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Aki in icu

Piotr Czempik, Daniel Cieśla, Piotr Knapik, Łukasz Krzych
BACKGROUND: Acute kidney injury (AKI) in critically ill patients has a deleterious impact on the prognosis, especially when renal replacement therapy (RRT) is required. This issue has not yet been investigated in the intensive care setting in Poland. OBJECTIVES: The aim of the study was to evaluate the short-term outcomes of AKI-RRT subjects, based on a large registry population. MATERIAL AND METHODS: This observational multicenter study covered 100 demographic and clinical variables from the Silesian Registry of ICUs regarding 15,030 adult patients hospitalized between October 2011 and December 2014...
March 16, 2018: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
Yanhua Wu, Yuanhan Chen, Shaowen Li, Wei Dong, Huaban Liang, Miaoyi Deng, Yingnan Chen, Shixin Chen, Xinling Liang
PURPOSE: To investigate the application value of "electronic alerts" ("e-alerts") for acute kidney injury (AKI) among high-risk wards of hospitals. METHODS: A prospective, randomized, controlled study was conducted. We developed an e-alert system for AKI and ran the system in intensive care units and divisions focusing on cardiovascular disease. The e-alert system diagnosed AKI automatically based on serum creatinine levels. Patients were assigned randomly to an e-alert group (467 patients) or non-e-alert group (408 patients)...
March 19, 2018: International Urology and Nephrology
Horng-Ruey Chua, Weng-Kin Wong, Venetia Huiling Ong, Dipika Agrawal, Anantharaman Vathsala, Hui-Ming Tay, Amartya Mukhopadhyay
PURPOSE: To evaluate 1-year mortality in patients with septic acute kidney injury (AKI) and to determine association between initial AKI recovery patterns ( reversal within 5 days, beyond 5 days but recovery, or nonrecovery) and chronic kidney disease (CKD) progression. METHODS: Prospective observational study, with retrospective evaluation of initial nonconsenters, of critically ill patients with septic AKI. RESULTS: We studied 207 patients (age, mean [SD]: 64 [16] years, 39% males), of which 56 (27%), 18 (9%), and 9 (4%) died in intensive care unit (ICU), post-ICU in hospital, and posthospitalization, respectively...
January 1, 2018: Journal of Intensive Care Medicine
Holly R Hanson, Lynn Babcock, Terri Byczkowski, Stuart L Goldstein
OBJECTIVE: To define those children who develop acute kidney injury (AKI) within 48 h of admission from the emergency department (ED) and ascertain patient-related factors in the ED associated with AKI. METHODS: Retrospective, cohort study of children, birth to 19 years, admitted to a tertiary pediatric hospital from the ED between January 2010 and December 2013 who had serum creatinine (SCr) drawn as part of clinical care. AKI was defined as a 50% increase in SCr above baseline, as measured within 48 h of hospital presentation...
March 17, 2018: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
V Schwenger, D Kindgen-Milles, C Willam, A Jörres, W Druml, D Czock, S J Klein, M Oppert, M Schmitz, J T Kielstein, A Zarbock, M Joannidis, S John
BACKGROUND: Acute kidney injury (AKI) is a common complication in intensive care unit (ICU) patients. The incidence of AKI in ICU patients exceeds 50% and the associated morbidity and mortality rates increase with severity of AKI. In addition, long-term consequences of AKI are underestimated and several studies show impaired long-term outcome after AKI. In about 5-25% of ICU patients with AKI renal replacement therapy (RRT) is required. OBJECTIVES: To assist in indication, timing, modality and application of renal replacement therapy of adult patients, current recommendations from the renal sections of the DGIIN (Deutschen Gesellschaft für Internistische Intensivmedizin und Notfallmedizin), ÖGIAIN (Österreichischen Gesellschaft für Internistische und Allgemeine Intensivmedizin und Notfallmedizin) and DIVI (Deutschen Interdisziplinären Vereinigung für Intensiv- und Notfallmedizin) are stated...
March 15, 2018: Medizinische Klinik, Intensivmedizin und Notfallmedizin
Jie-Qiong Liu, Guang-Yan Cai, Shuang Liang, Wen-Ling Wang, Si-Yang Wang, Fang-Lei Zhu, Sa-Sa Nie, Zhe Feng, Xiang-Mei Chen
PURPOSE OF THE STUDY: The incidence of acute kidney injury (AKI) with a poor prognosis in the elderly has been increasing each year. This study aimed to investigate the clinical characteristics of and risk factors for death from AKI in the elderly and help improve prognosis. STUDY DESIGN: This study was a retrospective cohort study based on data from adult patients (≥18 years old) admitted to 15 hospitals in China between 1 January 2009 and 31 December 2011. The characteristics of AKI in the elderly were compared with those in younger patients...
March 7, 2018: Postgraduate Medical Journal
Fabienne Aregger, Dominik E Uehlinger, Gerhard Fusch, Aldin Bahonjic, Rene Pschowski, Michael Walter, Joerg C Schefold
BACKGROUND: Acute kidney injury (AKI) is often observed in critically ill patients and is associated with high morbidity and mortality. Non-recovery from AKI has a negative impact on the prognosis of affected patients and early risk stratification seems key to improve clinical outcomes. We analyzed metabolites of a conserved key inflammatory pathway (i.e. tryptophan degradation pathway) in serial urine samples of patients with AKI. METHODS: One hundred twelve ICU patients with AKI were included in a prospective observational analysis...
February 26, 2018: BMC Nephrology
Yu Zhang, Li Jiang, Baomin Wang, Xiuming Xi
BACKGROUND: Although there were studies to investigate the risk factors for acute kidney injury (AKI) after surgery, most of them focused on one specific type of surgeries. The risk factors for postoperative AKI in patients undergoing all surgeries in intensive care units (ICU) have not been reported. METHODS: Data from 1731 patients undergoing surgery in 30 ICUs of 28 tertiary hospitals in Beijing from March to August 2012 were prospectively collected. AKI was defined and staged by the KDIGO criteria...
February 26, 2018: International Urology and Nephrology
Laura Di Leo, Federico Nalesso, Francesco Garzotto, Yun Xie, Bo Yang, Grazia Maria Virzì, Alberto Passannante, Raffaele Bonato, Mariarosa Carta, Davide Giavarina, Dario Gregori, Alessandra Brendolan, Fiorenza Ferrari, Claudio Ronco
BACKGROUND: Acute kidney injury (AKI) diagnosis is based on a rise in serum creatinine and/or fall in urine output. It has been shown that there are patients that fulfill AKI definition but do not have AKI, and there are also patients with evidence of renal injury who do not meet any criteria for AKI. Recently the innovative and emerging proteomic technology has enabled the identification of novel biomarkers that allow improved risk stratification. METHODS: Tissue inhibitor of metalloproteinases-2 (TIMP-2), insulin-like growth factor-binding protein 7 (IGFBP7) were measured to a cohort of 719 consecutive patients admitted to Intensive Care Unit (ICU)...
January 26, 2018: Blood Purification
Vesna D Stojanović, Nenad A Barišić, Tanja D Radovanović, Nataša B Kovač, Jelena D Djuran, Amira Peco E Antić, Aleksandra D Doronjski
BACKGROUND: The incidence of acute kidney injury (AKI) among the neonates treated at the Neonatal Intensive Care Unit is high with high mortality rates. Glutathione S-transferase (GST) class Pi plays an important role in the protection of cells from cytotoxic and oncogenic agents. The aim of the study was to examine whether the levels of serum glutathione S-transferase Pi (GST Pi) determined after birth have any predictive value for the outcome and development of AKI in premature neonates...
February 23, 2018: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
Christine K Federspiel, Theis S Itenov, Kala Mehta, Raymond K Hsu, Morten H Bestle, Kathleen D Liu
BACKGROUND: Duration of acute kidney injury (AKI) has been recognized a risk factor for adverse outcomes following AKI. We sought to examine the relationship of AKI duration and recurrent AKI with short-term outcomes in critically ill patients who were mechanically ventilated and met criteria for the acute respiratory distress syndrome. METHODS: Participants in the NHLBI ARDS Network SAILS multicenter trial who developed AKI were included in this analysis and divided into groups based on AKI duration...
February 23, 2018: Annals of Intensive Care
Jameela Abdulaziz Kari, Mohamed Ahmed Shalaby, Kholoud Sofyani, Ahmad Saleh Sanad, Albaraa Fuad Ossra, Rayan Smeer Halabi, Maha Hassan Aljuhani, Wael Mohammad Toffaha, Feras Aymen Moria, Samar Sabry, Hanan AbdelAziz Ahmed, Khalid Abdulaziz Alhasan, Sara Sharief, Osama Safdar
BACKGROUND: Acute kidney injury (AKI) is common in critically ill children with significant mortality and morbidity. Serum creatinine is an insensitive and late biomarker compared to newly proposed AKI biomarkers. METHODS: Prospective study in pediatric intensive care unit (PICU) over three months to compare between serum cystatin-C (s-Cys-C) and urinary neutrophil gelatinase-associated lipocalin (uNGAL) as AKI biomarkers at multiple time points with pediatric risk, injury, failure, loss, end-stage renal disease (pRIFLE) classification in diagnosing AKI...
February 20, 2018: World Journal of Pediatrics: WJP
Theis S Itenov, Rasmus Ehrenfried Berthelsen, Jens-Ulrik Jensen, Thomas A Gerds, Lars M Pedersen, Ditte Strange, Katrin Thormar, Jesper Løken, Mads H Andersen, Hamid Tousi, Nanna Reiter, Jens D Lundgren, Morten H Bestle
OBJECTIVE: Intensive care unit (ICU) patients with acute kidney injury (AKI) who recover kidney function within 28 days experience less severe chronic kidney impairment and have increased long term survival. The aims of this study were to develop and validate a risk prediction model to identify these patients. DESIGN: Observational study with development and validation of a risk prediction model. SETTING: Nine academic ICUs in Denmark. PARTICIPANTS: Development cohort of critically ill patients with AKI at ICU admission from the Procalcitonin and Survival Study cohort (n = 568), validation cohort of adult patients with AKI admitted to two university hospitals in Denmark in 2012-13 (n = 766)...
March 2018: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
Emad E Ghobrial, Salma Z Elhouchi, Sarah S Eltatawy, Lilian O Beshara
Acute kidney injury (AKI) in the newborn is a common problem in the neonatal intensive care unit with many underlying factors such as asphyxia, respiratory distress syndrome (RDS), and urogenital anomalies. The aim of this study is to highlight possible risk factors and profile of neonates developing AKI in the Neonatal Intensive Care Unit (NICU) of Cairo University Pediatric Hospital. The study was carried out on 90 neonates (30 patients and 60 controls), among neonates admitted to NICU. The study was done over two months, from January 2015 to March 2015...
January 2018: Saudi Journal of Kidney Diseases and Transplantation
Christian Ertmer, Bernhard Zwißler, Hugo Van Aken, Michael Christ, Fabian Spöhr, Axel Schneider, Robert Deisz, Matthias Jacob
BACKGROUND: Outcome data on fluid therapy in critically ill patients from randomised controlled trials may be different from data obtained by observational studies under "real-life" conditions. We conducted this prospective, observational study to investigate current practice of fluid therapy (crystalloids and colloids) and associated outcomes in 65 German intensive care units (ICUs). In total, 4545 adult patients who underwent intravenous fluid therapy were included. The main outcome measures were 90-day mortality, ICU mortality and acute kidney injury (AKI)...
February 17, 2018: Annals of Intensive Care
Dana Y Fuhrman, Sandra Kane-Gill, Stuart L Goldstein, Priyanka Priyanka, John A Kellum
BACKGROUND: Most studies of acute kidney injury (AKI) have focused on older adults, and little is known about AKI in young adults (16-25 years) that are cared for in an adult intensive care unit (ICU). We analyzed data from a large single-center ICU database and defined AKI using the Kidney Disease Improving Global Outcomes criteria. We stratified patients 16-55 years of age into four age groups for comparison and used multivariable logistic regression to identify associations of potential susceptibilities and exposures with AKI and mortality...
February 14, 2018: Annals of Intensive Care
A Rodríguez, L F Reyes, J Monclou, B Suberviola, M Bodí, G Sirgo, J Solé-Violán, J Guardiola, D Barahona, E Díaz, I Martín-Loeches, M I Restrepo
INTRODUCTION: Serum procalcitonin (PCT) concentration could be increased in patients with renal dysfunction in the absence of bacterial infection. OBJECTIVE: To determine the interactions among serum renal biomarkers of acute kidney injury (AKI) and serum PCT concentration, in patients admitted to the intensive care unit (ICU) due to lung influenza infection. DESIGN: Secondary analysis of a prospective multicentre observational study. SETTING: 148 Spanish ICUs...
February 9, 2018: Medicina Intensiva
Mullai Baalaaji, Muralidharan Jayashree, Karthi Nallasamy, Sunit Singhi, Arun Bansal
OBJECTIVE: To identify predictors and outcome of acute kidney injury (AKI) in children with diabetic ketoacidosis (DKA) admitted to a Pediatric Intensive Care Unit (PICU). METHODS: Retrospective case review of 79 children with DKA admitted between 2011-2014. RESULTS: Twenty eight children developed AKI during the hospital stay; 20 (71.4%) recovered with hydration alone. Serum chloride at 24 hours was independently associated with AKI. Children with AKI had prolonged acidosis and PICU stay and higher mortality...
February 9, 2018: Indian Pediatrics
Mehmet Oezkur, Attila Magyar, Phillip Thomas, Andreas Reif, Stefan Störk, Peter U Heuschmann, Rainer G Leyh, Martin Wagner
BACKGROUND: The Catechol-O-methyltransferase (COMT) represents the key enzyme in catecholamine degradation. Recent studies suggest that the COMT rs4680 polymorphism is associated with the response to endogenous and exogenous catecholamines. There are, however, conflicting data regarding the COMT Met/Met phenotype being associated with an increased risk of acute kidney injury (AKI) after cardiac surgery. The aim of the current study is to prospectively investigate the impact of the COMT rs4680 polymorphism on the incidence of AKI in patients undergoing cardiac surgery...
February 9, 2018: BMC Nephrology
Adrien Joseph, Stephanie Harel, Marion Venot, Sandrine Valade, Eric Mariotte, Claire Pichereau, Akli Chermak, Lara Zafrani, Elie Azoulay, Emmanuel Canet
Background: Despite substantial improvements in the management of multiple myeloma, renal failure remains an important burden that tremendously impairs prognosis. The purpose of this study was to describe the characteristics and to establish prognostic factors of renal recovery in myeloma patients admitted to the intensive care unit (ICU) for acute kidney injury (AKI) Stage 3 treated with renal replacement therapy (RRT). Methods: A retrospective single-centre cohort study was performed, including consecutive myeloma patients admitted to one medical ICU between 1 January 2007 and 1 September 2015 and treated with RRT...
February 2018: Clinical Kidney Journal
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