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https://www.readbyqxmd.com/read/29137024/effect-of-different-surgical-type-of-coronary-artery-bypass-grafting-on-kidney-injury-a-propensity-score-analysis
#1
Ming-Jen Chan, Cheng-Chia Lee, Shao-Wei Chen, Feng-Chun Tsai, Pyng-Jing Lin, Pei-Chun Fan, Hsiang-Hao Hsu, Ming-Yang Chang, Yung-Chang Chen, Chih-Hsiang Chang
Acute kidney injury (AKI) after coronary artery bypass grafting (CABG) is associated with a less favorable outcome. Off-pump surgery results in lower kidney dysfunction than conventional on-pump arrest surgery. On-pump arrest surgery results in a lower revascularization rate compared with off-pump surgery. On-pump beating heart (OPBH) CABG combines the advantages of beating heart surgery and cardiopulmonary bypass. This study compared the renal outcomes of 3 cardiac surgical methods. From January 2010 to December 2012, 373 patients who underwent on-pump CABG were enrolled...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29132515/acute-kidney-injury-in-the-critically-ill
#2
REVIEW
Robert A Maxwell, Christopher Michael Bell
Acute kidney injury (AKI) occurs frequently in the surgical intensive care unit and results in significant morbidity and mortality. AKI needs to be identified early and underlying causes treated or eliminated. Sepsis, major surgery such as coronary artery bypass, and hypovolemia are the most common causes and patients with underlying comorbidities have increased susceptibility. Treatment should begin by ensuring that patients are adequately resuscitated and all contributing causes are replaced or eliminated...
December 2017: Surgical Clinics of North America
https://www.readbyqxmd.com/read/29132411/an-isolated-elevation-in-blood-urea-level-is-not-uraemia-and-not-an-indication-for-renal-replacement-therapy-in-the-icu
#3
EDITORIAL
Jack Mackenzie, Bobby Chacko
The decision to initiate renal replacement therapy (RRT) and the optimal timing for commencement is a difficult decision faced by clinicians when treating acute kidney injury (AKI) in the intensive care setting. Without clinically significant ureamic symptoms or emergent indications (electrolyte abnormalities, volume overload) the timing of RRT initiation remains contentious and inconsistent across health providers. Current trends of initiating RRT in the ICU are often based on isolated blood urea levels without clear guidelines demonstrating an upper limit for treatment...
November 13, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29132321/the-role-of-the-specialized-team-in-the-operation-of-continuous-renal-replacement-therapy-a-single-center-experience
#4
Harin Rhee, Gum Sook Jang, Miyeun Han, In Seong Park, Il Young Kim, Sang Heon Song, Eun Young Seong, Dong Won Lee, Soo Bong Lee, Ihm Soo Kwak
BACKGROUND: The requirement of continuous renal replacement therapy (CRRT) is increasing with the growing incidence of acute kidney injury (AKI). The decision to initiate CRRT is not difficult if an adequate medical history is obtained. However, the handling and maintenance of CRRT constitute a labor-intensive intervention that requires specialized skills. For these reasons, our center organized a specialized CRRT team in March 2013. The aim of this study is to report on the role of a specialized CRRT team and to evaluate the team's outcome...
November 13, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/29128923/fluid-overload-independent-of-acute-kidney-injury-predicts-poor-outcomes-in-neonates-following-congenital-heart-surgery
#5
Kenneth E Mah, Shiying Hao, Scott M Sutherland, David M Kwiatkowski, David M Axelrod, Christopher S Almond, Catherine D Krawczeski, Andrew Y Shin
BACKGROUND: Fluid overload (FO) is common after neonatal congenital heart surgery and may contribute to mortality and morbidity. It is unclear if the effects of FO are independent of acute kidney injury (AKI). METHODS: This was a retrospective cohort study which examined neonates (age < 30 days) who underwent cardiopulmonary bypass in a university-affiliated children's hospital between 20 October 2010 and 31 December 2012. Demographic information, risk adjustment for congenital heart surgery score, surgery type, cardiopulmonary bypass time, cross-clamp time, and vasoactive inotrope score were recorded...
November 11, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/29124867/acute-kidney-injury-in-critically-ill-surgical-patients-epidemiology-risk-factors-and-outcomes
#6
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/29123872/serum-levels-of-interleukin-6-may-predict-organ-dysfunction-earlier-than-sofa-score
#7
Takashi Shimazui, Yosuke Matsumura, Taka-Aki Nakada, Shigeto Oda
Aim: To investigate the clinical utility of interleukin-6 (IL-6), procalcitonin (PCT), and C-reactive protein (CRP) as predictive markers in consideration of the time-course changes in critically ill patients with organ dysfunction. Methods: Serum levels of IL-6, PCT, CRP, and Sequential Organ Failure Assessment (SOFA) scores were measured sequentially in 92 patients during their initial 5 days following admission to the intensive care unit. Maximum values were analyzed...
July 2017: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29117994/role-of-adenosine-1a-receptor-signaling-on-gfr-early-after-the-induction-of-sepsis
#8
Jonathan M Street, Erik H Koritzinsky, Tiffany R Bellomo, Xuzhen Hu, Peter S T Yuen, Robert A Star
Sepsis and acute kidney injury (AKI) synergistically increase morbidity and mortality in the ICU. How sepsis reduces GFR and causes AKI is poorly understood; one proposed mechanism includes tubuloglomerular feedback (TGF). When sodium reabsorption by the proximal tubules is reduced in normal animals, the macula densa senses increased luminal sodium chloride, then adenosine 1a receptor (A1aR) signaling triggers tubuloglomerular feedback, reducing GFR through afferent arteriole vasoconstriction. We measured GFR and systemic hemodynamics early during cecal ligation and puncture-induced sepsis in wild-type and A1aR knockout mice...
November 8, 2017: American Journal of Physiology. Renal Physiology
https://www.readbyqxmd.com/read/29108006/incidence-and-outcomes-of-acute-kidney-injury-in-extremely-low-birth-weight-infants
#9
Chien-Chung Lee, Oi-Wa Chan, Mei-Yin Lai, Kai-Hsiang Hsu, Tai-Wei Wu, Wai-Ho Lim, Yu-Cheng Wang, Reyin Lien
BACKGROUND: Acute kidney injury (AKI) is a common event in the neonatal intensive care unit (NICU), especially in extremely-low-birth-weight (ELBW) infants. This cohort study investigated the incidence of and risk factors for AKI in ELBW infants and their overall survival at the postmenstrual age (PMA) of 36 weeks. METHODS: All ELBW infants admitted to our NICU between January 2010 and December 2013 were enrolled. Those who died prior to 72 hours of life, had congenital renal abnormality, or had only one datum of the serum creatinine (SCr) level after the first 24 hours of life were excluded...
2017: PloS One
https://www.readbyqxmd.com/read/29104728/oxidative-stress-and-acute-kidney-injury-in-critical-illness-pathophysiologic-mechanisms-biomarkers-interventions-and-future-perspectives
#10
REVIEW
Paraskevi Pavlakou, Vassilios Liakopoulos, Theodoros Eleftheriadis, Michael Mitsis, Evangelia Dounousi
Acute kidney injury (AKI) is a multifactorial entity that occurs in a variety of clinical settings. Although AKI is not a usual reason for intensive care unit (ICU) admission, it often complicates critically ill patients' clinical course requiring renal replacement therapy progressing sometimes to end-stage renal disease and increasing mortality. The causes of AKI in the group of ICU patients are further complicated from damaged metabolic state, systemic inflammation, sepsis, and hemodynamic dysregulations, leading to an imbalance that generates oxidative stress response...
2017: Oxidative Medicine and Cellular Longevity
https://www.readbyqxmd.com/read/29100016/urinary-versus-plasma-neutrophil-gelatinase-associated-lipocalin-ngal-as-a-predictor-of-mortality-for-acute-kidney-injury-in-intensive-care-unit-patients
#11
Ata Mahmoodpoor, Hadi Hamishehkar, Vahid Fattahi, Sarvin Sanaie, Pradeep Arora, Nader D Nader
OBJECTIVE: To examine urinary and plasma neutrophil gelatinase-associated lipocalin (NGAL) levels in predicting ICU mortality. DESIGN: Prospective observational. SETTING: University Critical Care setting. PARTICIPANTS: 50 patients with acute kidney injury (AKI). INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Serial urinary and plasma concentrations of NGAL were measured...
October 26, 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/29076682/outcomes-of-intensive-care-patients-having-septic-shock-at-a-tertiary-care-hospital-of-islamabad
#12
Azmat Ali, Awais Saeed Abbasi, Maliha Sheikh
BACKGROUND: Septic shock is defined as sepsis with circulatory, cellular and metabolic abnormalities which are associated with greater mortality more than 40%. The objective of this study was to identify shortcomings and act promptly and adequately. METHODS: This case series included 32 patients over a period of 03 months, September to November 2016 done at ICU of KRL Hospital Islamabad. RESULTS: The study only enrolled patients who fulfilled the criteria of septic shock...
July 2017: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/29061597/high-dose-versus-low-dose-haemofiltration-for-the-treatment-of-critically-ill-patients-with-acute-kidney-injury-an-updated-systematic-review-and-meta-analysis
#13
Peng Li, Li-Ping Qu, Dong Qi, Bo Shen, Yi-Mei Wang, Jia-Rui Xu, Wu-Hua Jiang, Hao Zhang, Xiao-Qiang Ding, Jie Teng
OBJECTIVE: The purpose of this study was to perform a systematic review and meta-analysis to evaluate the effect of high-dose versus low-dose haemofiltration on the survival of critically ill patients with acute kidney injury (AKI). We hypothesised that high-dose treatments are not associated with a higher risk of mortality. DESIGN: Meta-analysis. SETTING: Randomised controlled trials and two-arm prospective and retrospective studies were included...
October 22, 2017: BMJ Open
https://www.readbyqxmd.com/read/29058639/hospital-acquired-acute-kidney-injury-is-associated-with-increased-mortality-but-not-increased-readmission-rates-in-a-uk-acute-hospital
#14
Nerissa Jurawan, Tanya Pankhurst, Charles Ferro, Peter Nightingale, Jamie Coleman, David Rosser, Simon Ball
BACKGROUND: Acute Kidney Injury (AKI) has evoked much interest over the past decade and is reported to be associated with high inpatient mortality. Preventable death and increased readmission rates related to AKI have been the focus of considerable interest. METHODS: We studied hospital acquired AKI in all emergency hospital admissions, except transfers from ICU to ICU or patients known to renal services, to ascertain mortality and readmission rates, and trackable modifiable factors for death, using cox regression and Kaplan Meier survival curves...
October 20, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/29057120/ivc-measurements-in-critically-ill-patients-with-acute-renal-failure
#15
Rami Jambeih, Jean I Keddissi, Houssein A Youness
OBJECTIVE: To determine whether the inferior vena cava (IVC) measurement by bedside ultrasound (US-IVC) predicts improvement in renal function in patients with acute kidney injury (AKI). DESIGN: Prospective observational study. SETTING: Medical intensive care unit. PATIENTS: 33 patients with AKI were included. INTERVENTION: US-IVC was done on admission. The patients' management was done by the primary teams, who were unaware of the US-IVC findings...
2017: Critical Care Research and Practice
https://www.readbyqxmd.com/read/29055803/optimal-blood-pressure-decreases-acute-kidney-injury-after-gastrointestinal-surgery-in-elderly-hypertensive-patients-a-randomized-study-optimal-blood-pressure-reduces-acute-kidney-injury
#16
Xiujuan Wu, Zongming Jiang, Jing Ying, Yangyang Han, Zhonghua Chen
STUDY OBJECTIVE: To determine the appropriate mean arterial pressure (MAP) control level for elderly patients with hypertension during the perioperative period. DESIGN: A prospective, randomized study. SETTING: Three teaching hospitals in China. PATIENTS: Six hundred seventy-eight elderly patients with chronic hypertension undergoing major gastrointestinal surgery. INTERVENTIONS: Patients were randomly allocated to three groups and the target MAP level was strictly controlled to one of three levels: level I (65-79mmHg), level II (80-95mmHg), or level III (96-110mmHg)...
October 18, 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/29047417/levosimendan-for-patients-with-severely-reduced-left-ventricular-systolic-function-and-or-low-cardiac-output-syndrome-undergoing-cardiac-surgery-a-systematic-review-and-meta-analysis
#17
Filippo Sanfilippo, Joshua B Knight, Sabino Scolletta, Cristina Santonocito, Federico Pastore, Ferdinando L Lorini, Luigi Tritapepe, Andrea Morelli, Antonio Arcadipane
BACKGROUND: Previous studies have shown beneficial effects of levosimendan in high-risk patients undergoing cardiac surgery. Two large randomized controlled trials (RCTs), however, showed no advantages of levosimendan. METHODS: We performed a systematic review and meta-analysis (MEDLINE and Embase from inception until March 30, 2017), investigating whether levosimendan offers advantages compared with placebo in high-risk cardiac surgery patients, as defined by preoperative left ventricular ejection fraction (LVEF) ≤ 35% and/or low cardiac output syndrome (LCOS)...
October 19, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29047023/heparin-binding-protein-hbp-improves-prediction-of-sepsis-related-acute-kidney-injury
#18
Jonas Tverring, Suvi T Vaara, Jane Fisher, Meri Poukkanen, Ville Pettilä, Adam Linder
BACKGROUND: Sepsis-related acute kidney injury (AKI) accounts for major morbidity and mortality among the critically ill. Heparin-binding protein (HBP) is a promising biomarker in predicting development and prognosis of severe sepsis and septic shock that has recently been proposed to be involved in the pathophysiology of AKI. The objective of this study was to investigate the added predictive value of measuring plasma HBP on admission to the intensive care unit (ICU) regarding the development of septic AKI...
October 18, 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/29033442/efficacy-of-oxycodone-for-dyspnea-in-end-stage-heart-failure-with-renal-insufficiency-a-case-report
#19
Masayuki Tanaka, Hirofumi Maeba, Takeshi Senoo, Junji Iwasaka, Aki Ohkita, Haruna Kita, Kazuki Uchitani, Yasuhiko Hirota
A 67-year-old man with dilated cardiomyopathy and renal insufficiency was admitted to our hospital with dyspnea secondary to end-stage heart failure. We introduced oxycodone for medically refractory dyspnea instead of morphine because of the patient's renal insufficiency. After the administration of oxycodone, his dyspnea was alleviated without any adverse opioid effects, such as respiratory depression. After treating his heart failure, he was able to leave the intensive care unit. Oxycodone may therefore be a reliable agent for the treatment of dyspnea in patients with end-stage heart failure and renal insufficiency...
October 16, 2017: Internal Medicine
https://www.readbyqxmd.com/read/29027072/outcomes-of-acute-kidney-injury-in-a-nephrology-ward
#20
Ana R Fernandes, Márcio S R Viegas, Elsa Q Soares, Sofia S Coelho, Patricia Valério, José C Barreto, José M Vinhas
Acute kidney injury (AKI) is a global problem which predicts immediate and long-term adverse outcomes. We evaluated the AKI progression to end-stage renal disease, as well as the mortality associated with AKI and the in-hospital readmission rate because of a cardiovascular event in AKI patients admitted in a nephrology ward. A 5-year retrospective study was set in a nephrology department, with a follow-up period of up to 8 years. In a total of 191 patients, mean age was 73.83 ± 12.49 years, and 137 (71...
December 2017: International Urology and Nephrology
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