariate analysis to determine risk factors for the development of AKI included patients diagnosed with endocarditis between January 2009 and October 2013. RESULTS: Of 211 included patients, a total of 84 (39...
March 1, 2017: Journal of Chemotherapy
https://www.readbyqxmd.com/read/28183419/acute-kidney-injury-in-patients-continued-on-renin-angiotensin-system-blockers-during-hospitalization
#12
Numan Alabdan, Elvira O Gosmanova, Nhu Quynh T Tran, Carrie S Oliphant, Hu Pan, Joyce E Broyles, Joanna Q Hudson
BACKGROUND: Acute kidney injury (AKI) is common in hospitalized patients and is associated with adverse outcomes. This study aimed to evaluate patient characteristics and interventions during hospitalization associated with the development of AKI in patients continued on renin-angiotensin system (RAS) blockers during hospitalization. METHODS: A retrospective study of 184 adult patients admitted between January 2012 and September 2014 and continued on RAS blockers was conducted...
February 2017: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/28138128/understanding-and-preventing-contrast-induced-acute-kidney-injury
#13
REVIEW
Michael Fähling, Erdmann Seeliger, Andreas Patzak, Pontus B Persson
Contrast-induced acute kidney injury (CIAKI) occurs in up to 30% of patients who receive iodinated contrast media and is generally considered to be the third most common cause of hospital-acquired AKI. Accurate assessment of the incidence of CIAKI is obscured, however, by the use of various definitions for diagnosis, the different populations studied and the prophylactic measures put in place. A deeper understanding of the mechanisms that underlie CIAKI is required to enable reliable risk assessment for individual patients, as their medical histories will determine the specific pathways by which contrast media administration might lead to kidney damage...
March 2017: Nature Reviews. Nephrology
https://www.readbyqxmd.com/read/28091757/-renal-protection-in-intensive-care-myths-and-facts
#14
REVIEW
S John
BACKGROUND: Acute kidney injury (AKI) is a common and severe complication in patients on the intensive care unit with a significant impact on patient mortality, morbidity and costs of care; therefore, renal protective therapy is most important in these severely ill patients. AIM OF THE REVIEW: Many renal protective strategies have been postulated during the last decades, which are sometimes still in place as a kind of "myth" but which are not always proven by evidence-based "facts"...
February 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28051022/risk-factors-of-contrast-induced-acute-kidney-injury-in-patients-undergoing-emergency-percutaneous-coronary-intervention
#15
Ying Yuan, Hong Qiu, Xiao-Ying Hu, Tong Luo, Xiao-Jin Gao, Xue-Yan Zhao, Jun Zhang, Yuan Wu, Hong-Bing Yan, Shu-Bin Qiao, Yue-Jin Yang, Run-Lin Gao
BACKGROUND: Previous studies of contrast-induced acute kidney injury (CI-AKI) were mostly based on selective percutaneous coronary intervention (PCI) cases, and risk factors of CI-AKI after emergency PCI are unclear. The aim of this study was to explore the risk factors of CI-AKI in a Chinese population undergoing emergency PCI. METHODS: A total of 1061 consecutive patients undergoing emergency PCI during January 2013 and June 2015 were enrolled and divided into CI-AKI and non-CI-AKI group...
2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/28003911/automated-fluid-management-for-treatment-of-rhabdomyolysis
#16
Christian M Beilstein, John R Prowle, Christopher J Kirwan
Purpose. Fluid therapy aimed at increasing urine output is a commonly employed strategy to prevent acute kidney injury (AKI) in critically ill patients with rhabdomyolysis. Automated fluid management has the potential to optimise urine output while avoiding fluid accumulation in rhabdomyolysis patients. Methods. In a single centre clinical service evaluation we compared a convenience sample of critically ill adults with rhabdomyolysis treated with automated fluid management using the RenalGuard® device to patients managed with manual fluid adjustment following our standard rhabdomyolysis protocol...
2016: International Journal of Nephrology
https://www.readbyqxmd.com/read/28003286/prescription-of-renin-angiotensin-system-blockers-and-risk-of-acute-kidney-injury-a-population-based-cohort-study
#17
Kathryn E Mansfield, Dorothea Nitsch, Liam Smeeth, Krishnan Bhaskaran, Laurie A Tomlinson
OBJECTIVE: To investigate whether there is an association between use of ACE inhibitors (ACEI) and angiotensin receptor blockers (ARB) and risk of acute kidney injury (AKI). STUDY DESIGN: We conducted a new-user cohort study of the rate of AKI among users of common antihypertensives. SETTING: UK primary care practices contributing to the Clinical Practice Research Datalink (CPRD) eligible for linkage to hospital records data from the Hospital Episode Statistics (HES) database between April 1997 and March 2014...
December 21, 2016: BMJ Open
https://www.readbyqxmd.com/read/28002877/the-drugs-that-mostly-frequently-induce-acute-kidney-injury-a-case%C3%A2-%C3%A2-noncase-study-of-a-pharmacovigilance-database
#18
Marion Pierson-Marchandise, Valérie Gras, Julien Moragny, Joelle Micallef, Louise Gaboriau, Sylvie Picard, Gabriel Choukroun, Kamel Masmoudi, Sophie Liabeuf
AIMS: Acute kidney injury (AKI) is associated with a high hospitalization rate, accelerated long-term decline in kidney function and a high mortality rate. Adverse drug reactions (ADRs) constitute one of the most important modifiable factors in the context of AKI. Most studies of drug-induced AKI have focused on a sole drug class. The objective of the present study was to establish a comprehensive overview of drug-induced AKI on the basis of spontaneously reported ADRs in the French national pharmacovigilance database (FPVD)...
June 2017: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/27979049/medical-management-of-severe-alcoholic-hepatitis-expert%C3%A2-review-from-the-clinical-practice-updates-committee-of%C3%A2-the-aga-institute
#19
REVIEW
Mack C Mitchell, Lawrence S Friedman, Craig J McClain
The purpose of this clinical practice update is to review diagnostic criteria for severe acute alcoholic hepatitis and to determine the current best practices for this life-threatening condition. The best practices in this review are based on clinical trials, systematic reviews including meta-analysis and expert opinion to develop an approach to diagnosis and management. Best Practice Advice 1: Abstinence from drinking alcohol is the cornerstone of treatment for alcohol hepatitis (AH). Best Practice Advice 2: Patients with jaundice and suspected AH should have cultures of blood, urine, and ascites, if present, to determine the presence of bacterial infections regardless of whether they have fever...
January 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/27956671/defining-oliguria-during-cardiopulmonary-bypass-and-its-relationship-with-cardiac-surgery-associated-acute-kidney-injury
#20
D Hori, N M Katz, D M Fine, M Ono, V M Barodka, L C Lester, G Yenokyan, C W Hogue
BACKGROUND: While urine flow rate ≤0.5 ml kg(-1) h(-1) is believed to define oliguria during cardiopulmonary bypass (CPB), it is unclear whether this definition identifies risk for acute kidney injury (AKI) . The purpose of this retrospective study was to evaluate if urine flow rate during CPB is associated with AKI. METHODS: Urine flow rate was calculated in 503 patients during CPB. AKI in the first 48 h after surgery was defined by the Kidney Disease: Improving Global Outcomes classification...
December 2016: British Journal of Anaesthesia
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