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Acute kidney injury, chronic kidney disease

Kátia Alves Ramos, Cristiane Bitencourt Dias
INTRODUCTION: Among patients undergoing cardiac surgery, the occurrence of acute renal injury appears to be associated with worse prognosis and increased mortality. The objective of this study was to evaluate risk factors and the impact this complication on mortality and survival after cardiac surgery among patients without chronic kidney disease. METHODS: In this retrospective study, we reviewed the medical records of 142 patients who underwent elective coronary artery bypass grafting, valve replacement (single or multiple), or both (simultaneously) at a tertiary care hospital...
September 2018: Brazilian Journal of Cardiovascular Surgery
Lies Moonen, Hilde Geryl, Patrick C D'Haese, Benjamin A Vervaet
BACKGROUND: Acute kidney injury (AKI) is an underestimated, yet important, risk factor for the development of chronic kidney disease (CKD). Persistence of inflammation after a renal ischemic injury has been observed, both in experimental models and patients, and is thought to be an important mechanisms underlying progression of acute-to-chronic renal injury. Temporary suppression of inflammation immediately after AKI might therefore be a good first-line therapeutic strategy towards a better long term outcome...
December 3, 2018: BMC Nephrology
Thomas Vauchel, Romain Pirracchio, Maïté Chaussard, Matthieu Lafaurie, Martine Rouveau, Clotilde Rousseau, Mourad Benyamina, Sabri Soussi, François Dépret, Axelle Ferry, Haikel Oueslati, Marc Chaouat, Maurice Mimoun, Vincent Jarlier, Nabila Moreno, Alexandre Mebazaa, Matthieu Legrand
BACKGROUND: Multidrug-resistant (MDR) bacteria outbreaks represent a major threat in intensive care units. Patients may then be exposed to drug-related direct toxicity during such outbreaks. The objective of this study was to explore the impact of an outbreak of imipenem-resistant Acinetobacter baumannii (IR-AB) on renal outcomes. METHODS: We performed a before-and-after observational study in a French burn intensive care unit during an IR-AB outbreak: a 13-month period before (period A, October 2013-October 2014) and a 13-month period after outbreak control (period B, December 2014-December 2015)...
November 29, 2018: American Journal of Infection Control
Nicholas Cole, Nicholas M Selby, Lui G Forni
Background: Acute Kidney Injury (AKI) is associated with adverse outcomes; therefore identifying patients who are at risk of developing AKI in hospital may lead to targeted prevention. Aim: We undertook a UK-wide study in acute medical units (AMUs) to define those who develop hospital-acquired AKI (hAKI); to determine risk factors associated with hAKI and to assess the feasibility of developing a risk prediction score. Design: Prospective multicentre cohort study across 72 acute medical units in the UK...
November 28, 2018: QJM: Monthly Journal of the Association of Physicians
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
Cierra N Sharp, Mark Doll, Tess V Dupre, Levi J Beverly, Leah J Siskind
Aging is a risk factor for certain forms of kidney injury due to normal physiological changes, but the role aging plays in cisplatin-induced kidney injury is not well-defined in humans or animal models of the disease. To improve on current knowledge in this field, we treated eight and forty week old FVB/n mice with either one, high dose of cisplatin as a model of acute kidney injury (AKI) or with repeated, low doses of cisplatin (7 mg/kg cisplatin once a week for four weeks) as a clinically relevant model of chronic kidney disease (CKD) to determine if aging exacerbates cisplatin-induced kidney injury...
November 28, 2018: American Journal of Physiology. Renal Physiology
Nao Uchida, Naonori Kumagai, Yoshiaki Kondo
The kidney plays an essential role in the maintenance of homeostasis in healthy individuals, e.g., by regulating the amount of water and concentration of electrolyte in the body. Owing to the structural complexity, renal dysfunction is caused by a myriad of diseases and conditions, and in severe cases, it progresses to end-stage renal disease in which patients require renal replacement therapy, i.e., maintenance dialysis or kidney transplantation. The currently available therapeutic modalities, with the exception of renal transplantation, cannot recover severely deteriorated renal function...
2018: Advances in Experimental Medicine and Biology
Su-Mi Kim, Yang Gyun Kim, Dong-Jin Kim, Seon Hwa Park, Kyung-Hwan Jeong, Yu Ho Lee, Sung Jig Lim, Sang-Ho Lee, Ju-Young Moon
The NOD-like receptor family, pyrin domain containing-3 (NLRP3) inflammasome has been implicated in renal inflammation and fibrosis. However, the biological function of inflammasome-independent NLRP3 in non-immune cells is still unclear. We evaluated the role of inflammasome-independent NLRP3 in renal tubular cells and assessed the value of NLRP3 as a therapeutic target for acute kidney injury (AKI). Various renal tubular cell lines and primary cultured tubular cells from NLRP3 knockout (KO) mice were used for in vitro studies...
2018: Frontiers in Immunology
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
Jifu Jin, Su Chi Chang, Bo Shen, Jiarui Xu, Wuhua Jiang, Yimei Wang, Yamin Zhuang, Chunsheng Wang, Jie Teng, Xiaoqiang Ding
High estimated pulmonary artery systolic pressure (ePASP) has been established as a detrimental predictor for adverse outcomes in patients with chronic kidney disease. However, the relation between preoperative high ePASP and the development of cardiac surgery associated acute kidney injury (CSA-AKI) has not been validated. We performed a retrospective cohort study of adult patients who underwent valve surgery in 2015 at Zhongshan Hospital, Fudan University. Right ventricular systolic pressure, a surrogate for pulmonary systolic pressure, was estimated in the study group of 1056 patients by preoperative echocardiography...
November 6, 2018: American Journal of Cardiology
Emily J See, Kushani Jayasinghe, Neil Glassford, Michael Bailey, David W Johnson, Kevan R Polkinghorne, Nigel D Toussaint, Rinaldo Bellomo
Reliable estimates of the long-term outcomes of acute kidney injury (AKI) are needed to inform clinical practice and guide allocation of health care resources. This systematic review and meta-analysis aimed to quantify the association between AKI and chronic kidney disease (CKD), end-stage kidney disease (ESKD), and death. Systematic searches were performed through EMBASE, MEDLINE, and grey literature sources to identify cohort studies in hospitalized adults that used standardized definitions for AKI, included a non-exposed comparator, and followed patients for at least 1 year...
November 22, 2018: Kidney International
Toshiyuki Mizota, Li Dong, Chikashi Takeda, Atsuko Shiraki, Shino Matsukawa, Satoshi Shimizu, Shinichi Kai
PURPOSE: We conducted a retrospective cohort study to determine incidences of transient and persistent acute kidney injury (AKI) after major abdominal surgery and their impacts on long-term outcome. MATERIALS AND METHODS: We enrolled 3751 patients undergoing major abdominal surgery. Postoperative AKI was classified as transient or persistent based on the return of serum creatinine to the non-AKI range within 7 days post-surgery. Primary outcome was mortality within 1 year...
November 13, 2018: Journal of Critical Care
Santiago Garcia, Deepak L Bhatt, Martin Gallagher, Hani Jneid, James Kaufman, Paul M Palevsky, Hongsheng Wu, Steven D Weisbord
OBJECTIVES: The aim of this study was to compare intravenous (IV) sodium bicarbonate with IV sodium chloride and oral acetylcysteine with placebo for the prevention of contrast-associated acute kidney injury (CAAKI) and intermediate-term adverse outcomes. BACKGROUND: Data are conflicting on the optimal strategy to reduce CAAKI and related complications after percutaneous coronary intervention (PCI). METHODS: The PRESERVE (Prevention of Serious Adverse Events Following Angiography) trial used a 2 × 2 factorial design to randomize 5,177 patients with stage III or IV chronic kidney disease undergoing angiography to IV 1...
November 26, 2018: JACC. Cardiovascular Interventions
Rebecca S B Fischer, Chandan Vangala, Sreedhar Mandayam, Denis Chavarria, Ramón García-Trabanino, Felix Garcia, Linda L Garcia, Kristy O Murray
An epidemic of chronic kidney disease (CKD) of unknown etiology, known as Mesoamerican Nephropathy (MeN), has been ongoing in Latin America for at least two decades. MeN primarily affects young adults without traditional CKD risk factors, and agricultural workers are disproportionately afflicted. We previously identified an acute phase of MeN that involves acute kidney injury (AKI) with tubulointerstitial nephritis and systemic inflammation. Because clinical disease progression in MeN is not yet understood, we sought to determine clinical predictors for progression from acute MeN to CKD...
December 2018: Kidney International
Jing Zhang, Ying Guo, Qi Jin, Li Bian, Ping Lin
Background: Contrast-induced nephropathy (CIN) is a complication after the intravascular administration of a contrast medium injection. Previous studies have investigated statins as therapy for CIN due to its positive results in the prevention of contrast-induced acute kidney injury (CI-AKI). Nevertheless, the beneficial effects of rosuvastatin pretreatment in preventing CIN in patients with acute coronary syndromes still remain controversial. In this study, we performed a meta-analysis of randomized controlled trials (RCTs) to evaluate the beneficial impact of rosuvastatin in the prevention of CI-AKI in acute coronary syndrome patients...
2018: Drug Design, Development and Therapy
Kyoung Lok Min, Eun Sun Son, Jae Song Kim, Soo Hyun Kim, Sun Mi Jung, Min Jung Chang
BACKGROUND: Nephrotoxicity of intravenous (IV) colistin has impeded its clinical use; aerosolized (AS) colistin may be an alternative, but safety data are lacking. Therefore, this study aimed to evaluate the incidence of acute kidney injury (AKI) and risk factors associated with IV and AS colistin administration. METHODS: A retrospective study was performed in a tertiary referral hospital. Data were collected before and after colistin administration between October 2012 and April 2016...
2018: PloS One
Hong-Yan Li, Shen Yang, Jing-Chun Li, Jian-Xun Feng
Nephrotoxicity is a major toxic effect in chemotherapy, which constitutes up to 60% of hospitalized acute kidney injury (AKI). Very few treatment options exist to slow the transition from AKI to subsequent chronic kidney diseases (CKD). Here, we demonstrate that galectin-3 (Gal-3), a β-galactoside binding lectin that plays an important role in kidney fibrosis and renal failure, is one of the key factors for renal injury progression. Ectopic overexpression of Gal-3 significantly decreased the viability of HEK293, simultaneously inducing of cell cycle arrest and apoptosis...
November 19, 2018: Bioscience Reports
Rebecca L Ruebner, Jeffrey J Fadrowski
Tubulointerstitial nephritis (TIN) is a cause of acute kidney injury in children characterized histologically by an inflammatory cell infiltrate in the kidney interstitium. The most common causes of TIN in children include medications, infections, inflammatory disorders, and genetic conditions. TIN typically presents with nonoliguric acute kidney injury and may be associated with systemic symptoms, including fever, rash, and eosinophilia. The long-term prognosis is generally favorable, with full kidney recovery; however, some patients may develop progressive chronic kidney disease...
February 2019: Pediatric Clinics of North America
Maciej Fijałkowski, Joanna Stępniewska, Maciej Domański, Kazimierz Ciechanowski, Edyta Golembiewska
Eicosanoids are biologically active molecules that are created in the process of oxidation of arachidonic acid (AA) which is a constituent of the cell membrane phospholipids. Throughout the years it was evidenced by experiments that the lipid and lipid-derived metabolites play an important role in physiological and pathological processes in the kidneys. They are being considered as biomarkers in detecting acute kidney injury, nephrotoxicity, glomerulonephritis and early stages of diabetic nephropathy because of their participation in inflammatory processes and in oxidative stress...
November 19, 2018: Acta Biochimica Polonica
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