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Aki in icu

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https://www.readbyqxmd.com/read/28546861/association-between-recurrence-of-acute-kidney-injury-and-mortality-in-intensive-care-unit-patients-with-severe-sepsis
#1
Emilio Rodrigo, Borja Suberviola, Miguel Santibáñez, Lara Belmar, Álvaro Castellanos, Milagros Heras, Juan Carlos Rodríguez-Borregán, Angel Luis Martín de Francisco, Claudio Ronco
BACKGROUND: Acute kidney injury (AKI) occurs in more than half critically ill patients admitted in intensive care units (ICU) and increases the mortality risk. The main cause of AKI in ICU is sepsis. AKI severity and other related variables such as recurrence of AKI episodes may influence mortality risk. While AKI recurrence after hospital discharge has been recently related to an increased risk of mortality, little is known about the rate and consequences of AKI recurrence during the ICU stay...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/28545475/urinary-neprilysin-in-the-critically-ill-patient
#2
Sahra Pajenda, Karl Mechtler, Ludwig Wagner
BACKGROUND: Critically ill patients in intensive care face hazardous conditions. Among these, acute kidney injury (AKI) is frequently seen as a result of sepsis. Early diagnosis of kidney injury is of the utmost importance in the guidance of interventions or avoidance of treatment-induced kidney injury. On these grounds, we searched for markers that could indicate proximal tubular cell injury. METHODS: Urine samples of 90 patients admitted to the intensive or intermediate care unit were collected over 2 to 5 days...
May 25, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28542272/factors-associated-with-poor-outcomes-of-continuous-renal-replacement-therapy
#3
Chih-Chin Kao, Ju-Yeh Yang, Likwang Chen, Chia-Ter Chao, Yu-Sen Peng, Chih-Kang Chiang, Jenq-Wen Huang, Kuan-Yu Hung
Continuous renal replacement therapy (CRRT) is one of the dialysis modalities for critically ill patients. Despite intensive dialysis care, a high mortality rate is found in these patients. Our objective was to investigate the factors associated with poor outcomes in these patients. We conducted a retrospective cohort study using the National Health Insurance Research Database. Records of critically ill patients who received CRRT between 2007 and 2011 were retrieved, and the patients were categorized into two groups: those with acute kidney injury (AKI) and those with history of end-stage renal disease (ESRD)...
2017: PloS One
https://www.readbyqxmd.com/read/28540205/clinicopathological-spectrum-of-snake-bite-induced-acute-kidney-injury-from-india
#4
Sanjay Vikrant, Ajay Jaryal, Anupam Parashar
AIM: To study the clinico-pathological spectrum of snake bite-induced acute kidney injury (AKI). METHODS: A retrospective study of patients admitted at Indira Gandhi Medical College Hospital, Shimla with snake bite-induced AKI from July 2003 to June 2016. Medical records were evaluated for patient's information on demographic, clinical characteristics, complications and outcome. Outcomes of duration of hospital stay, requirement for intensive care unit support, treatment with dialysis, survival and mortality were analyzed...
May 6, 2017: World Journal of Nephrology
https://www.readbyqxmd.com/read/28534557/-circuit-life-span-of-continuous-renal-replacement-therapy-in-critically-ill-patients-with-or-without-conventional-anticoa-gulation-an-observational-prospective-study
#5
M Sanz Ganuza, F Hidalgo Martínez, N García-Fernández
BACKGROUND: The aim of this study was to describe the efficacy, security and viability of an anticoagulation system with continuous infusion of unfractionated heparin (UFH) versus one without any type of anticoagulant using 0.9% physiological saline washings, in critically ill patients with continuous renal replacement therapy (CRRT) and different risks of bleeding. METHODS: From October 2013 to April 2015 we conducted an observational prospective study in the intensive care unit (ICU)...
April 30, 2017: Anales del Sistema Sanitario de Navarra
https://www.readbyqxmd.com/read/28528131/no-increase-in-the-incidence-of-acute-kidney-injury-in-a-population-based-annual-temporal-trends-epidemiology-study
#6
Kianoush Kashani, Min Shao, Guangxi Li, Amy W Williams, Andrew D Rule, Walter K Kremers, Michael Malinchoc, Ognjen Gajic, John C Lieske
Recent literature suggests an increase in the incidence of acute kidney injury (AKI). We evaluated population-based trends of AKI over the course of nine years, using a validated electronic health record tool to detect AKI. All adult residents (18 years of age and older) of Olmsted County, Minnesota (MN), admitted to the Mayo Clinic Hospital between 2006 and 2014 were included. The incidence rate of AKI was calculated and temporal trends in the annual AKI incident rates assessed. During the nine-year study period, 10,283, and 41,847 patients were admitted to the intensive care unit or general ward, with 1,740 and 2,811 developing AKI, respectively...
May 18, 2017: Kidney International
https://www.readbyqxmd.com/read/28527880/intensive-monitoring-of-urine-output-is-associated-with-increased-detection-of-acute-kidney-injury-and-improved-outcomes
#7
Kui Jin, Raghavan Murugan, Florentina E Sileanu, Emily Foldes, Priyanka Priyanka, Gilles Clermont, John A Kellum
BACKGROUND: Urine output (UO) is a vital sign for critical ill patients but standards for monitoring and reporting vary widely between ICUs. Careful monitoring of UO could lead to earlier recognition of acute kidney injury (AKI) and better fluid management. We sought to determine if intensity of UO monitoring is associated with outcomes in patients with and without AKI. METHODS: Retrospective cohort study including 15,724 adults admitted to ICUs from 2000-2008. Intensive UO monitoring was defined as hourly recordings and no gaps >3 hours for the first 48 hours after ICU admission...
May 17, 2017: Chest
https://www.readbyqxmd.com/read/28525779/systematic-review-and-meta-analysis-of-renal-replacement-therapy-modalities-for-acute-kidney-injury-in-the-intensive-care-unit
#8
Danielle M Nash, Sebastian Przech, Ron Wald, Daria O'Reilly
PURPOSE: To compare clinical outcomes among critically ill adults with acute kidney injury (AKI) treated with continuous renal replacement therapy (CRRT), intermittent hemodialysis (IHD) or sustained low efficiency dialysis (SLED). MATERIALS AND METHODS: We completed a systematic review and meta-analysis of studies published in 2015 or earlier using MEDLINE®, EMBASE®, Cochrane databases and grey literature. Eligible studies included randomized clinical trials (RCTs) or prospective cohort studies comparing outcomes of mortality, dialysis dependence or length of stay among critically ill adults receiving CRRT, IHD or SLED to treat AKI...
May 9, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28523356/evaluation-of-height-dependent-and-height-independent-methods-of-estimating-baseline-serum-creatinine-in-critically-ill-children
#9
Erin Hessey, Rami Ali, Marc Dorais, Geneviève Morissette, Michael Pizzi, Nikki Rink, Philippe Jouvet, Jacques Lacroix, Véronique Phan, Michael Zappitelli
BACKGROUND: Baseline serum creatinine (bSCr) is required for diagnosing acute kidney injury (AKI). In children, bSCr is commonly defined as the lowest measurement within 3 months of admission. Measured values are often missing and estimating bSCr using height-based glomerular filtration rate (GFR) equations is problematic when height is unavailable. METHODS: This is a retrospective cohort study including 538 children admitted to the intensive care unit (ICU) between 2003 and 2005 at two centers in Canada, with measured bSCr, height, and ICU-SCr values...
May 18, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28511674/predictors-of-fifty-days-in-hospital-mortality-in-patients-with-culture-negative-neutrocytic-ascites
#10
Chinmaya Kumar Bal, Vikram Bhatia, Ripu Daman
BACKGROUND: Culture negative neutrocytic ascites is a variant of spontaneous bacterial peritonitis. But there are conflicting reports regarding the mortality associated with culture negativeneutrocytic ascites. Therefore we aim to determine the predictors of mortality associated with culture negativeneutrocytic ascites in a larger sample population. METHODS: We analysed 170 patients consecutively admitted to intensive care unit with diagnosis of culture negative neutrocytic ascites...
May 16, 2017: BMC Gastroenterology
https://www.readbyqxmd.com/read/28505627/endothelial-damage-signals-refractory-acute-kidney-injury-in-critically-ill-patients
#11
Theis S Itenov, Jens-Ulrik Jensen, Sisse R Ostrowski, Pär I Johansson, Katrin M Thormar, Jens D Lundgren, Morten H Bestle
Critically ill patients with acute kidney injury (AKI) are heterogeneous on pathophysiology and prognosis. The role of endothelial damage in the pathogenesis of refractory AKI has not been clarified. The aim was to determine if biomarkers of endothelial damage, independently of the inflammatory insult on the kidney, can predict recovery of acute kidney injury. METHODS: From the "Procalcitonin And Survival Study" multicenter intensive care unit cohort, followed for 28 days after admission, we included patients without chronic kidney disease, who survived >24 h after admission and with plasma samples at admission available for biomarker analysis...
June 2017: Shock
https://www.readbyqxmd.com/read/28487870/volume-related-weight-gain-as-an-independent-indication-for-renal-replacement-therapy-in-the-intensive-care-units
#12
REVIEW
Tibor Fülöp, Lajos Zsom, Mihály B Tapolyai, Miklos Z Molnar, László Rosivall
Attempts to identify specific therapies to reverse acute kidney injury (AKI) have been unsuccessful in the past; only modifying risk profile or addressing the underlying disease processes leading to AKI proved efficacious. The current thinking on recognizing AKI is compromised by a "kidney function percent-centered" viewpoint, a paradigm further reinforced by the emergence of serum creatinine-based automated glomerular filtration reporting over the last two decades. Such thinking is, however, grossly corrupted for AKI and poorly applicable in critically ill patients in general...
2017: Journal of Renal Injury Prevention
https://www.readbyqxmd.com/read/28486440/electronic-health-record-based-predictive-models-for-acute-kidney-injury-screening-in-pediatric-inpatients
#13
Li Wang, Tracy L McGregor, Deborah P Jones, Brian C Bridges, Geoffrey M Fleming, Jana Shirey-Rice, Michael F McLemore, Lixin Chen, Asli Weitkamp, Daniel W Byrne, Sara L Van Driest
BACKGROUNDAcute kidney injury (AKI) is common in pediatric inpatients and associated with increased morbidity, mortality, and length of stay. Early identification can reduce severity.METHODSTo create and validate an electronic health record (EHR)-based AKI screening tool, we generated temporally distinct development and validation cohorts using retrospective data from our tertiary care children's hospital, including children 28 days through 21 years old with sufficient serum creatinine measurements to determine AKI status...
May 9, 2017: Pediatric Research
https://www.readbyqxmd.com/read/28483379/the-incidence-of-pediatric-acute-kidney-injury-is-increased-when-identified-by-a-change-in-a-creatinine-based-electronic-alert
#14
Jennifer Holmes, Gethin Roberts, Kate May, Kay Tyerman, John Geen, John D Williams, Aled O Phillips
A prospective national cohort study was undertaken to collect data on all cases of pediatric (under 18 yrs of age) acute kidney injury (AKI) identified by a biochemistry-based electronic alert using the Welsh National electronic AKI reporting system. Herein we describe the utility and limitation of using this modification of the KDIGO creatinine-based system data set to characterize pediatric AKI. Of 1,343 incident episodes over a 30-month period, 34.5% occurred in neonates of which 83.8% were AKI stage 1. Neonatal 30-day mortality was 4...
May 5, 2017: Kidney International
https://www.readbyqxmd.com/read/28468676/blood-pressure-deficits-in-acute-kidney-injury-not-all-about-the-mean-arterial-pressure
#15
Lui G Forni, Michael Joannidis
Acute kidney injury (AKI) is associated with increased morbidity and mortality. Although there are many causes of AKI, it is known that patients undergoing high-risk surgery are known to be at significant risk. Although much effort has centred on the minimum arterial pressure needed to maintain renal perfusion, this tends to be based on relatively crude measures such as the mean arterial pressure (MAP), which is widely used as an index for the optimal blood pressure. The rationale behind maintaining MAP is to provide adequate organ perfusion, although this is difficult to assess other than by applying crude end-points...
May 4, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28468613/low-mean-perfusion-pressure-is-a-risk-factor-for-progression-of-acute-kidney-injury-in-critically-ill-patients-a-retrospective-analysis
#16
Marlies Ostermann, Anna Hall, Siobhan Crichton
BACKGROUND: The aim was to investigate whether mean perfusion pressure (MPP) calculated as the difference between mean arterial pressure (MAP) and central venous pressure (CVP) was associated with risk of progression from AKI I to AKI III in critically ill patients. METHODS: Retrospective analysis of adult patients admitted to a multi-disciplinary adult intensive care unit (ICU) between July 2007 and June 2009 who developed AKI I and in whom advanced haemodynamic monitoring was initiated within 12 h of diagnosis of AKI I...
May 3, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28466293/-renal-replacement-therapy-in-acute-kidney-injury
#17
REVIEW
S J Klein, M Joannidis
Acute kidney injury is still a common complication in intensive care units and is associated with a significantly increased risk for morbidity and mortality. Various treatment concepts, like continuous renal replacement therapy (RRT) or (modified) intermittent procedures, as well as different methods of anticoagulation and the general decision of when and if to initiate RRT have to be considered by the treating physician. While giving vital input on when to initiate RRT, the German ELAIN (Early versus late initiation of renal replacement therapy in critically ill patients) trial and the French AKIKI (The artificial kidney initiation in kidney injury) trial raised many more questions...
May 2, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/28464841/the-impact-of-continuous-renal-replacement-therapy-on-renal-outcomes-in-dialysis-requiring-acute-kidney-injury-may-be-related-to-the-baseline-kidney-function
#18
Marisa Aparecida de Souza Oliveira, Thais Oliveira Claizoni Dos Santos, Julio Cesar Martins Monte, Marcelo Costa Batista, Virgilio Gonçalves Pereira, Bento Fortunato Cardoso Dos Santos, Oscar Fernando Pavão Santos, Marcelino de Souza Durão
BACKGROUND: Many controversies exist regarding the management of dialysis-requiring acute kidney injury (D-AKI). No clear evidence has shown that the choice of dialysis modality can change the survival rate or kidney function recovery of critically ill patients with D-AKI. METHODS: We conducted a retrospective study investigating patients (≥16 years old) admitted to an intensive care unit with D-AKI from 1999 to 2012. We analyzed D-AKI incidence, and outcomes, as well as the most commonly used dialysis modality over time...
May 3, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28460210/hypoxic-hepatitis-its-biochemical-profile-causes-and-risk-factors-of-mortality-in-critically-ill-patients-a-cohort-study-of-565-patients
#19
Mohammed M Aboelsoud, Amen I Javaid, Mazen O Al-Qadi, James H Lewis
PURPOSE: A retrospective analysis of critically-ill patients with hypoxic hepatitis (HH) to characterize the biochemical profile and to identify predictors of mortality using the Medical Information Mart for Intensive Care III database. METHODS: HH was defined as a rapid increase in AST/ALT≥800IU/L after exclusion of other causes. We investigated the correlation between various clinical and laboratory parameters and mortality rates using regression models. RESULTS: Among 38,645 ICU-patients, 565 (1...
April 26, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28457076/improvement-in-creatinine-clearance-after-open-heart-surgery-in-infants-as-an-early-indicator-of-surgical-success
#20
Amit Dagan, Ovadia Dagan
BACKGROUND: Early surgical correction of congenital heart malformations in neonates and small infants may be complicated by acute kidney injury (AKI), which is associated with higher morbidity and mortality rates, especially in patients who require dialysis. Glomerular filtration rate (GFR) is considered the best measurement of renal function which, in neonates and infants, is highly dependent on heart function. OBJECTIVES: To determine whether measurements of creatinine clearance after open heart surgery in neonates and young infants can serve as an early indicator of surgical success or AKI...
December 2016: Israel Medical Association Journal: IMAJ
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