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https://www.readbyqxmd.com/read/27915351/the-role-of-nephrologist-in-the-intensive-care-unit
#1
Zoltán H Endre
Participation by nephrologists is needed in most intensive care units, even when such units are 'closed'. This participation should assist with diagnosis and management of intrinsic and complex renal diseases such as vasculitis, complex metabolic and electrolyte disorders including hyponatremia, and acute kidney injury (AKI) with and without underlying chronic kidney disease (CKD). Early nephrologist involvement will also facilitate transition to continuing care and follow-up after an episode of AKI, but may also assist in avoiding dialysis where treatment is futile...
December 3, 2016: Blood Purification
https://www.readbyqxmd.com/read/27915328/critical-care-nephrology-a-multidisciplinary-approach
#2
Lilia Rizo-Topete, Claudio Ronco
Acute kidney injury (AKI) is a serious medical condition affecting millions of people. Patients in intensive care unit (ICU) who develop AKI have increased morbidity and mortality, prolonged length of stay in ICU and hospital and increased costs, especially when they require renal replacement therapy. In the latter case, morbidity and mortality increase further. In order to meet the needs of the critically ill patients, a multidisciplinary care team is required, combining the efforts of physicians and nurses from different disciplines as well as nephrologists and intensivists...
December 3, 2016: Blood Purification
https://www.readbyqxmd.com/read/27904540/outcome-of-acute-kidney-injury-in-critical-care-unit-based-on-aki-network
#3
Seyed Mohammadreza Hashemian, Hamidreza Jamaati, Behrooz Farzanegan Bidgoli, Farin Rashid Farrokhi, Majid Malekmohammad, Sepehr Roozdar, Seyed Amir Mohajerani, Ahmad Bagheri, Golnar Radmnand, Behzad Hatami, Mandana Chitsazan
BACKGROUND: Acute Kidney Injury (AKI) is an unsolved clinical problem in critical care patients with a high mortality rate, increasing incidence, and no definitive therapy. We studied the incidence, risk factors, and mortality associated with AKI in ICU patients. MATERIALS AND METHODS: In a prospective study, patient demographics, reason for hospitalization, reason for ICU admission, Length of ICU stay, laboratory data, and Vital signs were recorded in prepared forms during the ICU stay...
2016: Tanaffos
https://www.readbyqxmd.com/read/27900964/incidence-of-pediatric-acute-kidney-injury-in-hospitalized-patients
#4
Mohd Ashraf, Naveed Shahzad, Altaf Hussain, Shafat Ahmed Tak, Syed Tariq Ahmed Bukhari, Aliya Kachru
Pediatric acute kidney injury (pAKI) is a common complication associated with high mortality in children. The objective of this study was to determine the incidence of acute kidney injury (AKI) and mortality in hospitalized (critically ill and non-critically ill) patients. This was a retrospective study conducted during the period of June 1, 2013, to May 31, 2014, at the Postgraduate Department of Pediatrics, G. B. Pant Hospital, an Associated Hospital of Government Medical College, Srinagar, Jammu and Kashmir, India...
November 2016: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/27876077/post-traumatic-acute-kidney-injury-a-cross-sectional-study-of-trauma-patients
#5
Wei-Hung Lai, Cheng-Shyuan Rau, Shao-Chun Wu, Yi-Chun Chen, Pao-Jen Kuo, Shiun-Yuan Hsu, Ching-Hua Hsieh, Hsiao-Yun Hsieh
BACKGROUND: The causes of post-traumatic acute kidney injury (AKI) are multifactorial, and shock associated with major trauma has been proposed to result in inadequate renal perfusion and subsequent AKI in trauma patients. This study aimed to investigate the true incidence and clinical presentation of post-traumatic AKI in hospitalized adult patients and its association with shock at a Level I trauma center. METHODS: Detailed data of 78 trauma patients with AKI and 14,504 patients without AKI between January 1, 2009 and December 31, 2014 were retrieved from the Trauma Registry System...
November 22, 2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/27875774/risk-factors-for-acute-kidney-injury-in-critically-ill-patients-with-complicated-intra-abdominal-infection
#6
Alejandro Suarez-de-la-Rica, Víctor Anillo, Ana Montero, Carmen Hernandez-Gancedo, Araceli Lopez-Tofiño, Fernando Gilsanz, Emilio Maseda
PURPOSE: The aim was to determine the factors related to acute kidney injury (AKI) in surgical septic patients with complicated intra-abdominal infection (CIAI) and mortality associated to AKI. METHODS: An observational study was performed in patients with CIAI requiring surgery and ICU admission (June 2011-June 2013). Factors at admission associated with developing of AKI and renal replacement therapy (RRT) and association between mortality and AKI and RRT were studied...
November 9, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/27867655/veno-arterial-extracorporeal-membrane-oxygenation-va-ecmo-in-postcardiotomy-cardiogenic-shock-how-much-pump-flow-is-enough
#7
COMMENT
Federico Pappalardo, Andrea Montisci
Post-cardiotomy cardiogenic shock (PCCS) is a complication of heart surgery associated with a poor prognosis: veno-arterial extracorporeal membrane oxygenation (VA ECMO) ensures end-organ perfusion while fully replacing heart and lung function, though it is associated with unsatisfactory results. Few studies have identified reliable predictors of poor prognosis early in the course of extracorporeal support. A recent study showed the strong prognostic power of urine output in the first 24 hours of VA ECMO in predicting early and late mortality of PCCS...
October 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/27863270/fluid-resuscitation-mediates-the-association-between-inhalational-burn-injury-and-acute-kidney-injury-in-the-major-burn-population
#8
Avinash B Kumar, William Andrews, Yaping Shi, Matthew S Shotwell, Scott Dennis, Jonathan Wanderer, Blair Summitt
BACKGROUND: It is known that acute respiratory distress syndrome and acute lung injury are independent risk factors for developing acute kidney injury (AKI) through complex pathophysiologic mechanisms. Our specific aim is to evaluate the risk factors for AKI postburn injury and whether inhalation thermal injury is an independent risk factor for developing AKI in the major burn population. METHODS: This is an institutional review board-approved, retrospective cohort study of patients admitted to a tertiary burn intensive care unit between 2011 and 2013...
October 19, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/27861388/early-initiation-of-renal-replacement-treatment-in-patients-with-acute-kidney-injury-a-systematic-review-and-meta-analysis
#9
Hongwei Wang, Liwei Li, Qinjun Chu, Yong Wang, Zhisong Li, Wei Zhang, Lanlan Li, Long He, Yanqiu Ai
BACKGROUND: Acute kidney injury (AKI) is associated with a substantially increased risk of mortality for many hospitalized patients. It has been suggested that early initiation of renal replacement treatment has a favorable outcome in critically ill patients complicated with AKI. However, results of studies evaluating the effect of early initiation strategy of renal replacement treatment on AKI have been controversial and contradictory. The aim of this meta-analysis is to examine the effect of early initiation of renal replacement treatment on patients with AKI...
November 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27858178/proteome-analysis-of-hemofilter-adsorbates-to-identify-novel-substances-of-sepsis-a-pilot-study
#10
Tomoaki Hashida, Taka-Aki Nakada, Mamoru Satoh, Keisuke Tomita, Rui Kawaguchi, Fumio Nomura, Shigeto Oda
Blood purification therapy using hemofilters with high adsorbing capabilities has been reported to remove excessive humoral mediators from the blood of patients with sepsis. However, there are insufficient studies of the adsorbates bound to hemofilter membranes. We hypothesized that these adsorbates in acute kidney injury (AKI) patients with sepsis were different from those in patients without sepsis and that proteome analysis of the adsorbates would identify novel substances of sepsis. This study included 20 patients who had AKI upon admission to intensive care units (ICUs) and who received continuous renal replacement therapy using polymethyl methacrylate hemofilters...
November 17, 2016: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
https://www.readbyqxmd.com/read/27852290/acute-kidney-injury-subphenotypes-based-on-creatinine-trajectory-identifies-patients-at-increased-risk-of-death
#11
Pavan K Bhatraju, Paramita Mukherjee, Cassianne Robinson-Cohen, Grant E O'Keefe, Angela J Frank, Jason D Christie, Nuala J Meyer, Kathleen D Liu, Michael A Matthay, Carolyn S Calfee, David C Christiani, Jonathan Himmelfarb, Mark M Wurfel
BACKGROUND: Acute kidney injury (AKI) is common among intensive care unit (ICU) patients. AKI is highly heterogeneous, with variable links to poor outcomes. Current approaches to classify AKI severity and identify patients at highest risk for poor outcomes focus on the maximum change in serum creatinine (SCr) values. However, these scores are hampered by the need for a reliable baseline SCr value and the absence of a component differentiating transient from persistent rises in SCr. We hypothesized that identification of resolving or nonresolving AKI subphenotypes based on the early trajectory of SCr values in the ICU would better differentiate patients at risk of hospital mortality...
November 17, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27850930/1294-initiation-of-early-dialysis-in-icu-patients-with-aki-a-systematic-review-and-meta-analysis
#12
Dipayan Chaudhuri, Kwadwo Kyeremanteng
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27832187/risk-factors-for-acute-kidney-injury-after-congenital-cardiac-surgery-in-infants-and-children-a-retrospective-observational-study
#13
Sun-Kyung Park, Min Hur, Eunhee Kim, Won Ho Kim, Jung Bo Park, Youngwon Kim, Ji-Hyuk Yang, Tae-Gook Jun, Chung Su Kim
Acute kidney injury (AKI) after pediatric cardiac surgery is associated with high morbidity and mortality. Modifiable risk factors for postoperative AKI including perioperative anesthesia-related parameters were assessed. The authors conducted a single-center, retrospective cohort study of 220 patients (aged 10 days to 19 years) who underwent congenital cardiac surgery between January and December 2012. The incidence of AKI within 7 days postoperatively was determined using the Kidney Disease: Improving Global Outcomes (KDIGO) criteria...
2016: PloS One
https://www.readbyqxmd.com/read/27830927/observational-clinical-study-on-organ-dysfunction-associated-with-dosing-of-antibiotics-in-a-paediatric-intensive-care-unit
#14
Sascha Tafelski, Alexander Gratopp, Florian Richter, Sylvia Kramer, Claudia Spies, Klaus D Wernecke, Irit Nachtigall
BACKGROUND: Medication errors are of concern especially in paediatric patients. This study investigates impact of dosing errors of antibiotics on outcome in critically ill paediatric patients. METHODS: Retrospective study including all consecutive patients admitted to one university paediatric intensive care unit (PICU) in 2010 with length of PICU stay >24hrs, age <18 years and antibiotic therapy. Antibiotic dosages were evaluated for compliance with recommended dosing individually adapted for bodyweight, age and organ function...
November 10, 2016: Minerva Pediatrica
https://www.readbyqxmd.com/read/27822078/acute-kidney-injury-adjusted-to-volume-status-in-critically-ill-patients-recognition-of-delayed-diagnosis-restaging-and-associated-outcomes
#15
Harout Yacoub, Leen Khoury, Youssef El Douaihy, Chadi Salmane, Jeanne Kamal, Marc Saad, Patricia Nasr, Jared Radbel, Elie El-Charabaty, Suzanne El-Sayegh
Critically ill patients receive a significant amount of fluids leading to a positive fluid balance; this dilutes serum creatinine resulting in an overestimated glomerular filtration rate. The goal of our study is to identify undiagnosed or underestimated acute kidney injury (AKI) in the intensive care unit (ICU). It will also identify the morbidity and mortality associated with an underestimated AKI. We reviewed records of patients admitted to our institution (Staten Island University Hospital) between 2012 and 2013 for more than 2 days...
2016: International Journal of Nephrology and Renovascular Disease
https://www.readbyqxmd.com/read/27817055/hypoalbuminemia-a-risk-factor-for-acute-kidney-injury-development-and-progression-to-chronic-kidney-disease-in-critically-ill-patients
#16
Min Shao, Shengyu Wang, Praveen Kolumam Parameswaran
PURPOSE: The increased likelihood of poor outcomes in critically ill patients with hypoalbuminemia is well recognized. However, hypoalbuminemia remains poorly defined as an independent predictor of acute kidney injury (AKI) and stage 4 chronic kidney diseases (CKD4). The aim of this study was to assess the role of hypoalbuminemia as an independent risk factor for AKI and CKD4 in critically ill patients. DESIGN: A retrospective cohort study. SETTING: General intensive care unit (ICU) at Anhui Provincial Hospital, PR China...
November 5, 2016: International Urology and Nephrology
https://www.readbyqxmd.com/read/27811558/renal-protection-in-the-21st-century
#17
Melanie Meersch, Alexander Zarbock
PURPOSE OF REVIEW: Among critically ill patients, acute kidney injury (AKI) is still a common and serious complication with a tremendous impact on short-term and long-term outcomes. The objective of this review is to discuss strategies for renal protection and prevention of AKI in ICU patients. RECENT FINDINGS: It is fundamental to identify patients at risk for AKI as soon as possible and as accurately as possible. In order to achieve these goals, translational approaches implementing new biomarkers have shown promising results...
December 2016: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/27806970/snake-bite-mortality-in-children-beyond-bite-to-needle-time
#18
M P Jayakrishnan, M G Geeta, P Krishnakumar, T V Rajesh, Biju George
OBJECTIVE: To study the clinical characteristics and predictors of mortality from snake bite envenomation in children. DESIGN: Prospective observational study with a one-group cohort design. SETTING: Paediatric intensive care unit of a tertiary care hospital in South India. SUBJECTS: The study cohort consisted of 145 children (55 girls and 90 boys) <12 years of age with snake bite envenomation. METHODS: Demographic and clinical details were recorded in a semistructured pro forma...
November 2, 2016: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/27803928/acute-kidney-injury-classified-by-serum-creatinine-and-urine-output-in-critically-ill-cancer-patients
#19
Bertha M Córdova-Sánchez, Ángel Herrera-Gómez, Silvio A Ñamendys-Silva
Acute kidney injury (AKI) is common in critically ill patients and is associated with higher mortality. Cancer patients are at an increased risk of AKI. Our objective was to determine the incidence of AKI in our critically ill cancer patients, using the criteria of serum creatinine (SCr) and urine output (UO) proposed by the Kidney Disease: Improving Global Outcomes (KDIGO). Methods. We performed a retrospective cohort analysis of a prospectively collected database at the intensive care unit (ICU) of the Instituto Nacional de Cancerología from January 2013 to March 2015...
2016: BioMed Research International
https://www.readbyqxmd.com/read/27788614/study-of-the-role-of-tumor-necrosis-factor-%C3%AE-%C3%A2-308%C3%A2-g-a-and-interleukin-10-1082-g-a-polymorphisms-as-potential-risk-factors-to-acute-kidney-injury-in-patients-with-severe-sepsis-using-high-resolution-melting-curve-analysis
#20
Doaa I Hashad, Eman T Elsayed, Tamer A Helmy, Samier M Elawady
RATIONAL: Septic acute kidney injury (AKI) is a prevalent complication in intensive care units with an increased incidence of complications. OBJECTIVE: The aim of the present study was to assess the use of high-resolution melting curve (HRM) analysis in investigating whether the genetic polymorphisms; -308 G/A of tumor necrosis factor-α (TNF-α), and -1082 G /A of Interleukin-10 (IL-10) genes may predispose patients diagnosed with severe sepsis to the development of AKI...
October 27, 2016: Renal Failure
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