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https://www.readbyqxmd.com/read/29777769/a-combined-approach-for-the-early-recognition-of-acute-kidney-injury-after-adult-cardiac-surgery
#1
Cédrick Zaouter, Julien Potvin, Marie-Lise Bats, Marie-Christine Beauvieux, Alain Remy, Alexandre Ouattara
BACKGROUND: Cardiac surgery-associated acute kidney injury (CSA-AKI) is a frequent complication. The current criteria to detect CSA-AKI rise only when organic dysfunction has occurred. The Doppler Renal Resistive Index (RRI) and the urinary G1 cell cycle arrest proteins (TIMP-2 and IGFBP7) have been advocated to predict CSA-AKI at an early stage after cardiac surgery. The primary objective was to determine the predictive value of these new markers to detect CSA-AKI after elective heart surgery in patients at risk to develop AKI...
May 16, 2018: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/29773712/acute-kidney-injury-and-risk-of-heart-failure-and-atherosclerotic-events
#2
Alan S Go, Chi-Yuan Hsu, Jingrong Yang, Thida C Tan, Sijie Zheng, Juan D Ordonez, Kathleen D Liu
BACKGROUND AND OBJECTIVES: AKI in the hospital is common and is associated with excess mortality. We examined whether AKI is also independently associated with a higher risk of different cardiovascular events in the first year after discharge. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We conducted a retrospective analysis of a cohort between 2006 and 2013 with follow-up through 2014, within Kaiser Permanente Northern California. We identified all adults admitted to 21 hospitals who had one or more in-hospital serum creatinine test result and survived to discharge...
May 17, 2018: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/29767223/evaluation-of-renal-function-estimation-formulas-specific-to-dynamic-renal-function-for-drug-dosing-in-critically-ill-patients
#3
Lianjie Xiong, Z Kevin Lu, April Miller Quidley, Bebbyn S Alford, P Brandon Bookstaver
OBJECTIVES: The study compared estimated creatinine clearance (eCrCl) between the Cockcroft-Gault (CG) equation and the Jelliffe, Chiou, and Brater equations designed for estimation in dynamic renal function and resulting antimicrobial dosing concordance of five antimicrobials (cefepime, meropenem, piperacillin/tazobactam, vancomycin, and fluconazole) commonly used in the intensive care unit (ICU). METHODS: Electronic medical records were used to identify the target patient population...
May 2018: Southern Medical Journal
https://www.readbyqxmd.com/read/29766216/impact-of-angiotensin-converting-enzyme-inhibitors-or-receptor-blockers-on-post-icu-discharge-outcome-in-patients-with-acute-kidney-injury
#4
Etienne Gayat, Alexa Hollinger, Alain Cariou, Nicolas Deye, Antoine Vieillard-Baron, Samir Jaber, Benjamin G Chousterman, Qin Lu, Pierre François Laterre, Xavier Monnet, Michael Darmon, Marc Leone, Bertrand Guidet, Romain Sonneville, Jean-Yves Lefrant, Marie-Céline Fournier, Matthieu Resche-Rigon, Alexandre Mebazaa, Matthieu Legrand
PURPOSE: Acute kidney injury (AKI) is associated with the activation of the renin-angiotensin system. Whether angiotensin-converting enzyme inhibitors (ACEi) or angiotensin-receptor blockers (ARB) improve outcome in patients recovering from AKI remains unexplored. The purpose was to investigate the association between prescription of ACEi/ARB at intensive care unit (ICU) discharge and 1-year outcome in patients recovering from AKI. METHODS: Association between ACEi/ARB and 1-year mortality rate was explored in 1551 patients discharged from 21 European ICUs in an observational cohort...
May 15, 2018: Intensive Care Medicine
https://www.readbyqxmd.com/read/29765932/fluid-overload-and-renal-angina-index-at-admission-are-associated-with-worse-outcomes-in-critically-ill-children
#5
Sidharth K Sethi, Veena Raghunathan, Shilpi Shah, Maninder Dhaliwal, Pranaw Jha, Maneesh Kumar, Sravanthi Paluri, Shyam Bansal, Maroun J Mhanna, Rupesh Raina
Objectives: We investigated the association of fluid overload and oxygenation in critically sick children, and their correlation with various outcomes (duration of ventilation, ICU stay, and mortality). We also assessed whether renal angina index (RAI) at admission can predict mortality or acute kidney injury (AKI) on day 3 after admission. Design and setting: Prospective study, pediatric intensive care in a tertiary hospital. Duration: June 2013-June 2014. Patients: Patients were included if they needed invasive mechanical ventilation for >24 h and had an indwelling arterial catheter...
2018: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/29750636/outcomes-of-very-elderly-treated-with-dialysis-for-acute-kidney-injury
#6
Ezra Gabbay, Yehudit Zangi, Alon Bnayah, Jawad Atrash, Itzchak Slotki, Linda Shavit
BACKGROUND: The factors that determine prognosis in elderly patients with dialysis-requiring acute kidney injury (AKI-D) is uncertain. The purpose of this study was to examine predictors of in-hospital mortality in these patients. MATERIALS AND METHODS: A retrospective, single-center study of hospitalized patients ≥ 70 years old with AKI-D. Clinical and demographic variables were compared between survivors and non-survivors, independent predictors of hospital mortality were identified by logistic regression...
May 11, 2018: Clinical Nephrology
https://www.readbyqxmd.com/read/29747292/-the-timing-of-renal-replacement-therapy-on-mortality-in-patients-with-acute-renal-injury-a-reanalysis-of-two-recently-published-randomized-control-trials
#7
J W Han, J T Liu, P L Ma
To investigate the sources of inconsistent findings between two randomized control trials["initiation strategies for renal-replacement therapy in the intensive care unit"(AKIKI trial) vs"effect of early vs delayed initiation of renal replacement therapy on mortality in critically ill patients with acute kidney injury"(ELAIN trial) ], regarding"timing of renal replacement therapy (RRT) on mortality in patients with acute kidney injury (AKI). By reanalysis of the published data, it was found that demographics, severity of primary disease and stage of AKI before initiation of RRT were quite different between AKIKI and ELAIN trials...
May 1, 2018: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
https://www.readbyqxmd.com/read/29743761/predictors-of-mortality-in-acute-kidney-injury-patients-admitted-to-medicine-intensive-care-unit-in-a-rural-tertiary-care-hospital
#8
Amrish Saxena, Shrikant V Meshram
Background: Acute kidney injury (AKI) is a challenging problem faced by intensive care clinicians worldwide, and it is associated with high morbidity and mortality, especially in critically ill patients. Materials and Methods: A hospital-based prospective, observational study was conducted in patients of AKI admitted to the Intensive Care Unit (ICU) of the Department of Medicine in a rural tertiary care hospital located in central India. Data of all consecutive AKI inpatients related to demographic variables, clinical profile, and laboratory investigations were collected from patient's medical records...
April 2018: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29738093/acute-kidney-injury-epidemiology-outcomes-complications-and-therapeutic-strategies
#9
REVIEW
Shigeo Negi, Daisuke Koreeda, Sou Kobayashi, Takuro Yano, Koichi Tatsuta, Toru Mima, Takashi Shigematsu, Masaki Ohya
Acute kidney injury (AKI) is one of the most common serious complications for all hospital admissions, with its incidence increasing among hospitalized patients, particularly those in the intensive care unit. Despite significant improvements in critical care and dialysis technology, AKI is associated with an increased risk of short- and long-term mortality, prolonged hospital stays, and dialysis dependence. These risks are particularly relevant for critically ill patients with AKI severe enough to require renal replacement therapy (RRT)...
May 8, 2018: Seminars in Dialysis
https://www.readbyqxmd.com/read/29732396/incidence-and-outcomes-of-neonatal-acute-kidney-injury-awaken-a-multicentre-multinational-observational-cohort-study
#10
Jennifer G Jetton, Louis J Boohaker, Sidharth K Sethi, Sanjay Wazir, Smriti Rohatgi, Danielle E Soranno, Aftab S Chishti, Robert Woroniecki, Cherry Mammen, Jonathan R Swanson, Shanty Sridhar, Craig S Wong, Juan C Kupferman, Russell L Griffin, David J Askenazi
Background: Single-center studies suggest that neonatal acute kidney injury (AKI) is associated with poor outcomes. However, inferences regarding the association between AKI, mortality, and hospital length of stay are limited due to the small sample size of those studies. In order to determine whether neonatal AKI is independently associated with increased mortality and longer hospital stay, we analyzed the Assessment of Worldwide Acute Kidney Epidemiology in Neonates (AWAKEN) database...
November 2017: The lancet child & adolescent health
https://www.readbyqxmd.com/read/29724256/gut-kidney-crosstalk-in-septic-acute-kidney-injury
#11
REVIEW
Jingxiao Zhang, Ghada Ankawi, Jian Sun, Kumar Digvijay, Yongjie Yin, Mitchell H Rosner, Claudio Ronco
Sepsis is the leading cause of acute kidney injury (AKI) in the intensive care unit (ICU). Septic AKI is a complex and multifactorial process that is incompletely understood. During sepsis, the disruption of the mucus membrane barrier, a shift in intestinal microbial flora, and microbial translocation may lead to systemic inflammation, which further alters host immune and metabolic homeostasis. This altered homeostasis may promote and potentiate the development of AKI. As part of this vicious cycle, when AKI develops, the clearance of inflammatory mediators and metabolic products is decreased...
May 3, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29716530/body-weight-definitions-for-evaluating-a-urinary-diagnosis-of-acute-kidney-injury-in-patients-with-sepsis
#12
Shinshu Katayama, Kansuke Koyama, Yuya Goto, Toshitaka Koinuma, Ken Tonai, Jun Shima, Masahiko Wada, Shin Nunomiya
BACKGROUND: We hypothesized that the use of actual body weight might lead to more frequent misdiagnosis of acute kidney injury (AKI) than when ideal body weight is used in underweight and/or obese patients. We examined which definition of body weight is most effective in establishing a urinary diagnosis of AKI in septic patients. METHODS: Consecutive patients aged ≥ 20 years admitted to the intensive care unit of a university hospital between June 2011 and December 2016 were analyzed...
May 2, 2018: BMC Nephrology
https://www.readbyqxmd.com/read/29714433/peritoneal-dialysis-in-neonates-six-years-of-single-center-experience
#13
Ferda Özlü, Hacer Yapıcıoğlu Yıldızdaş, Gül Şeker, Hüseyin Şimşek, Aysun Karabay Bayazıt, Mehmet Satar
Background/aim: Peritoneal dialysis (PD) is generally considered the practical dialysis modality for neonates in the treatment of acute kidney injury (AKI) and metabolic disturbances. The aim of this study was to evaluate the indications, complications, and outcomes of PD between January 2011 and December 2016. Materials and methods: This study included all 56 neonates that underwent PD over six years in our neonatal intensive care unit (NICU). A retrospective chart review was performed for all patients in our institution...
April 30, 2018: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/29712717/long-term-mortality-after-acute-kidney-injury-in-the-pediatric-icu
#14
Erin Hessey, Geneviève Morissette, Jacques Lacroix, Sylvie Perreault, Susan Samuel, Marc Dorais, Philippe Jouvet, Jean-Philippe Lafrance, Jacques LeLorier, Véronique Phan, Ana Palijan, Michael Pizzi, Louise Roy, Michael Zappitelli
OBJECTIVES: (1) To evaluate the association between acute kidney injury (AKI) in the PICU and long-term mortality and (2) to determine the extent to which adding the urine output (UO)-defined AKI alters the association. METHODS: A 2-center retrospective cohort study of children (≤18 years old) admitted to the PICU between 2003 and 2005 for noncardiac surgery, with follow-up until 2010. Patients with end stage renal disease, no provincial health insurance number, who died during hospitalization, or could not be linked to administrative data were excluded...
May 2018: Hospital Pediatrics
https://www.readbyqxmd.com/read/29707319/perioperative-management-and-outcomes-of-minimally-invasive-esophagectomy-case-study-of-a-high-volume-tertiary-center-in-taiwan
#15
Tzu Chang, Po-Ni Hsiao, Man-Yin Tsai, Pei-Ming Huang, Ya-Jung Cheng
Background: Mortality and complication rates for surgical esophagectomy remain high despite progress in surgical techniques and perioperative care. Minimally invasive surgery and intraoperative goal-directed fluid management are gaining popularity in Taiwan; however, perioperative complications and short-term outcomes have been rarely reported. In this retrospective study, we analyzed the surgical procedures performed as well as the perioperative outcomes and treatments after esophagectomy in a high-volume medical center in Taiwan...
March 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29696581/potential-biomarkers-of-tissue-hypoxia-during-acute-hemodilutional-anemia-in-cardiac-surgery-a-prospective-study-to-assess-tissue-hypoxia-as-a-mechanism-of-organ-injury
#16
Gregory M T Hare, Kaho Han, Yevheniy Leshchyshyn, Nikhil Mistry, Tiffanie Kei, Si Yuan Dai, Albert K Y Tsui, Razak A Pirani, Jaideep Honavar, Rakesh P Patel, Sanjay Yagnik, Shelley L Welker, Tessa Tam, Alexander Romaschin, Philip W Connelly, W Scott Beattie, C David Mazer
PURPOSE: Hemodilutional anemia is associated with acute kidney injury (AKI) and mortality in patients undergoing cardiac surgery by mechanisms that may include tissue hypoxia. Our hypothesis was to assess if changes in the potential hypoxic biomarkers, including methemoglobin and erythropoietin, correlated with a decrease in hemoglobin (Hb) concentration following hemodilution on cardiopulmonary bypass (CPB). METHODS: Arterial blood samples were taken from patients (n = 64) undergoing heart surgery and CPB at baseline, during CPB, following CPB, and in the intensive care unit (ICU)...
April 25, 2018: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/29696106/evaluation-of-the-effect-of-aminophylline-in-reducing-the-incidence-of-acute-kidney-injury-after-cardiac-surgery
#17
Shahrbanoo Shahbazi, Peyman Alishahi, Elham Asadpour
Objectives: Acute renal failure is a common complication of major cardiovascular surgeries (One-third of patients). Adenosine release as a vascular vasodilator increases after cardiac surgery, which reduces renal and glomerular blood flow and subsequently causes kidney ischemic damage. The present study aimed at evaluating the impact of aminophylline as an adenosine receptor antagonist on renal function after cardiac surgery hoping to find an appropriate method to reduce acute kidney injury...
August 2017: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/29694931/urinary-potassium-excretion-and-its-association-with-acute-kidney-injury-in-the-intensive-care-unit
#18
Alasdair R Burns, Kwok M Ho
PURPOSE: Using urinary indices as a quick bedside test to assist management of oliguria and acute kidney injury (AKI) has long been sought. This study assessed whether urinary potassium excretion is related to simultaneously calculated creatinine clearance (CrCl) and can predict AKI in the critically ill. MATERIALS AND METHODS: In this prospective cohort study, the correlation between 2-h urinary potassium excretion and simultaneously calculated CrCl of 61 critically ill patients was assessed by Pearson's correlation coefficient, and their ability to predict AKI (≥stage 1 KDIGO) in the subsequent 7 days was assessed by area under the receiver-operating-characteristic (AUROC) curve...
April 16, 2018: Journal of Critical Care
https://www.readbyqxmd.com/read/29693474/acute-kidney-injury-in-critically-ill-patients-with-sepsis-clinical-characteristics-and-outcomes
#19
De-Yuan Zhi, Jin Lin, Hai-Zhou Zhuang, Lei Dong, Xiao-Jun Ji, Dong-Cheng Guo, Xiao-Wei Yang, Shuai Liu, Zu Yue, Shu-Jing Yu, Mei-Li Duan
OBJECTIVE: The objectives of this study were to examine the clinical profile of critically ill patients with septic acute kidney injury (AKI) and to investigate clinical characteristics associated with the outcome of patients. METHODS: Data from 582 critically ill patients were collected and retrospectively reviewed. Patients were divided into two groups: without AKI development and with AKI development. Baseline characteristics, laboratory, and other clinical data were compared between these two groups, and correlations between the characteristics and AKI development were examined...
April 25, 2018: Journal of Investigative Surgery: the Official Journal of the Academy of Surgical Research
https://www.readbyqxmd.com/read/29693303/sofa-coagulation-score-and-changes-in-platelet-counts-in-severe-acute-kidney-injury-analysis-from-the-randomised-evaluation-of-normal-versus-augmented-level-renal-study
#20
Jin Lin, Martin Gallagher, Rinaldo Bellomo, Meili Duan, Konlawi Trongtrakul, Amanda Ying Wang
AIM: To evaluate the prognostic value of baseline SOFA coagulation score (SOFA-CS) and change in platelet counts in patients with severe acute kidney injury (AKI) requiring continuous renal replacement therapy (CRRT). METHODS: We performed a secondary analysis from the Randomised Evaluation of Normal versus Augmented Level of RRT (RENAL) study. The primary endpoint was all-cause mortality at 90 days after randomisation. The association between baseline SOFA-CS, changes in platelet counts, process of care, and clinical outcomes were analysed using multivariate Cox model adjusted for baseline variables...
April 24, 2018: Nephrology
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