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Predictors of AKI

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
Chenxi Huang, Karthik Murugiah, Shiwani Mahajan, Shu-Xia Li, Sanket S Dhruva, Julian S Haimovich, Yongfei Wang, Wade L Schulz, Jeffrey M Testani, Francis P Wilson, Carlos I Mena, Frederick A Masoudi, John S Rumsfeld, John A Spertus, Bobak J Mortazavi, Harlan M Krumholz
BACKGROUND: The current acute kidney injury (AKI) risk prediction model for patients undergoing percutaneous coronary intervention (PCI) from the American College of Cardiology (ACC) National Cardiovascular Data Registry (NCDR) employed regression techniques. This study aimed to evaluate whether models using machine learning techniques could significantly improve AKI risk prediction after PCI. METHODS AND FINDINGS: We used the same cohort and candidate variables used to develop the current NCDR CathPCI Registry AKI model, including 947,091 patients who underwent PCI procedures between June 1, 2009, and June 30, 2011...
November 2018: PLoS Medicine
Daniel Maxwell, Peter Rhee, Mack Drake, Juvonda Hodge, Walter Ingram, Rachael Williams
BACKGROUND: Frailty has demonstrated enhanced prognostic ability for elderly patient morbidity. The aim was to create a burn-specific frailty index for elderly patients and compare it to commonly used scoring systems in burn management. METHODS: From 2013 to 2017, we prospectively surveyed a randomized cohort of patients ≥65-years-old previously admitted to our burn unit. Prognostic comparisons with 6 commonly used indices and multivariate risk analyses were performed...
November 14, 2018: American Journal of Surgery
Wenjian Mao, Jingyi Wu, He Zhang, Jing Zhou, Bo Ye, Gang Li, Lin Gao, Xiaoyao Li, Lu Ke, Zhihui Tong, Weiqin Li, Jieshou Li
OBJECTIVE: We aimed to evaluate whether early (first 48 h) hyperchloremia and/or the change of serum chloride concentration are associated with acute kidney injury (AKI) in patients with moderately severe and severe acute pancreatitis (MSAP and SAP). METHODS: We retrospectively collected the data of patients with a primary diagnosis of MSAP or SAP from a tertiary center between January 2014 and June 2017. Consecutive chloride levels within the first 48 h after admission were retrieved for further calculation...
November 17, 2018: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
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
Erik Roman-Pognuz, Jonathan Elmer, Jon C Rittenberger, Francis X Guyette, Giorgio Berlot, Silvia De Rosa, Alberto Peratoner, Blanca Martinez Lopez de Arroyabe, Umberto Lucangelo, Clifton W Callaway
OBJECTIVE: Ischemia and reperfusion injury (IRI) in cardiac arrest patients after return to spontaneous circulation causes dysfunctions in multiple organs. Kidney injury is generally transient but in some patients persists and contributes both to mortality and increased resource utilisation. Ongoing shock may compound renal injury from IRI, resulting in persistent dysfunction. We tested whether cardiac dysfunction was associated with the development of persistent acute kidney injury (PAKI) in the first 72 h after cardiac arrest...
November 20, 2018: Heart & Lung: the Journal of Critical Care
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
Johannes P C van den Akker, Jan Bakker, A B J Groeneveld, C A den Uil
PURPOSE: In critical illness, the relation between the macrocirculation, microcirculation and organ dysfunction, such as acute kidney injury (AKI), is complex. This study aimed at identifying predictors for AKI in patients with cardiogenic shock. MATERIALS AND METHODS: Thirty-nine adult cardiogenic shock patients, with an admission creatinine <200 μmol l-1 , and whose microcirculation was measured within 48 h were enrolled. Patient data were analyzed if AKI stage ≥1 developed according to the Kidney Disease/Improving Outcomes classification within 48 h after admission...
November 10, 2018: Journal of Critical Care
Samuel J Weisenthal, Caroline Quill, Samir Farooq, Henry Kautz, Martin S Zand
Acute Kidney Injury (AKI), a sudden decline in kidney function, is associated with increased mortality, morbidity, length of stay, and hospital cost. Since AKI is sometimes preventable, there is great interest in prediction. Most existing studies consider all patients and therefore restrict to features available in the first hours of hospitalization. Here, the focus is instead on rehospitalized patients, a cohort in which rich longitudinal features from prior hospitalizations can be analyzed. Our objective is to provide a risk score directly at hospital re-entry...
2018: PloS One
Jianjun Xu, Yun Xia, Suzhen Li, Xiang Cheng, Shaobo Hu, Xing Zhou, Yang Gao, Guoliang Wang, Qichang Zheng
BACKGROUND: The aspartate aminotransferase (AST) / alanine aminotransferase (ALT) ratio(AST/ALT) is an independent predictor of hepatic disease. OBJECTIVES: To evaluate the association between pre-operative AST/ALT and post-operative acute kidney injury(AKI) in hepatocellular carcinoma (HCC) patients. METHODS: A total of 422 hepatitis B- or C- virus associated HCC patients, who underwent hepatectomy between September 2012 and April 2018, were enrolled this retrospective study...
November 19, 2018: Annals of Clinical Biochemistry
Mai Matsumoto, Naomi Ishige, Azusa Sakamoto, Aki Saito, Shinji Ikemoto
OBJECTIVE: Breakfast skipping is regarded as a public health issue among adults worldwide. Nutrition knowledge has been reported to be one of predictors of dietary behaviour. Therefore, the aim of the present study was to examine the association between nutrition knowledge and breakfast skipping. DESIGN: Data regarding nutrition knowledge were obtained by using a validated, self-administered general nutrition knowledge questionnaire for Japanese adults (JGNKQ). Participants were classified into three nutrition knowledge level groups according to total JGNKQ score: Low, Middle and High...
November 19, 2018: Public Health Nutrition
Maija Toivakka, Aki Pihlapuro, Markku Tykkyläinen, Lauri Mehtätalo, Tiina Laatikainen
BACKGROUND: Assessment of the differences in the outcomes of care by socioeconomic status (SES) is beneficial for both the efficient targeting of health care services and to decrease health inequalities. This study compares the effects of three patient-based SES predictors (earned income, educational attainment, employment status) with three small-area-based SES predictors (median income, educational attainment, proportion of the unemployed) on the treatment outcomes of type 2 diabetes patients...
November 14, 2018: BMC Public Health
Kelly Roveran Genga, Mark Trinder, HyeJin Julia Kong, Xuan Li, Alex K K Leung, Tadanaga Shimada, Keith R Walley, James A Russell, Gordon A Francis, Liam R Brunham, John H Boyd
High-density cholesterol (HDL-C) levels are influenced by genetic variation in several genes. Low levels of HDL-C have been associated with increased risk of acute kidney injury (AKI). We investigated whether genetic polymorphisms in ten genes known to regulate HDL-C levels are associated with both HDL-C levels and AKI development during sepsis. Two cohorts were retrospectively analyzed: Derivation Cohort (202 patients with sepsis enrolled at the Emergency Department from 2011 to 2014 in Vancouver, Canada); Validation Cohort (604 septic shock patients enrolled into the Vasopressin in Septic Shock Trial (VASST))...
November 13, 2018: Scientific Reports
Diamantina Marouli, Kostas Stylianou, Eleftherios Papadakis, Nikolaos Kroustalakis, Stavroula Kolyvaki, Georgios Papadopoulos, Christos Ioannou, Alexandra Papaioannou, Eugene Daphnis, Dimitris Georgopoulos, Helen Askitopoulou
BACKGROUND: Postoperative Acute Kidney Injury (AKI) is a common and serious complication associated with significant morbidity and mortality. While several pre- and intra-operative risk factors for AKI have been recognized in cardiac surgery patients, relatively few data are available regarding the incidence and risk factors for perioperative AKI in other surgical operations. The aim of the present study was to determine the risk factors for perioperative AKI in patients undergoing major abdominal surgery...
November 9, 2018: Journal of Clinical Medicine
Takao Nonaka, Naoyuki Kimura, Daijiro Hori, Yusuke Sasabuchi, Mitsunori Nakano, Koichi Yuri, Masamitsu Sanui, Harunobu Matsumoto, Atsushi Yamaguchi
Objective : To investigate the predictors of acute kidney injury (AKI) following surgery for abdominal aortic aneurysm. Materials and Methods : Subjects were 642 non-hemodialysis patients (open aortic repair [OAR] group, n=453; endovascular aortic repair [EVAR] group, n=189) who underwent elective surgery between 2009 and 2015. AKI was assessed according to the Kidney Disease Improving Global Outcomes criteria. In-hospital mortality and incidence of AKI were compared between the OAR and EVAR groups. The effect of AKI on outcomes and predictors of AKI were examined in both groups...
September 25, 2018: Annals of Vascular Diseases
Kenichiro Otsuka, Kenei Shimada, Hisashi Katayama, Haruo Nakamura, Hirotoshi Ishikawa, Hisateru Takeda, Kohei Fujimoto, Noriaki Kasayuki, Minoru Yoshiyama
Renal dysfunction and its change pattern are associated with short- and long-term mortality. However, it remains to be investigated whether or not worsening renal function (WRF) defined by baseline renal function identified from different time points would provide prognostic implication on outcomes in acute coronary syndrome (ACS) patients. This study consists of 334 ACS patients (mean age 68 ± 11 years, 75% male) treated with emergent percutaneous coronary intervention (PCI). Estimated glomerular filtration rate (eGFR) was evaluated on baseline, during hospitalization, at discharge, and at 3-month follow-up...
November 1, 2018: Heart and Vessels
Stephanie Attard, Jesmar Buttigieg, Stephanie Galea, Malcolm Mintoff, Emanuel Farrugia, Andrew Cassar
INTRODUCTION AND AIMS: Transcatheter aortic valve implantation (TAVI) is an alternative procedure for patients with symptomatic aortic stenosis unfit for open heart surgery. Notwithstanding the safer profile, TAVI can still result in serious complications including acute kidney injury (AKI). MATERIALS AND METHODS: We conducted a single-center retrospective study to investigate the incidence of AKI following TAVI, identify any predictors, and assess the impact on patient survival...
December 2018: Clinical Nephrology
M Kopytsya, Ya Hilova, I Vyshnevska, O Petyunina
Aim - to research sST2 level in risk of acute kidney injury after ST-elevation myocardial infarction (STEMI). 103 patients with STEMI, 75 (72.8%) male and 28 (27.2%) female at average age 61.85±12.23 years were enrolled. All the patients were divided to 2 groups according to AKIN classification: with creatinine dynamic more than 26.4 µmol/l (1st and more stage) and without those. Serum level of sST2, N-terminated pro-B-type natriuretic peptide (NT- proBNP ) determined by enzyme-like immunoassay at the 1st day of STEMI...
September 2018: Georgian Medical News
Uvesh Mansuri, Achint A Patel, Mihir Dave, Kinsuk Chauhan, Aakashi S Shah, Ramyasree Banala, David Ali, Saad Kamal, Pooja Verma, Shamim Ahmed, Prakash Maiyani, Ambarish C Pathak, Shajoti Rahman, Sejal Savani, Surta Pandya, Girish Nadkarni
Background Community-acquired pneumonia (CAP) is a common cause of hospitalization. While there are single-center studies on acute kidney injury requiring dialysis (AKI-D) and CAP, data on national trends and outcomes regarding AKI-D in CAP hospitalizations is lacking. Methods We utilized the Nationwide Inpatient Sample to analyze trends overall and within subgroups. We also utilized multivariate regression to adjust for potential confounders of annual trends and to generate adjusted odds ratios (aOR) for predictors and outcomes, including mortality and adverse discharge...
August 20, 2018: Curēus
Daisuke Shishikura, Yu Kataoka, Anthony D Pisaniello, Sinny Delacroix, Joseph K Montarello, Stephen J Nicholls, Stephen G Worthley
BACKGROUND: Acute kidney injury (AKI) can be a major complication of transcatheter aortic valve replacement (TAVR). Atheroembolization of debris during catheter manipulation has been considered as a potential factor causing AKI. This study investigates the impact of aortic atheroma burden on AKI post-TAVR and evaluates the potential of preoperative multislice computed tomographic (MSCT) imaging for the assessment of AKI in these patients. METHODS AND RESULTS: Preoperative multislice computed tomographic images were analyzed in 278 patients with symptomatic severe aortic stenosis who underwent TAVR...
August 2018: Circulation. Cardiovascular Interventions
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