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Acute kidney injury on chronic kidney disease

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https://www.readbyqxmd.com/read/29169177/acute-kidney-injury-in-elderly-population-a-prospective-observational-study
#1
Cássia Gomes da Silveira Santos, Rafael Fernandes Romani, Ricardo Benvenutti, João Otávio Ribas Zahdi, Miguel Carlos Riella, Marcelo Mazza do Nascimento
BACKGROUND/AIMS: Acute kidney injury (AKI) has been reported as a recognized condition among the elderly population; however, its clinical epidemiology is still poorly evaluated. We propose to evaluate the epidemiological profile of AKI in hospitalized elderly patients and the variables associated with renal replacement therapy (RRT) dependency at discharge after an episode of AKI. METHODS: This prospective observational study enrolled 286 elderly patients (aged ≥60 years), who had a diagnosis of AKI and were admitted to a tertiary care hospital...
November 23, 2017: Nephron
https://www.readbyqxmd.com/read/29168475/chronic-kidney-disease
#2
REVIEW
Paola Romagnani, Giuseppe Remuzzi, Richard Glassock, Adeera Levin, Kitty J Jager, Marcello Tonelli, Ziad Massy, Christoph Wanner, Hans-Joachim Anders
Chronic kidney disease (CKD) is defined by persistent urine abnormalities, structural abnormalities or impaired excretory renal function suggestive of a loss of functional nephrons. The majority of patients with CKD are at risk of accelerated cardiovascular disease and death. For those who progress to end-stage renal disease, the limited accessibility to renal replacement therapy is a problem in many parts of the world. Risk factors for the development and progression of CKD include low nephron number at birth, nephron loss due to increasing age and acute or chronic kidney injuries caused by toxic exposures or diseases (for example, obesity and type 2 diabetes mellitus)...
November 23, 2017: Nature Reviews. Disease Primers
https://www.readbyqxmd.com/read/29166543/transcatheter-or-surgical-aortic-valve-replacement-in-patients-with-advanced-kidney-disease-a-propensity-score-matched-analysis
#3
Rajkumar Doshi, Jay Shah, Vaibhav Patel, Varun Jauhar, Perwaiz Meraj
BACKGROUND: Transcatheter aortic valve replacement (TAVR) is an alternative for surgically inoperable patients with severe aortic stenosis. Advanced kidney disease may significantly affect outcomes in patients treated with TAVR and surgical aortic valve replacement (SAVR). HYPOTHESIS: TAVR is associated with better in-hospital outcomes compared with SAVR in patients with advanced kidney disease. METHODS: We identified our sample from the National Inpatient Sample between 2012 and 2014, using International Classification of Diseases, Ninth Revision, Clinical Modification codes...
November 22, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/29162339/acute-kidney-injury-and-risk-of-incident-heart-failure-among-us-veterans
#4
Nisha Bansal, Michael E Matheny, Robert A Greevy, Svetlana K Eden, Amy M Perkins, Sharidan K Parr, James Fly, Khaled Abdel-Kader, Jonathan Himmelfarb, Adriana M Hung, Theodore Speroff, T Alp Ikizler, Edward D Siew
BACKGROUND: Acute kidney injury (AKI) is common and associated with poor outcomes. Heart failure is a leading cause of cardiovascular disease among patients with chronic kidney disease. The relationship between AKI and heart failure remains unknown and may identify a novel mechanistic link between kidney and cardiovascular disease. STUDY DESIGN: Observational study. SETTING & PARTICIPANTS: We studied a national cohort of 300,868 hospitalized US veterans (2004-2011) without a history of heart failure...
November 18, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/29155318/kidney-pathology-after-hematologic-cell-transplantation-a-single-center-observation-study-of-indication-biopsies-and-autopsies
#5
Michael Girsberger, Jörg P Halter, Helmut Hopfer, Michael Dickenmann, Thomas Menter
Hematopoietic cell transplantation (HCT) is an increasingly used treatment for hematologic malignancies as well as for non-malignant diseases. Kidney impairment remains an important early and late posttransplant complication. Numerous histopathologic changes have been reported but the pathophysiology is still incompletely understood. Furthermore, correlations between clinical findings and morphologic changes are not well studied. Between 2000 and 2016, 17 patients after allogeneic (n=12) or autologous (n=5) HCT underwent kidney biopsy for either proteinuria or deterioration of kidney function at our center...
November 16, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/29142963/understanding-electronic-aki-alerts-characterization-by-definitional-rules
#6
Jennifer Holmes, Gethin Roberts, Soma Meran, John D Williams, Aled O Phillips
Introduction: Automated acute kidney injury (AKI) electronic alerts are based on comparing creatinine with historic results. Methods: We report the significance of AKI defined by 3 "rules" differing in the time period from which the baseline creatinine is obtained, and AKI with creatinine within the normal range. Results: A total of 47,090 incident episodes of AKI occurred between November 2013 and April 2016. Rule 1 (>26 μmol/l increase in creatinine within 48 hours) accounted for 9...
May 2017: KI Reports
https://www.readbyqxmd.com/read/29133918/fast-simultaneous-assessment-of-renal-and-liver-function-using-polymethine-dyes-in-animal-models-of-chronic-and-acute-organ-injury
#7
A T Press, M J Butans, T P Haider, C Weber, S Neugebauer, M Kiehntopf, U S Schubert, M G Clemens, M Bauer, A Kortgen
Simultaneous assessment of excretory liver and kidney function is still an unmet need in experimental stress models as well as in critical care. The aim of the study was to characterize two polymethine-dyes potentially suitable for this purpose in vivo. Plasma disappearance rate and elimination measurements of simultaneously injected fluorescent dyes DY-780 (hepato-biliary elimination) and DY-654(renal elimination) were conducted using catheter techniques and intravital microscopy in animals subjected to different organ injuries, i...
November 13, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29131132/points-of-concern-in-post-acute-kidney-injury-management
#8
Jill Vanmassenhove, Raymond Vanholder, Norbert Lameire
The incidence of acute kidney injury (AKI) will in the future remain high, partly due to an increase in comorbidities and other AKI favoring factors such as the rise in high-risk diagnostic and therapeutic interventions. AKI has emerged as a major public health concern with high human and financial costs. It has recently been demonstrated that patients surviving an AKI episode show increased all-cause mortality, chronic kidney disease (CKD), ESRD, cardiovascular events, and reduced quality of life. Although it is important to acknowledge that, after an AKI episode, the risk of dying by far exceeds the risk of developing incident or progressive CKD and/or entering a maintenance renal replacement therapy (RRT) program, currently only a minority of patients are referred for renal follow-up, even after AKI-requiring RRT...
November 2, 2017: Nephron
https://www.readbyqxmd.com/read/29127652/dapagliflozin-as-a-cause-of-acute-tubular-necrosis-with-heavy-consequences-a-case-report
#9
Christos Pleros, Elisavet Stamataki, Antonia Papadaki, Nikolaos Damianakis, Rafaela Poulidaki, Charikleia Gakiopoulou, Ioannis Tzanakis
A 50-year-old man with type II diabetes, hypertension and dyslipidemia, presented with non-oliguric acute kidney injury (AKI) and anemia. Renal biopsy showed acute tubular necrosis (ATN) with extensive cytoplasmic vacuolization and areas of tubulitis. These findings were ultimately attributed to dapagliflozin, which he started 3 months earlier due to poor glycemic control. ATN with similar microscopic findings has been described with larger doses of dapagliflozin in non-clinical trials. Our patient was started on dialysis and remained dialysis-dependent for 4 weeks while his renal function improved gradually thereafter...
November 10, 2017: CEN Case Reports
https://www.readbyqxmd.com/read/29124867/acute-kidney-injury-in-critically-ill-surgical-patients-epidemiology-risk-factors-and-outcomes
#10
Konlawij Trongtrakul, Chaiwut Sawawiboon, Amanda Y Wang, Anusang Chitsomkasem, Ploynapas Limphunudom, Sathit Kurathong, Surasee Prommoon, Thananda Trakarnvanich, Nattachai Srisawat
AIM: Acute kidney injury (AKI) is one of the most serious complications seen in intensive care units (ICUs). However, its epidemiology, risk factors and clinical outcomes in surgical critically ill patients remains unclear. METHODS: A prospective cohort study was conducted in surgical intensive care unit (ICU) of the university hospital in Bangkok, Thailand. AKI was diagnosed according to the KDIGO 2012 criteria. RESULTS: A total of 189 of the 400 patients enrolled in our study developed AKI (47...
November 10, 2017: Nephrology
https://www.readbyqxmd.com/read/29120031/histopathological-immunohistochemical-and-stereological-analysis-of-the-effect-of-gingko-biloba-egb761-on-the-hippocampus-of-rats-exposed-to-long-term-cellphone-radiation
#11
Fikret Gevrek
Cellular phones are major sources of electromagnetic radiation (EMR) that can penetrate the human body and pose serious health hazards. The increasingly widespread use of mobile communication systems has raised concerns about the effects of cellphone radiofrequency (RF) on the hippocampus because of its close proximity to radiation during cellphone use. The effects of cellphone EMR exposure on the hippocampus of rats and the possible counteractive effects of ginkgo biloba (Egb761) were aimed to investigate...
November 9, 2017: Histology and Histopathology
https://www.readbyqxmd.com/read/29118769/clinical-usefulness-of-urinary-liver-fatty-acid-binding-protein-excretion-for-predicting-acute-kidney-injury-during-the-first-7-days-and-the-short-term-prognosis-in-acute-heart-failure-patients-with-non-chronic-kidney-disease
#12
Akihiro Shirakabe, Noritake Hata, Nobuaki Kobayashi, Hirotake Okazaki, Masato Matsushita, Yusaku Shibata, Suguru Nishigoori, Saori Uchiyama, Kuniya Asai, Wataru Shimizu
Background: The clinical significance of urinary liver fatty acid-binding protein (u-LFABP) in acute heart failure (AHF) patients remains unclear. Methods and Results: The u-LFABP levels on admission of 293 AHF patients were analyzed. The patients were divided into 2 groups according to the u-LFABP quartiles (Q1, Q2, and Q3 = low u-LFABP [L] group vs. Q4 = high u-LFABP [H] group). We evaluated the diagnostic and prognostic value of u-LFABP and compared the findings between the chronic kidney disease (CKD; n = 165) and non-CKD patients (n = 128)...
October 2017: Cardiorenal Medicine
https://www.readbyqxmd.com/read/29118018/th17-cells-contribute-to-pulmonary-fibrosis-and-inflammation-during-chronic-kidney-disease-progression-following-acute-ischemia
#13
Purvi Mehrotra, Jason A Collett, Susan J Gunst, David P Basile
Acute kidney injury (AKI) is associated with high mortality rates and predisposes development of chronic kidney disease (CKD). Distant organ damage, particularly in the lung, may contribute to mortality in AKI patients. Animal models of AKI demonstrate an increase in pulmonary infiltration of lymphocytes and reveal an acute compromise of lung function, but the chronic effects of AKI on pulmonary inflammation are unknown. We hypothesized that in response to renal I/R, there is a persistent systemic increase in Th17 cells with potential effects on pulmonary structure and function...
November 8, 2017: American Journal of Physiology. Regulatory, Integrative and Comparative Physiology
https://www.readbyqxmd.com/read/29114233/the-jnk-signaling-pathway-in-renal-fibrosis
#14
REVIEW
Keren Grynberg, Frank Y Ma, David J Nikolic-Paterson
Fibrosis of the glomerular and tubulointerstitial compartments is a common feature of chronic kidney disease leading to end-stage renal failure. This fibrotic process involves a number of pathologic mechanisms, including cell death and inflammation. This review focuses on the role of the c-Jun amino terminal kinase (JNK) signaling pathway in the development of renal fibrosis. The JNK pathway is activated in response to various cellular stresses and plays an important role in cell death and inflammation. Activation of JNK signaling is a common feature in most forms of human kidney injury, evident in both intrinsic glomerular and tubular cells as well as in infiltrating leukocytes...
2017: Frontiers in Physiology
https://www.readbyqxmd.com/read/29111542/a-call-to-action-to-develop-integrated-curricula-in-cardiorenal-medicine
#15
Claudio Ronco, Federico Ronco, Peter A McCullough
With the adoption of the new definition and classification of cardiorenal syndrome (CRS) and its relevant subtypes, much attention has been placed on elucidating the mechanisms of heart and kidney interactions. The pathophysiologic pathways are of great interest by which acute heart failure may result in acute kidney injury (AKI; type 1), chronic heart failure accelerates the progression of chronic kidney disease (CKD; type 2), AKI provokes cardiac events (type 3), and CKD increases the risk and severity of cardiovascular disease (type 4)...
2017: Reviews in Cardiovascular Medicine
https://www.readbyqxmd.com/read/29110930/determinants-of-acute-kidney-injury-and-renal-function-decline-after-endovascular-abdominal-aortic-aneurysm-repair
#16
Randolph G Statius van Eps, Banne Nemeth, Ronne T A Mairuhu, Jan J Wever, Hugo T C Veger, Hans van Overhagen, Lukas C van Dijk, Bob Knippenberg
OBJECTIVE/BACKGROUND: Endovascular aneurysm repair (EVAR) may be associated with renal injury and more insight is needed into potential risk factors. The aim was to identify clinical, anatomical, and peri-procedural parameters as potential risk factors for the occurrence of acute kidney injury (AKI) and to evaluate chronic kidney disease (CKD) after EVAR. METHODS: A cohort of 212 consecutive patients who underwent elective EVAR for abdominal aortic aneurysm from January 2009 to October 2016 was included...
October 27, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/29108104/renal-function-after-intravitreal-administration-of-vascular-endothelial-growth-factor-inhibitors-in-patients-with-diabetes-and-chronic-kidney-disease
#17
Yusuke Kameda, Tetsuya Babazono, Yasuko Uchigata, Shigehiko Kitano
This study aimed to determine whether intravitreal administration of vascular endothelial growth factor inhibitors is associated with deterioration of renal function, as seen with systemic administration, in patients with diabetes and chronic kidney disease. Estimated glomerular filtration rates before and after 160 intravitreal injections of vascular endothelial growth factor inhibitors (aflibercept, bevacizumab, or ranibizumab) were compared in 69 patients with diabetes and with a baseline estimated glomerular filtration rate <60 mL/min/1...
November 6, 2017: Journal of Diabetes Investigation
https://www.readbyqxmd.com/read/29092921/contrast-induced-acute-kidney-injury-and-mortality-in-st-elevation-myocardial-infarction-treated-with-primary-percutaneous-coronary-intervention
#18
Johanne Silvain, Lee S Nguyen, Vincent Spagnoli, Mathieu Kerneis, Paul Guedeney, Nicolas Vignolles, Kristel Cosker, Olivier Barthelemy, Claude Le Feuvre, Gérard Helft, Jean-Philippe Collet, Gilles Montalescot
OBJECTIVES: Contrast-induced acute kidney injury (CI-AKI) is a common and potentially severe complication in patients with ST elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (pPCI). There is no consensus on the best definition of CI-AKI to identify patients at risk of haemodialysis or death. The objective of this study was to assess the association of CI-AKI, using four definitions, on inhospital mortality, mortality or haemodialysis requirement over 1-year follow-up, in patients with STEMI treated with pPCI...
November 1, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/29092740/preoperative-aldosterone-receptor-blockade-and-outcomes-of-cardiac-surgery-in-patients-with-chronic-kidney-disease%C3%A2
#19
Linda Shavit, Shuli Silberman, Rachel Tauber, Ofer Merin, Daniel Bitran, Daniel Fink
BACKGROUND AND AIMS: Recent clinical evidence demonstrates that chronic low-dose mineralocorticoid receptor antagonists (MRA), when added to optimal treatment, result in reductions in cardiovascular mortality. However, continuation of MRAs before cardiac surgery in patients with CKD has never been evaluated and its potential benefit or harm in this specific clinical setting is largely unknown. MATERIALS AND METHODS: This is an observational study that included adult CKD patients undergoing cardiac surgery...
October 26, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/29083099/therapeutic-application-of-extracellular-vesicles-in-kidney-disease-promises-and-challenges
#20
REVIEW
Lin-Li Lv, Wei-Jun Wu, Ye Feng, Zuo-Lin Li, Tao-Tao Tang, Bi-Cheng Liu
Extracellular vesicles (EVs) are nanosized, membrane-bound vesicles released from different cells. Recent studies have revealed that EVs may participate in renal tissue damage and regeneration through mediating inter-nephron communication. Thus, the potential use of EVs as therapeutic vector has gained considerable interest. In this review, we will discuss the basic characteristics of EVs and its role in nephron cellular communication. Then, the application of EVs as therapeutic vector based on its natural content or as carriers of drug, in acute and chronic kidney injury, was discussed...
October 30, 2017: Journal of Cellular and Molecular Medicine
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