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AKI liver

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Background: Acute illness, existing co-morbidities and surgical stress response can all contribute to postoperative acute kidney injury (AKI) in patients undergoing major gastrointestinal surgery. The aim of this study was prospectively to develop a pragmatic prognostic model to stratify patients according to risk of developing AKI after major gastrointestinal surgery. Methods: This prospective multicentre cohort study included consecutive adults undergoing elective or emergency gastrointestinal resection, liver resection or stoma reversal in 2-week blocks over a continuous 3-month period...
December 2018: BJS open
Sina Bagheri, Shahrbanoo Shahbazi, Masih Shafa, Afshin Borhani-Haghighi, Mahsa Kiani, Mohammad Mahdi Sagheb
Background: Remote ischemic preconditioning (RIPC) protects other organs from subsequent lethal ischemic injury, but uncertainty remains. We investigated if RIPC could prevent acute kidney injury (AKI) in patients undergoing coronary artery bypass graft (CABG) surgery. Methods: This parallel-group, double-blind, randomized, controlled trial was done on adults undergoing elective or urgent on-pump CABG surgery from 2013 to 2017 in Shiraz, Iran. Patients were allocated to RIPC or control groups through permuted blocking...
November 2018: Iranian Journal of Medical Sciences
W J Wang, Q Song, H G Ding
Objective: To investigate the clinical features and risk factors for acute kidney injury (AKI) in patients with cirrhosis. Methods: A total of 1 165 hospitalized patients with chronic liver diseases were enrolled. Among them, 94 patients had chronic hepatitis, while 1 071 patients were diagnosed as cirrhosis. The clinical data, renal and liver function were retrospectively analyzed. AKI was determined according to the criteria proposed by International Club of Ascites. Compared with chronic hepatitis group, the clinical features and risk factors for AKI in patients with cirrhosis were evaluated using logistic regression...
December 1, 2018: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
Anthony Bonavia, Kai Singbartl
The liver and kidney are key organs of metabolic homeostasis in the body and display complex interactions. Liver diseases often have direct and immediate effects on renal physiology and function. Conversely, acute kidney injury (AKI) is a common problem in patients with both acute and chronic liver diseases. AKI in patients with acute liver failure is usually multifactorial and involves insults similar to those seen in the general AKI population. Liver cirrhosis affects and is directly affected by aberrations in systemic and renal hemodynamics, inflammatory response, renal handling of sodium and free water excretion, and additional nonvasomotor mechanisms...
October 2018: Seminars in Respiratory and Critical Care Medicine
Kathleen D Liu, Jingrong Yang, Thida C Tan, David V Glidden, Sijie Zheng, Leonid Pravoverov, Chi-Yuan Hsu, Alan S Go
RATIONALE & OBJECTIVE: Acute kidney injury (AKI) has numerous sequelae. Repeated episodes of AKI may be an important determinant of adverse outcomes, including chronic kidney disease and death. In a population-based cohort study, we sought to determine the incidence of and predictors for recurrent AKI. STUDY DESIGN: Retrospective cohort study. SETTING & PARTICIPANTS: 38,659 hospitalized members of Kaiser Permanente Northern California who experienced an episode of AKI from 2006 to 2013...
October 10, 2018: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Yu-Feng Lin, Tao-Min Huang, Shuei-Liong Lin, Vin-Cent Wu, Kwan-Dun Wu
Objective: Prompt assessment of perioperative complications is critical for the comprehensive care of surgical patients. Acute kidney injury requiring dialysis (AKI-D) is associated with high mortality, yet little is known about how long-term outcomes of patients have evolved. The association of AKI-D with postsurgical outcomes has not been well studied. Methods: We investigated patients from the National Health Insurance Research Database and validated by the multicenter Clinical Trial Consortium for Renal Diseases cohort...
2018: Clinical Epidemiology
Hyung-Chul Lee, Soo Bin Yoon, Seong-Mi Yang, Won Ho Kim, Ho-Geol Ryu, Chul-Woo Jung, Kyung-Suk Suh, Kook Hyun Lee
Acute kidney injury (AKI) after liver transplantation has been reported to be associated with increased mortality. Recently, machine learning approaches were reported to have better predictive ability than the classic statistical analysis. We compared the performance of machine learning approaches with that of logistic regression analysis to predict AKI after liver transplantation. We reviewed 1211 patients and preoperative and intraoperative anesthesia and surgery-related variables were obtained. The primary outcome was postoperative AKI defined by acute kidney injury network criteria...
November 8, 2018: Journal of Clinical Medicine
Francis P Robertson, Arthur C Yeung, Victoria Male, Suehana Rahman, Susan Mallett, Barry J Fuller, Brian R Davidson
BACKGROUND: Acute Kidney Injury, a common complication of liver transplant, is associated with a significant increase in the risk of morbidity, mortality and graft loss. Current diagnostic criteria leaves a delay in diagnosis allowing further potential irreversible damage. Early biomarkers of renal injury are of clinical importance and Neutrophil Gelatinase Associated Lipocalins (NGALs) and Syndecan-1 were investigated. METHODS: AKI was defined according to the Acute Kidney Injury Network criteria...
October 30, 2018: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
Beate Appenrodt, Frank Lammert
Renal failure is a severe complication in patients with liver cirrhosis. It is associated with increased mortality and morbidity. Diagnosis is a challenge because it is mainly based on serum creatinine, which does not seem to be an ideal measure of renal function in cirrhosis. The definition of renal failure in these patients has been changed for optimizing treatment and for improving outcome and prognosis. The new criteria are based on the adapted KDIGO (Kidney Disease: Improving Global Outcomes) staging system...
August 2018: Visceral Medicine
Kinsuk Chauhan, Yorg Azzi, Geovani Faddoul, Luz Liriano-Ward, Paul Chang, Girish Nadkarni, Veronica Delaney, Scott Ames, Neha Debnath, Nandita Singh, Vinita Sehgal, Graciela Di Boccardo, Felipe Garzon, Vinay Nair, Rebecca Kent, Susan Lerner, Steven Coca, Ron Shapiro, Sander Florman, Thomas Schiano, Madhav C Menon
SLK allocation protocols allocate dual-organs based on a sustained eGFR of 30 ml/min or less. A 2017-UNOS update includes CKD3 as dual organ candidates but only when the listing eGFR is less than 30 ml/min while recommending a "safety net" for prioritized kidney listing post-LT. We retrospectively reviewed adult LTs examine whether the UNOS proposal captured the LT population at highest risk for developing post-LT ESRD. Among 290 LT-recipients, 67 had pre-LT CKD3, 141 had AKI, of whom 47 required dialysis (<4 weeks)...
October 19, 2018: Clinical Transplantation
Benjamin P T Loveday, Martin J Dib, Sangita Sequeira, Nouf Alotaiby, Robin Visser, Andrew S Barbas, Alice C Wei, Sean P Cleary, Carol-Anne Moulton, Steven Gallinger, Paul D Greig, Ian D McGilvray
BACKGROUND: The left renal vein (LRV) may be used for venous reconstruction during hepato-pancreato-biliary (HPB) surgery, although concerns exist about compromising renal function. This study aimed to determine renal outcomes following LRV harvest during HPB resections. METHODS: Circumferential PV/SMV resections from 2008 to 2014 were included within two groups (LRV harvest, Control). Absolute and change in Creatinine (Cr) and estimated GFR (eGFR), and rates of acute kidney injury (AKI) and chronic kidney disease (CKD), were compared...
October 12, 2018: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
Hajar F Karaali, Ragaee R Fahmi, Jamilah M Borjac
Background Acetaminophen (APAP) is one of the most widely used drugs to treat pain. Its overdose is lethal causing liver and kidney failure. Nephrotoxicity and hepatotoxicity are mostly due to the overproduction of reactive oxygen species. Ocimum basilicum, known as basil, is a commonly used medicinal plant due to its versatile role as antibacterial, antifungal, and anti-oxidative. We aim in this study to investigate the preventive and protective effect of basil leaves aqueous extract against APAP-induced hepatorenal toxicity in BALB/c mice...
October 12, 2018: Journal of Complementary & Integrative Medicine
Lena Sibulesky, Scott W Biggins, Raimund Pichler
Acute kidney injury (AKI) is a frequent postoperative complication after liver transplantation. The etiology is multifactorial, including perioperative renal status, surgery related events, and postoperative immunosuppression therapy. The role of renal hypoperfusion and hepatic ischemia-reperfusion injury as causes of early AKI are now being increasingly recognized. Further studies should focus on therapies that would attenuate this injury.
September 27, 2018: World Journal of Hepatology
Geraldo Bezerra da Silva Junior, Sérgio Luiz Arruda Parente Filho, Douglas de Sousa Soares, Rodrigo da Nóbrega de Alencar, Tiago Tomaz Teles Peixoto, Isadora Sales Nogueira, Antônio Mendes Ponte de Oliveira Filho, Fernanda Holanda Menezes, Malena Gadelha Cavalcante, Roberto da Justa Pires Neto, Elizabeth de Francesco Daher
OBJECTIVE: HIV-related mortality is still high, especially in developed countries. The aim of this study is to investigate factors associated to death in HIV-infected patients. METHODS: This is a cross-sectional study with all HIV adult patients admitted to a tertiary infectious diseases hospital in Fortaleza, Northeast Brazil, from January 2013 to December 2014. Patients were divided into two groups: survivors and non-survivors. Demo-graphical, clinical and laboratory data were compared and a logistic regression was performed in order to investigate risk factors for death...
June 2018: Revista da Associação Médica Brasileira
William Beaubien-Souligny, Marie-Noëlle Pépin, Louis Legault, Jean-François Cailhier, Jean Éthier, Louis Bouchard, Bernard Willems, André Y Denault
Rationale: Acute kidney injury (AKI) is a frequent complication after liver transplantation. In some patients, prompt intervention targeted at a specific etiology is of paramount importance. Presenting concerns of the patients: A 25 years old man with advanced liver cirrhosis caused by sclerosing cholangitis and autoimmune hepatitis underwent orthotopic liver transplantation. One month after surgery, severe AKI developed in conjunction with recurrent ascites and lower extremity edema...
2018: Canadian Journal of Kidney Health and Disease
Ying Tang, Shiu-Kwong Mak, An P Xu, Hui-Yao Lan
Acute kidney injury (AKI) is characterized by both non-inflammatory and inflammatory process, and accumulating evidence has demonstrated that inflammation plays a key role in the pathogenesis and progression of AKI. C-reactive protein (CRP), an acute reactant produced by liver and many inflammatory cells, acts not only as an inflammation biomarker, but also as a pathogenic factor for AKI. Indeed, increased concentration of CRP is associated with poor outcome of varied etiologically related AKI patients. In recent years, the role of CRP is gradually recognized as an active participant in the pathogenesis and progression of AKI by exacerbating local inflammation, impairing the proliferation of damaged tubular epithelial cells and promoting fibrosis of injured renal tissue...
October 2018: Nephrology
Arthur C Y Yeung, Andrew Morozov, Francis P Robertson, Barry J Fuller, Brian R Davidson
BACKGROUND: Acute kidney injury (AKI) is common after orthotopic liver transplantation (OLT) usually occurring early post-transplant. Multiple causes include graft preservation injury, blood loss, hypotension but also severity of recipient liver disease. Early intervention in AKI has both short and long term patient benefits. Unfortunately there are no current clinical biomarkers of early AKI. AIM: To assess the value of NGAL in predicting AKI following OLT. METHODS: Ovid MEDLINE and EMBASE were searched between the years of 2000 and 2017 for studies using keywords: Neutrophil Gelatinase Associated Lipocalin or NGAL variants combined with synonyms for liver transplantation...
September 28, 2018: International Journal of Surgery
Li-Li Huang, Rui-Ting Long, Gui-Ping Jiang, Xiao Jiang, Hang Sun, Hui Guo, Xiao-Hui Liao
Mitochondria are the center of energy metabolism in the cell and the preferential target of various toxicants and ischemic injury. Renal ischemia-reperfusion (I/R) injury triggers proximal tubule injury and the mitochondria are believed to be the primary subcellular target of I/R injury. The promotion of mitochondrial biogenesis (MB) is critical for the prevention I/R injury. The results of our previous study showed that augmenter of liver regeneration (ALR) has anti-apoptotic and anti-oxidant functions. However, the modulatory mechanism of ALR remains unclear and warrants further investigation...
December 2018: Apoptosis: An International Journal on Programmed Cell Death
Joanna Baron-Stefaniak, Judith Schiefer, Paul Lichtenegger, Edmund J Miller, Gabriela A Berlakovich, Peter Faybik, David M Baron
BACKGROUND: Elevated concentrations of D-dopachrome tautomerase (D-DT) were associated with adverse outcome in various clinical settings. However, no study assessed D-DT concentrations in patients requiring orthotopic liver transplantation (OLT). The aim of this observational study was to measure serum D-DT concentrations in patients undergoing OLT and associate D-DT with survival and acute kidney injury (AKI). METHODS: Forty-seven adults with end-stage liver disease undergoing OLT were included...
September 22, 2018: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
Alexsander K. Bressan, Matthew T. James, Elijah Dixon, Oliver F. Bathe, Francis R. Sutherland, Chad G. Ball
Background: Acute kidney injury (AKI) is associated with increased morbidity and mortality after liver resection. Patients with hepatocellular carcinoma (HCC) have a higher risk of AKI owing to the underlying association between hepatic and renal dysfunction. Use of the Acute Kidney Injury Network (AKIN) diagnostic criteria is recommended for patients with cirrhosis, but remains poorly studied following liver resection. We compared the prognostic value of the AKIN creatinine and urine output criteria in terms of postoperative outcomes following liver resection for HCC...
October 1, 2018: Canadian Journal of Surgery. Journal Canadien de Chirurgie
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