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https://www.readbyqxmd.com/read/28183419/acute-kidney-injury-in-patients-continued-on-renin-angiotensin-system-blockers-during-hospitalization
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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-non-case-study-of-a-pharmacovigilance-database
#7
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)...
December 21, 2016: 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
#8
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
#9
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
https://www.readbyqxmd.com/read/27936153/impact-of-transient-and-persistent-acute-kidney-injury-on-chronic-kidney-disease-progression-and-mortality-after-gastric-surgery-for-gastric-cancer
#10
Chang Seong Kim, Eun Hui Bae, Seong Kwon Ma, Sun-Seog Kweon, Soo Wan Kim
Acute kidney injury (AKI) is common after gastric surgery for gastric cancer and associated with adverse outcomes. However, the impact of transient or persistent AKI on clinical outcomes after gastric surgery for gastric cancer has not been described. We performed a retrospective study of 4,886 patients with normal renal function who underwent partial or total gastrectomy for gastric cancer between June 2002 and December 2012. AKI patients were classified as transient and persistent AKI based on the return of serum creatinine to the level indicating no AKI within 7 days...
2016: PloS One
https://www.readbyqxmd.com/read/27706879/acute-kidney-injury-post-major-orthopaedic-surgery-a-single-centre-case-control-study
#11
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
https://www.readbyqxmd.com/read/27676190/risk-factors-and-prognosis-of-cardiorenal-syndrome-type-1-in-elderly-chinese-patients-a-retrospective-observational-cohort-study
#12
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...
2016: Kidney & Blood Pressure Research
https://www.readbyqxmd.com/read/27673681/acute-kidney-injury-treated-with-dialysis-outside-the-intensive-care-unit-a-retrospective-observational-single-center-study
#13
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
https://www.readbyqxmd.com/read/27624603/the-effect-of-tolvaptan-on-renal-excretion-of-electrolytes-and-urea-nitrogen-in-patients-undergoing-coronary-artery-bypass-surgery
#14
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
https://www.readbyqxmd.com/read/27556709/nurses-knowledge-to-identify-early-acute-kidney-injury
#15
MULTICENTER STUDY
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
https://www.readbyqxmd.com/read/27530232/does-furosemide-increase-oxidative-stress-in-acute-kidney-injury
#16
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
https://www.readbyqxmd.com/read/27490717/mechanisms-of-triple-whammy-acute-kidney-injury
#17
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...
November 2016: Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/27300258/risk-factors-of-acute-kidney-injury-after-acute-myocardial-infarction
#18
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...
October 2016: Renal Failure
https://www.readbyqxmd.com/read/27259093/rhabdomyolysis-and-acute-kidney-injury-creatine-kinase-as-a-prognostic-marker-and-validation-of-the-mcmahon-score-in-a-10-year-cohort-a-retrospective-observational-evaluation
#19
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
https://www.readbyqxmd.com/read/27233298/excessively-high-hydration-volume-may-not-be-associated-with-decreased-risk-of-contrast-induced-acute-kidney-injury-after-percutaneous-coronary-intervention-in-patients-with-renal-insufficiency
#20
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
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