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https://www.readbyqxmd.com/read/28091757/-renal-protection-in-intensive-care-myths-and-facts
#1
S John
BACKGROUND: Acute kidney injury (AKI) is a common and severe complication in patients on the intensive care unit with a significant impact on patient mortality, morbidity and costs of care; therefore, renal protective therapy is most important in these severely ill patients. AIM OF THE REVIEW: Many renal protective strategies have been postulated during the last decades, which are sometimes still in place as a kind of "myth" but which are not always proven by evidence-based "facts"...
January 13, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28091436/acute-kidney-injury-in-lagos-pattern-outcomes-and-predictors-of-in-hospital-mortality
#2
B T Bello, A A Busari, C O Amira, Y R Raji, R W Braimoh
CONTEXT: The pattern of acute kidney injury (AKI) differs significantly between developed and developing countries. AIMS: The aim of th study was to determine the pattern and clinical outcomes of AKI in Lagos, Southwest Nigeria. SETTINGS AND DESIGN: A retrospective review of hospital records of all patients with a diagnosis of AKI over a 20-month period. SUBJECTS AND METHODS: Records of 54 patients were reviewed. Information retrieved included, bio-data, etiology of AKI, results of laboratory investigations, and patient outcomes...
February 2017: Nigerian Journal of Clinical Practice
https://www.readbyqxmd.com/read/28079263/comparison-of-rates-of-nephrotoxicity-associated-with-vancomycin-in-combination-with-piperacillin-tazobactam-administered-as-an-extended-versus-standard-infusion
#3
Mariam Mousavi, Tanya Zapolskaya, Marco R Scipione, Eddie Louie, John Papadopoulos, Yanina Dubrovskaya
STUDY OBJECTIVE: Despite recent reports of relatively high rates (16-37%) of acute kidney injury (AKI) in patients receiving the combination of intravenous piperacillin-tazobactam (PTZ) and vancomycin, data are limited evaluating the impact of PTZ infusion strategy on the occurrence of nephrotoxicity. The objective of this study was to compare the rates of nephrotoxicity in patients receiving vancomycin in combination with PTZ administered as an extended infusion (EI) versus a standard infusion (SI)...
January 12, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28078828/biomarkers-upon-discontinuation-of-renal-replacement-therapy-predict-60-day-survival-and-renal-recovery-in-critically-ill-patients-with-acute-kidney-injury
#4
Tingting Yang, Si Sun, Yuliang Zhao, Qiang Liu, Mei Han, Liping Lin, Baihai Su, Songmin Huang, Lichuan Yang
Introduction There is no consensus on the specific indications for weaning critically ill patients with acute kidney injury (AKI) off renal replacement therapy (RRT). This study aimed to explore the prognostic value of several biomarkers measured upon discontinuation of RRT for their value in predicting 60-day survival and renal recovery in an effort to add knowledge to the decision-making process regarding RRT withdrawal. Methods We prospectively enrolled 102 patients with AKI who required RRT from the intensive care unit...
January 11, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28060212/urinary-mitochondrial-dna-levels-identify-acute-kidney-injury-in-surgical-critical-illness-patients
#5
Qiongyuan Hu, Jianan Ren, Jie Wu, Guanwei Li, Xiuwen Wu, Song Liu, Gefei Wang, Guosheng Gu, Huajian Ren, Zhiwu Hong, Jieshou Li
BACKGROUND: Recent studies showed that mitochondrial injury and mitochondrial DNA (mtDNA) damage are associated with the initiation and progression of acute kidney injury (AKI). However, practical limitations of existing assays of mitochondrial function have limited our ability to study the link between mitochondrial dysfunction and renal injury. Therefore, we evaluated urinary mtDNA (UmtDNA) as a biomarker of AKI in critical illness patients. METHODS: DNA was isolated from urine samples in surgical intensive care unit (SICU) patients and quantified by quantitative polymerase chain reaction (PCR)...
January 4, 2017: Shock
https://www.readbyqxmd.com/read/28050898/impact-of-transfusion-on-patients-with-sepsis-admitted-in-intensive-care-unit-a-systematic-review-and-meta-analysis
#6
REVIEW
Claire Dupuis, Romain Sonneville, Christophe Adrie, Antoine Gros, Michael Darmon, Lila Bouadma, Jean-François Timsit
Red blood cell transfusion (RBCT) threshold in patients with sepsis remains a matter of controversy. A threshold of 7 g/dL for stabilized patients with sepsis is commonly proposed, although debated. The aim of the study was to compare the benefit and harm of restrictive versus liberal RBCT strategies in order to guide physicians on RBCT strategies in patients with severe sepsis or septic shock. Four outcomes were assessed: death, nosocomial infection (NI), acute lung injury (ALI) and acute kidney injury (AKI)...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28045915/alkalosis-in-critically-ill-patients-with-severe-sepsis-and-septic-shock
#7
Simon Kreü, Allan Jazrawi, Jan Miller, Amir Baigi, Michelle Chew
INTRODUCTION: Although metabolic alkalosis is a common occurrence in intensive care units (ICUs), no study has evaluated its prevalence or outcomes in patients with severe sepsis or septic shock. METHODS: This is a retrospective cohort study of critically ill patients suffering from severe sepsis and septic shock admitted to the ICUs of Halmstad and Varberg County hospitals. From 910 patient records, 627 patients met the inclusion criteria. We investigated the relationship between metabolic alkalosis and mortality...
2017: PloS One
https://www.readbyqxmd.com/read/28042364/predictors-of-acute-kidney-injury-in-neurocritical-care-patients-receiving-continuous-hypertonic-saline
#8
Michael J Erdman, Heidi Riha, Lauren Bode, Jason J Chang, G Morgan Jones
BACKGROUND AND PURPOSE: Continuous intravenous 3% hypertonic saline (HTS) infusions are commonly used for the management of cerebral edema following severe neurologic injuries. Despite widespread use, data regarding the incidence and predictors of nephrotoxicity are lacking. The purpose of this study was to describe the incidence and identify predictors of acute kidney injury (AKI) in neurocritical care patients administered continuous infusion HTS. METHODS: This was an institutional review board-approved, multicenter, retrospective cohort study of patients receiving HTS infusions at 2 academic medical centers...
January 2017: Neurohospitalist
https://www.readbyqxmd.com/read/28035621/implications-of-dynamic-changes-in-mir-192-expression-in-ischemic-acute-kidney-injury
#9
Lulu Zhang, Yuan Xu, Song Xue, Xudong Wang, Huili Dai, Jiaqi Qian, Zhaohui Ni, Yucheng Yan
PURPOSE: Ischemia-reperfusion injury (IRI) is a major cause of acute kidney injury (AKI) with poor outcomes. While many important functions of microRNAs (miRNAs) have been identified in various diseases, few studies reported miRNAs in acute kidney IRI, especially the dynamic changes in their expression and their implications during disease progression. METHODS: The expression of miR-192, a specific kidney-enriched miRNA, was assessed in both the plasma and kidney of IRI rats at different time points after kidney injury and compared to renal function and kidney histological changes...
December 29, 2016: International Urology and Nephrology
https://www.readbyqxmd.com/read/28031705/earlier-nephrology-consultation-may-not-be-associated-with-improved-short-term-survival-of-acute-kidney-injury-in-very-elderly-men
#10
Qinglin Li, Meng Zhao, Jing Du, Xiaodan Wang
OBJECTIVES: A delayed nephrology consultation (NC) may be associated with a poor prognosis in acute kidney injury (AKI) patients. The aims of this study were to compare the clinical and laboratory characteristics of elderly AKI patients evaluated and not evaluated by nephrologists and to generate a hypothesis regarding the relationship between the timing of the NC and 90-day outcomes. METHODS: From 2007 to 2015, this study explored associations among the presence and timing of NC with the non-intensive care unit stay and 90-day mortality in elderly AKI patients at the Geriatric Department of the Chinese People's Liberation Army General Hospital...
2017: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/28030644/timing-and-location-of-medical-emergency-team-activation-is-associated-with-seriousness-of-outcome-an-observational-study-in-a-tertiary-care-hospital
#11
Takeo Kurita, Taka-Aki Nakada, Rui Kawaguchi, Koichiro Shinozaki, Ryuzo Abe, Shigeto Oda
PURPOSE: The medical emergency team (MET) can be activated anytime and anywhere in a hospital. We hypothesized the timing and location of MET activation are associated with seriousness of outcome. MATERIALS AND METHODS: We tested for an association of clinical outcomes with timing and location using a university hospital cohort in Japan (n = 328). The primary outcome was short-term serious outcome (unplanned ICU admission after MET activation or death at scene)...
2016: PloS One
https://www.readbyqxmd.com/read/28028134/fibroblast-growth-factor-23-levels-associate-with-aki-and-death-in-critical-illness
#12
David E Leaf, Kirolos A Jacob, Anand Srivastava, Margaret E Chen, Marta Christov, Harald Jüppner, Venkata S Sabbisetti, Aline Martin, Myles Wolf, Sushrut S Waikar
Elevated plasma levels of the osteocyte-derived hormone fibroblast growth factor 23 (FGF23) have emerged as a powerful biomarker of cardiovascular disease and death in patients with CKD. Whether elevated urinary or plasma FGF23 levels are prospectively associated with AKI and death in critically ill patients is unknown. We therefore conducted a prospective cohort study of 350 critically ill patients admitted to intensive care units at an academic medical center to investigate whether higher urinary FGF23 levels associate with the composite end point of AKI or in-hospital mortality (AKI/death)...
December 27, 2016: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/28018150/frequency-of-and-risk-factors-for-acute-kidney-injury-associated-with-vancomycin-use-in-the-pediatric-intensive-care-unit
#13
Sarah Bonazza, Lauren C Bresee, Timothy Kraft, B Catherine Ross, Deonne Dersch-Mills
BACKGROUND: Published information evaluating frequency of and risk factors for vancomycin-induced acute kidney injury (AKI) in the pediatric intensive care unit (PICU) population is conflicting. OBJECTIVES: The primary objective was to describe the proportion of our PICU patients who developed AKI with intravenous (IV) vancomycin. The secondary objective was to describe the associated potential risk factors. METHODS: Pediatric patients (0-18 years) who received their first IV vancomycin dose in the PICU were evaluated in this retrospective chart review...
November 2016: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/28009331/a-study-of-acute-kidney-injury-in%C3%A2-hospitalized-preterm-neonates-in-nicu
#14
N Nagaraj, P K Berwal, A Srinivas, A Berwal
OBJECTIVES: This study was carried out to determine the incidence, clinical features, etiology and outcome of functional and intrinsic acute kidney injury (AKI) in preterm neonates. METHODS: This is a prospective observational study on premature infants admitted to the neonatal intensive care unit (NICU) over an eight month period. All biochemical parameters of renal function tests were monitored and statically analyzed. RESULTS: The study included 450 infants; of them 300 were inborn and 150 infants were outborn and transported to the NICU...
2016: Journal of Neonatal-perinatal Medicine
https://www.readbyqxmd.com/read/28001178/careful-selection-of-predictor-variables-of-aki-for-robust-regression-model-in-intensive-care-unit
#15
Tauqeer Hussain Mallhi, Amer Hayat Khan, Azmi Sarriff, Azreen Syazril Adnan, Yusra Habib Khan
No abstract text is available yet for this article.
December 2016: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
https://www.readbyqxmd.com/read/27997877/effects-of-low-dose-atrial-natriuretic-peptide-infusion-on-cardiac-surgery-associated-acute-kidney-injury-a-multicenter-randomized-controlled-trial
#16
Chieko Mitaka, Tetsu Ohnuma, Takanori Murayama, Fumio Kunimoto, Michio Nagashima, Tetsuhiro Takei, Naoya Iguchi, Makoto Tomita
PURPOSE: To evaluate the effects of atrial natriuretic peptide (ANP) on renal function and medical costs in patients with acute kidney injury (AKI) associated with cardiac surgery. MATERIALS AND METHODS: The Japanese trial for AKI in Post-cardiovascular surgery patients by ANP (JAPAN) was a prospective, multicenter, randomized, double-blind, placebo-controlled study conducted in 11 hospitals in Japan. Acute kidney injury was defined as an increase in serum creatinine of at least 0...
December 11, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/27993157/early-phase-cumulative-hypotension-duration-and-severe-stage-progression-in-oliguric-acute-kidney-injury-with-and-without-sepsis-an-observational-study
#17
Junichi Izawa, Tetsuhisa Kitamura, Taku Iwami, Shigehiko Uchino, Masanori Takinami, John A Kellum, Takashi Kawamura
BACKGROUND: Managing blood pressure in patients with acute kidney injury (AKI) could effectively prevent severe-stage progression. However, the effect of hypotension duration in the early phase of AKI remains poorly understood. This study investigated the association between early-phase cumulative duration of hypotension below threshold mean arterial pressure (MAP) and severe-stage progression of oliguric AKI in critically ill patients, and assessed the difference in association with presence of sepsis...
December 19, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27986669/risk-of-acute-kidney-injury-in-patients-on-concomitant-vancomycin-and-piperacillin-tazobactam-compared-to-those-on-vancomycin-and-cefepime
#18
Bhagyashri Navalkele, Jason M Pogue, Shigehiko Karino, Bakht Nishan, Madiha Salim, Shantanu Solanki, Amina Pervaiz, Nader Tashtoush, Hamadullah Shaikh, Sunitha Koppula, Jonathan Koons, Tanveer Hussain, William Perry, Richard Evans, Emily T Martin, Ryan P Mynatt, Kyle P Murray, Michael J Rybak, Keith S Kaye
BACKGROUND: Recent evidence suggests that among patients receiving vancomycin, receipt of concomitant piperacillin-tazobactam increases the risk of nephrotoxicity. Well-controlled, adequately powered studies comparing rates of acute kidney injury (AKI) among patients receiving vancomycin + piperacillin-tazobactam (VPT) compared to similar patients receiving vancomycin + cefepime (VC) are lacking. In this study we compared the incidence of AKI among patients receiving combination therapy with VPT to a matched group receiving VC...
October 20, 2016: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/27984075/moderate-aerobic-exercise-on-the-recovery-phase-of-gentamicin-induced-acute-kidney-injury-in-rats
#19
C S Oliveira, A M Rodrigues, G B Nogueira, M A Nascimento, G R Punaro, E M S Higa
INTRODUCTION: Acute kidney injury is a serious public health problem, especially in intensive care units, where patients may require dialysis support, resulting in 50% mortality. AIM: To evaluate the effects of moderate aerobic exercise on the recovery phase of acute kidney injury induced by gentamicin in rats. MAIN METHODS: Male adult Wistar rats were allocated into 4 groups: W10+R30, G10+R30, W10+EX30 and G10+EX30; W10 received water (gentamicin vehicle) and G10 received gentamicin for 10days; R30 remained resting and EX30 made exercise for 30days after gentamicin suspension...
October 29, 2016: Life Sciences
https://www.readbyqxmd.com/read/27974972/acute-kidney-injury-in-diabetes-mellitus
#20
REVIEW
D Patschan, G A Müller
Diabetes mellitus (DM) significantly increases the overall morbidity and mortality, particularly by elevating the cardiovascular risk. The kidneys are severely affected as well, partly as a result of intrarenal athero- and arteriosclerosis but also due to noninflammatory glomerular damage (diabetic nephropathy). DM is the most frequent cause of end-stage renal disease in our society. Acute kidney injury (AKI) remains a clinical and prognostic problem of fundamental importance since incidences have been increased in recent years while mortality has not substantially been improved...
2016: International Journal of Nephrology
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