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Acute kidney injury

Hilla Chen, Itamar Aroch, Gilad Segev
OBJECTIVE: To describe the clinical course and successful management of a dog with crush syndrome, rhabdomyolysis, myoglobinuria, and associated acute kidney injury (AKI). CASE SUMMARY: An 8-year-old female, neutered, mixed-breed dog was referred to the Veterinary Teaching Hospital due to crush injury and suspected AKI. Blood tests and urinalysis showed markedly increased serum creatine kinase activity, myoglobinuria, and AKI. The dog was managed successfully with intermittent hemodialysis, and completely recovered...
September 17, 2018: Journal of Veterinary Emergency and Critical Care
Mustafa E Ibrahim, Cara Chang, Yichun Hu, Susan L Hogan, Nickie Mercke, Madeleine Gomez, Cindy L O'Bryant, Daniel W Bowles, Blessy George, Xia Wen, Brian Buckley, Lauren Aleksunes, Melanie S Joy
PURPOSE: The ability to predict and detect clinical and subclinical nephrotoxicity early in the course of therapy has the potential to improve long-term outcomes in cancer patients receiving cisplatin chemotherapy. Pharmacokinetic parameters could serve as predictors of cisplatin-induced nephrotoxicity. METHODS: Participants [n = 13] were treated with a 1-h cisplatin infusion [30-75 mg/m2 ]. Blood was collected pre-dose and up to 6 h post-dose. Urinary biomarkers [KIM-1, calbindin, clusterin, GST-pi, β2M, albumin, NGAL, osteopontin, clusterin, MCP-1, cystatin C, and TFF3] were measured at baseline, days 3 and 10...
September 15, 2018: European Journal of Clinical Pharmacology
Ryan L Crass, Keith A Rodvold, Bruce A Mueller, Manjunath P Pai
Antibiotic renal dose adjustments are determined in subjects with stable chronic kidney disease and may not translate to patients in late phase trials and practice. Ceftolozane/tazobactam, ceftazidime/avibactam, and telavancin all carry precautionary statements for reduced clinical response in patients with baseline creatinine clearance 30 - 50 mL/min, potentially due to unnecessary dose reduction in the setting of acute kidney injury (AKI). In this review, we discuss the regulatory landscape for antibiotics eliminated by the kidney and highlight the importance of the first 48 hours of therapy...
September 13, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Shujuan Qiu, Xuexun Chen, Yunyan Pang, Zhaoguang Zhang
Renal ischemia/reperfusion injury is a main cause of acute kidney injury (AKI) triggering an inflammatory response associated with infiltrating macrophages. Lipocalin-2 (Lcn2) levels correlate positively and protect against renal ischemia/reperfusion injury. However, the mechanisms remain unclear. The aim of study was to investigate the protective mechanisms of Lcn2 on renal ischemia/reperfusion injury. We found that Lcn2 deficiency significantly aggravated renal injury as evidenced by higher serum creatinine, more severe morphological injury, and increased tubular epithelial cell death in mice...
September 13, 2018: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
Racquel Wells, Mahboob Rahman
PURPOSE OF REVIEW: To review the impact of the Systolic Blood Pressure Interventional Trial (SPRINT) on renal function and chronic kidney disease. RECENT FINDINGS: Hypertension is a risk factor for cardiovascular and kidney outcomes in patients with chronic kidney disease (CKD). The benefits of intensive blood pressure lowering in the CKD population in previous studies are unclear. The SPRINT compared standard (< 140 mmHg) and intensive (< 120 mmHg) blood pressure management in nondiabetic patients with high risk of cardiovascular disease...
September 14, 2018: Current Hypertension Reports
Kelly R McMahon, Maya Harel-Sterling, Michael Pizzi, Louis Huynh, Erin Hessey, Michael Zappitelli
BACKGROUND: Childhood cancer survivors treated with cisplatin, ifosfamide, or carboplatin are at risk for late kidney and blood pressure (BP) abnormalities. Few studies have comprehensively evaluated kidney outcomes and 24-h ambulatory BP monitoring (ABPM) in this population. We aimed to describe chemotherapy-associated acute kidney injury (AKI) and late kidney outcomes using standardized definitions. METHODS: This was a single-center longitudinal pilot study of 23 children who participated in a previous study during cisplatin, carboplatin, or ifosfamide treatment...
September 14, 2018: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
Tak Kyu Oh, Sunghee Han, Ah-Young Oh, Saeyeon Kim, Jung-Hee Ryu
BACKGROUND: The relationship between preoperative hyperglycemia and postoperative acute kidney injury (AKI) occurrence in non-cardiac surgery including laparoscopic surgery remains unclear. This study aimed to assess the relationship between preoperative chronic hyperglycemia and postoperative AKI occurrence after a major laparoscopic abdominal surgery. METHODS: We retrospectively reviewed medical records of diabetic patients (≥ 20 years old) who underwent elective major laparoscopic abdominal surgery procedures between 2010 and 2016...
September 14, 2018: Journal of Anesthesia
Jinning Ye, Yufeng Ren, Zhewei Wei, Jianjun Peng, Chuangqi Chen, Wu Song, Min Tan, Yulong He, Yujie Yuan
BACKGROUND & PURPOSE: Cytoreductive surgery (CRS) plus Hyperthermic intraperitoneal chemotherapy (HIPEC) is an effective measure for peritoneal carcinomatosis. The cisplatin (CP) applied in HIPEC carries a risk of kidney injury. This study aims to investigate CP-induced nephrotoxicity post HIPEC and to explore its risk factors. METHODS: From January 2012 to July 2013, 99 patients undergoing CRS + HIPEC were retrospectively reviewed. Patients were divided into CP and Non-CP HIPEC groups...
September 2018: Surgical Oncology
Scott R Burks, Matthew E Nagle, Michele N Bresler, Saejeong J Kim, Robert A Star, Joseph A Frank
Mesenchymal stromal cell (MSC) therapies combined with renal pulsed focused ultrasound (pFUS) pretreatment increase MSC homing and improve cisplatin-induced acute kidney injury (AKI) better than MSC alone. However, mechanisms underlying improved outcomes remain unknown. We hypothesize pFUS up-regulates renal interferon-γ (IFNγ) and stimulates MSC to produce interleukin-10 (IL-10) after migrating to kidneys. To demonstrate initially, MSC cultured with IFNγ up-regulated IL-10. More MSC-derived IL-10 was detected in kidneys when IFNγ-stimulated MSC were infused and they improved AKI better than unstimulated MSC...
September 14, 2018: Journal of Cellular and Molecular Medicine
Samira Bell, Michelle Lim
No abstract text is available yet for this article.
September 11, 2018: Nephrology, Dialysis, Transplantation
Guillaume L Hoareau, Carl A Beyer, Lauren E Walker, Kevin K Chung, Ian J Stewart
Trauma-induced acute kidney injury (AKI) has affected many U.S. warfighters throughout history. We seek to provide a historical review of the epidemiology of combat-acquired AKI and to highlight the importance of adapting current renal replacement therapy (RRT) capabilities to prepare for the next armed conflict. While severe AKI was rare in the recent conflicts in Iraq and Afghanistan, an analysis of prior wars suggests that it will be more common in future combat operations characterized by prolonged evacuation times, limited resuscitation capabilities, and delayed aeromedical evacuation...
September 12, 2018: Military Medicine
Abhilash Koratala, Alejandra Mena Gutierrez, Gajapathiraju Chamarthi, Xu Zeng, Kawther F Alquadan
High index of suspicion is required for ischemic nephropathy in renal transplant recipients presenting with unexplained acute kidney injury, as it is potentially reversible. Carbon dioxide (CO2) angiogram is a good alternative to evaluate vasculature in patients with renal dysfunction where iodinated contrast is relatively contraindicated.
September 2018: Clinical Case Reports
Swapnil Patel, Mohammad A Hossain, Firas Ajam, Mayurkumar Patel, Mihir Nakrani, Jasmine Patel, Alsadiq Alhillan, Mohamed Hammoda, Anas Alrefaee, Michael Levitt, Arif Asif
Acute kidney injury (AKI) due to an acute interstitial nephritis (AIN) is common and can lead to increased morbidity and mortality. Medications such as antibiotics, nonsteroidal anti-inflammatory drugs (NSAIDs), proton pump inhibitors (PPI) and rifampin are common offending agents. Anticoagulant-associated AIN is more frequently reported with the use of warfarin; however, only few case reports have reported an association with the use of novel oral anticoagulants (NOACs). Herein, we report the case of a 59-year-old male who developed AKI after initiating dabigatran for the treatment of atrial fibrillation...
October 2018: Journal of Clinical Medicine Research
Yasuhiro Arakawa, Yoshihiro Shirai, Kazumi Hayashi, Yujiro Tanaka, Akira Matsumoto, Katsunori Nishikawa, Shingo Yano
Combination chemotherapy using docetaxel, cisplatin and 5-fluorouracil (DCF) is a promising treatment option for patients with advanced esophageal squamous cell carcinoma (ESCC), although its clinical application is limited by severe systemic toxicities. There are no validated markers for predicting the adverse effects caused by this regimen. This pharmacogenetic study enrolled 57 patients with chemotherapy-naive advanced ESCC between July 2012 and March 2016 (UMIN000008462). All patients received at least one course of DCF chemotherapy (docetaxel, 60 mg/m2 on day 1; cisplatin, 70 mg/m2 on day 1; 5-fluorouracil, 600 mg/m2 on days 1-5)...
October 2018: Oncology Letters
Yan Wang, Fenling Feng, Minna Liu, Jiahong Xue, Huimei Huang
Acute kidney injury (AKI) is a hyper-inflammation-induced abrupt loss of kidney function and has become a major public health problem. The cecal ligation and puncture (CLP) model of peritonitis in rat pups mimics the development of sepsis-induced pediatric AKI is pre-renal without morphological changes of the kidneys and high lethality. Resveratrol, a natural polyphenolic compound with low toxicity, has obvious anti-oxidant and anti-inflammatory properties. The present study aimed to determine whether resveratrol alleviates pediatric AKI and investigated the potential mechanism...
October 2018: Experimental and Therapeutic Medicine
Chao-Wei Lee, Hao-Wei Kou, Hong-Shiue Chou, Hsu-Huan Chou, Song-Fong Huang, Chih-Hsiang Chang, Chun-Hsing Wu, Ming-Chin Yu, Hsin-I Tsai
Background: Sepsis is a syndrome characterized by a constellation of clinical manifestations and a significantly high mortality rate in the surgical intensive care unit (ICU). It is frequently complicated by acute kidney injury (AKI), which, in turn, increases the risk of mortality. Therefore, it is of paramount importance to identify those septic patients at risk for the development of AKI and mortality. The objective of this pilot study was to evaluate several different biomarkers, including NGAL, calprotectin, KIM-1, cystatin C, and GDF-15, along with SOFA scores, in predicting the development of septic AKI and associated in-hospital mortality in critically ill surgical patients...
2018: World Journal of Emergency Surgery: WJES
Pere Ginès, Elsa Solà, Paolo Angeli, Florence Wong, Mitra K Nadim, Patrick Kamath
Hepatorenal syndrome (HRS) is a form of kidney function impairment that characteristically occurs in cirrhosis. Recent changes in terminology have led to acute HRS being referred to as acute kidney injury (AKI)-HRS and chronic HRS as chronic kidney disease (CKD)-HRS. AKI-HRS is characterized by a severe impairment of kidney function owing to vasoconstriction of the renal arteries in the absence of substantial abnormalities in kidney histology. Pathogenetic mechanisms involve disturbances in circulatory function due to a marked splanchnic arterial vasodilation, which triggers the activation of vasoconstrictor factors...
September 13, 2018: Nature Reviews. Disease Primers
Ying-Ying Chen, Vin-Cent Wu, Wei-Chieh Huang, Yu-Chang Yeh, Mai-Szu Wu, Chiu-Ching Huang, Kwan-Dun Wu, Ji-Tseng Fang, Chih-Jen Wu
(1) Background: Norepinephrine (NE) is the first-line vasoactive agent used in septic shock patients; however, the effect of norepinephrine on dialysis-required septic acute kidney injury (AKI-D) patients is uncertain. (2) Methods: To evaluate the impact of NE on 90-day mortality and renal recovery in septic AKI-D patients, we enrolled patients in intensive care units from 30 hospitals in Taiwan. (3) Results: 372 patients were enrolled and were divided into norepinephrine users and non-users. After adjustment by Inverse probability of treatment weighted (IPTW), there was no significant difference of baseline comorbidities between the two groups...
September 12, 2018: Journal of Clinical Medicine
Toshiki Kuno, Yohei Numasawa, Mitsuaki Sawano, Toshiomi Katsuki, Masaki Kodaira, Ikuko Ueda, Masahiro Suzuki, Shigetaka Noma, Koji Negishi, Shiro Ishikawa, Hiroaki Miyata, Keiichi Fukuda, Shun Kohsaka
BACKGROUND: Limiting the contrast volume to creatinine clearance (V/CrCl) ratio is crucial for preventing contrast-induced acute kidney injury (CI-AKI) after percutaneous coronary intervention (PCI). However, the incidence of CI-AKI and the distribution of V/CrCl ratios may vary according to patient body habitus. OBJECTIVE: We aimed to identify the clinical factors predicting CI-AKI in patients with different body mass indexes (BMIs). METHODS: We evaluated 8782 consecutive patients undergoing PCI and who were registered in a large Japanese database...
2018: PloS One
Areg Grigorian, Viktor Gabriel, Ninh T Nguyen, Brian R Smith, Sebastian Schubl, Boris Borazjani, Victor Joe, Jeffry Nahmias
PURPOSE: Obesity has been shown in a single-center study to be a risk factor for rhabdomyolysis. More recently, sickle cell trait, known to be more prevalent in blacks, has been shown to be a risk factor for rhabdomyolysis. We hypothesized that in trauma patients, black race and a higher body mass index (BMI) are associated with risk for rhabdomyolysis and acute kidney injury (AKI). MATERIALS AND METHODS: The National Trauma Data Bank (NTDB) was queried (2013-2015) to identify patients age ≥18 years and grouped by BMI: normal (18...
September 13, 2018: Journal of Investigative Surgery: the Official Journal of the Academy of Surgical Research
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