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Acute Kidney Injury Dialysis

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https://www.readbyqxmd.com/read/28443283/vascular-access-site-for-renal-replacement-therapy-in-acute-kidney-injury-a-post-hoc-analysis-of-the-atn-study
#1
Yue-Harn Ng, Kavitha Ganta, Herbert Davis, V Shane Pankratz, Mark Unruh
BACKGROUND: Acute kidney injury requiring renal replacement therapy (RRT) in the intensive care unit portends a poor prognosis. The decisions regarding dialysis catheter placement is based mainly on physician discretion with little evidence to support the choice of dialysis catheter location. METHODS: The Veterans Affairs/National Institutes of Health Acute Renal Failure Trial Network Study was a multicenter, prospective, randomized trial of intensive vs. less intensive RRT in critically ill patients with AKI...
2017: Frontiers in Medicine
https://www.readbyqxmd.com/read/28437374/icu-patients-requiring-renal-replacement-therapy-initiation-fewer-survivors-and-more-dialysis-dependents-from-80-years-old
#2
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/28430830/assessment-of-global-kidney-health-care-status
#3
Aminu K Bello, Adeera Levin, Marcello Tonelli, Ikechi G Okpechi, John Feehally, David Harris, Kailash Jindal, Babatunde L Salako, Ahmed Rateb, Mohamed A Osman, Bilal Qarni, Syed Saad, Meaghan Lunney, Natasha Wiebe, Feng Ye, David W Johnson
Importance: Kidney disease is a substantial worldwide clinical and public health problem, but information about available care is limited. Objective: To collect information on the current state of readiness, capacity, and competence for the delivery of kidney care across countries and regions of the world. Design, Setting, and Participants: Questionnaire survey administered from May to September 2016 by the International Society of Nephrology (ISN) to 130 ISN-affiliated countries with sampling of key stakeholders (national nephrology society leadership, policy makers, and patient organization representatives) identified by the country and regional nephrology leadership through the ISN...
April 21, 2017: JAMA: the Journal of the American Medical Association
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
#4
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/28426384/a-2-year-old-boy-with-circulatory-failure-owing-to-streptococcal-toxic-shock-syndrome-case-report
#5
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
https://www.readbyqxmd.com/read/28411480/hemorrhagic-fever-with-renal-syndrome-in-albania-focus-on-predictors-of-acute-kidney-injury-in-hfrs
#6
Elvana Rista, Arben Pilaca, Ilir Akshija, Ariol Rama, Endri Harja, Edmond Puca, Silvia Bino, Vilma Cadri, Majlinda Kota, Thereska Nestor, Harxhi Arjan
BACKGROUND: Hemorrhagic fever with renal syndrome (HFRS) is a rodent borne zoonosis, caused by the members of the family Bunyaviridae, genus Hantavirus. The main clinical features of the infection by this virus family are fever, thrombocytopenia and acute kidney injury. OBJECTIVE: The aim of our study was to identify, for the first time, characteristic features of HFRS in the Albanian population. STUDY DESIGN: The study comprised 33 consecutive patients admitted with suspected HFRS from April 2011-April 2016 at one center...
March 31, 2017: Journal of Clinical Virology: the Official Publication of the Pan American Society for Clinical Virology
https://www.readbyqxmd.com/read/28410645/epidemiology-and-risk-factors-for-early-mortality-after-dialysis-initiation
#7
REVIEW
Robert N Foley
Confronted with the decision to initiate dialysis, patients and caregivers often seek information about how expected survival chances evolve, both initially and afterward, providing the patient survives beyond arbitrary periods of time. Large registry data, used to examine these issues, may be subject to early ascertainment bias, such as those accruing from nonregistration of with end-stage kidney disease who die shortly after dialysis initiation and inclusion of patients with acute kidney injury with slower than typical recovery rates...
March 2017: Seminars in Nephrology
https://www.readbyqxmd.com/read/28409285/urinary-calprotectin-kidney-injury-molecule-1-and-neutrophil-gelatinase-associated-lipocalin-for-the-prediction-of-adverse-outcome-in-pediatric-acute-kidney-injury
#8
Jens H Westhoff, Felix S Seibert, Sina Waldherr, Frederic Bauer, Burkhard Tönshoff, Alexander Fichtner, Timm H Westhoff
Early identification of patients with acute kidney injury (AKI) being at high risk for adverse outcome can influence medical treatment. This study compares urinary calprotectin, kidney injury molecule-1 (KIM-1), and neutrophil gelatinase-associated lipocalin (NGAL) for their performance in predicting mortality and need for renal replacement therapy (RRT) in pediatric AKI patients. Urinary biomarker concentrations were assessed prospectively in 141 subjects aged 0-18 years including 55 patients with established AKI according to pediatric Risk, Injury, Failure, Loss, and End-stage kidney disease (pRIFLE) criteria, 27 patients without AKI, and 59 healthy children...
April 14, 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/28409034/increased-intracranial-pressure-during-hemodialysis-in-a-patient-with-anoxic-brain-injury
#9
Anton Lund, Mette B Damholt, Ditte G Strange, Jesper Kelsen, Hasse Møller-Sørensen, Kirsten Møller
Dialysis disequilibrium syndrome (DDS) is a serious neurological complication of hemodialysis, and patients with acute brain injury are at increased risk. We report a case of DDS leading to intracranial hypertension in a patient with anoxic brain injury and discuss the subsequent dialysis strategy. A 13-year-old girl was admitted after prolonged resuscitation from cardiac arrest. Computed tomography (CT) revealed an inferior vena cava aneurysm and multiple pulmonary emboli as the likely cause. An intracranial pressure (ICP) monitor was inserted, and, on day 3, continuous renal replacement therapy (CRRT) was initiated due to acute kidney injury, during which the patient developed severe intracranial hypertension...
2017: Case Reports in Critical Care
https://www.readbyqxmd.com/read/28404621/longitudinal-risk-of-adverse-events-in-patients-with-acute-kidney-injury-after-percutaneous-coronary-intervention-insights-from-the-national-cardiovascular-data-registry
#10
Javier A Valle, Lisa A McCoy, Thomas M Maddox, John S Rumsfeld, P Michael Ho, Ivan P Casserly, Brahmajee K Nallamothu, Matthew T Roe, Thomas T Tsai, John C Messenger
BACKGROUND: Acute kidney injury (AKI) remains a common complication after percutaneous coronary intervention (PCI) and is associated with adverse in-hospital patient outcomes. The incidence of adverse events after hospital discharge in patients having post-PCI AKI is poorly defined, and the relationship between AKI and outcomes after hospital discharge remains understudied. METHODS AND RESULTS: Using the National Cardiovascular Data Registry CathPCI registry, we assessed the incidence of AKI among Medicare beneficiaries after PCI from 2004 to 2009 and subsequent post-discharge adverse events at 1 year...
April 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28391314/continued-monitoring-of-acute-kidney-injury-survivors-might-not-be-necessary-in-those-regaining-an-estimated-glomerular-filtration-rate-60%C3%A2-ml-min-at-1-year
#11
Sokratis Stoumpos, Patrick B Mark, Emily P McQuarrie, Jamie P Traynor, Colin C Geddes
Background.: Severe acute kidney injury (AKI) among hospitalized patients often necessitates initiation of short-term dialysis. Little is known about the long-term outcome of those who recover to normal renal function. The aim of this study was to determine the long-term renal outcome of patients experiencing AKI requiring dialysis secondary to hypoperfusion injury and/or sepsis who recovered to apparently normal renal function. Methods.: All adult patients with AKI requiring dialysis in our centre between 1 January 1980 and 31 December 2010 were identified...
January 1, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28389813/plasma-neutrophil-gelatinase-associated-lipocalin-is-associated-with-iron-status-in-anemic-patients-with-pre-dialysis-chronic-kidney-disease
#12
Il Young Kim, Joo Hui Kim, Dong Won Lee, Soo Bong Lee, Harin Rhee, Sang Heon Song, Eun Young Seong, Ihm Soo Kwak
BACKGROUND: Iron deficiency anemia is common in patients with chronic kidney disease (CKD). Neutrophil gelatinase-associated lipocalin (NGAL), a biomarker of acute kidney injury, is known to be associated with iron metabolism. We investigated whether plasma NGAL level is associated with iron status in pre-dialysis CKD patients with anemia. METHODS: This study included 419 patients who had anemia. The subjects were into categorized into a pre-dialysis group (estimated glomerular filtration rate [eGFR] <60 ml/min/1...
April 7, 2017: Clinical and Experimental Nephrology
https://www.readbyqxmd.com/read/28388752/-acute-kidney-injury-potentials-to%C3%A2-improve-aki-related-health-care-structure
#13
REVIEW
Christian Nusshag, Konrad Obermann, Markus Weigand, Vedat Schwenger
Since 2005 the AKI numbers nearly increased threefold. The prevailing health care structure for AKI-management in Germany possesses major potential for improvement. Despite a clear advantage regarding mortality and renal recovery, the cost-intensive CRRT is the predominant procedure in AKI-therapy. Conversion of 85 % of the CRRT-procedures to a dialysis procedure (IHD/SLED) enables annual savings in AKI-therapy by 7.3 million Euros. A reinvestment can finance a strengthened collaboration with licensed nephrologists to improve therapy quality and availability of RRT-units in local hospitals...
April 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28380638/when-is-a-meta-analysis-conclusive-a-guide-to-trial-sequential-analysis-with-an-example-of-remote-ischemic-preconditioning-for-renoprotection-in-patients-undergoing-cardiac-surgery
#14
Pavel S Roshanov, Brittany B Dennis, Nicholas Pasic, Amit X Garg, Michael Walsh
Regardless of whether a randomized trial finds a statistically significant effect for an intervention or not, readers often wonder if the trial was large enough to be conclusive. To answer this question, we can estimate the required sample size for a trial by considering how commonly the outcome occurs, the smallest effect of clinical importance and the acceptable risk of falsely detecting or rejecting that effect. But when is a meta-analysis conclusive? We explain and illustrate the interpretation of Trial Sequential Analysis (TSA), a method increasingly used to answer this question...
April 1, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28375502/pro-prevention-of-acute-kidney-injury-time-for-teamwork-and-new-biomarkers
#15
Claudio Ronco, Lilia Rizo-Topete, Mara Serrano-Soto, Kianoush Kashani
Acute kidney injury (AKI) is a common condition in critically ill patients. Multiple studies have identified AKI as a strong independent risk factor for higher morbidity and mortality. AKI is often multifactorial, asymptomatic and difficult to predict. In recent years, the discovery of several AKI biomarkers, including the recent validation and approval of cell cycle arrest biomarkers (NephroCheck, Astute Medical, San Diego, CA, USA), has provided additional tools to detect patients at high risk of AKI and improve their outcomes...
March 1, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28372584/long-term-clinical-outcome-for-patients-poisoned-by-the-fungal-nephrotoxin-orellanine
#16
Heidi Hedman, Johan Holmdahl, Johan Mölne, Kerstin Ebefors, Börje Haraldsson, Jenny Nyström
BACKGROUND: Accidental intake of mushrooms of the Cortinarius species (deadly webcap) may cause irreversible renal damage and the need for dialysis or transplantation. The species is found in forests of Northern Europe, Scandinavia and North America and may be mistaken for other edible mushrooms. The highly selective nephrotoxic compound of the mushroom is called orellanine. Very little is known about the long-term effects of the nephrotoxin. METHODS: We identified patients who ingested deadly webcap in the period of 1979 to 2012...
April 3, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28361230/acute-kidney-injury-and-fluid-overload-in-infants-and-children-after-cardiac-surgery
#17
David M Kwiatkowski, Catherine D Krawczeski
Acute kidney injury is a common and serious complication after congenital heart surgery, particularly among infants. This comorbidity has been independently associated with adverse outcomes including an increase in mortality. Postoperative acute kidney injury has a complex pathophysiology with many risk factors, and therefore no single medication or therapy has been demonstrated to be effective for treatment or prevention. However, it has been established that the associated fluid overload is one of the major determinants of morbidity, particularly in infants after cardiac surgery...
March 30, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28360366/peritoneal-dialysis-to-treat-patients-with-acute-kidney-injury-the-saving-young-lives-experience-in-west-africa-proceedings-of-the-saving-young-lives-session-at-the-first-international-conference-of-dialysis-in-west-africa-dakar-senegal-december-2015
#18
Niang Abdou, Sampson Antwi, Laurence Adonis Koffi, Francis Lalya, Victoria May Adabayeri, Norah Nyah, Dennis Palmer, Ariane Brusselmans, Brett Cullis, John Feehally, Mignon McCulloch, William Smoyer, Fredric O Finkelstein
In December 2015, as part of the First African Dialysis Conference organized in Dakar, Senegal, 5 physicians from West African countries who have participated in the Saving Young Lives Program reviewed their experiences establishing peritoneal dialysis (PD) programs to treat patients with acute kidney injury (AKI). Thus far, nearly 200 patients have received PD treatment in these countries. The interaction and discussion amongst the participants at the meeting was meaningful and informative. The presentations highlighted the creativity, conviction, and determination of the physicians in overcoming the various barriers and challenges they encountered to establish PD/AKI programs...
March 2017: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
https://www.readbyqxmd.com/read/28357590/non-machinery-dialysis-that-achieves-blood-purification-therapy-without-using-full-scale-dialysis-machines
#19
Takaya Abe, Mistutaka Onoda, Tomohiko Matsuura, Jun Sugimura, Wataru Obara, Toshiya Sato, Mihoko Takahashi, Kenta Chiba, Tomiya Abe
An electrical or water supply and a blood purification machine are required for renal replacement therapy. There is a possibility that acute kidney injury can occur in large numbers and on a wide scale in the case of a massive earthquake, and there is the potential risk that the current supply will be unable to cope with acute kidney injury cases. However, non-machinery dialysis requires exclusive circuits and has the characteristic of not requiring the full-scale dialysis machines. We performed perfusion experiments that used non-machinery dialysis and recent blood purification machines in 30-min intervals, and the effectiveness of non-machinery dialysis was evaluated by the assessing the removal efficiency of potassium, which causes lethal arrhythmia during acute kidney injury...
March 29, 2017: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
https://www.readbyqxmd.com/read/28355404/daily-variability-of-resting-energy-expenditure-in-acute-kidney-injury-patients-on-dialysis
#20
Cassiana Regina de Góes, Ana Claudia Soncini Sanches, André Balbi, Daniela Ponce
INTRODUCTION: It is needed for nutrition prescription correct estimate of resting energy expenditure (REE), which is a challenge given the possible daily variation in critically ill patients with acute kidney injury (AKI). OBJECTIVE: To evaluate the daily variability of REE measured by indirect calorimetry (IC) in patients with AKI and dialysis indication and identify clinical variables associated with REE. METHODS: The REE was measured on the time of dialysis indication and the subsequent four days...
March 2017: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
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