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AKI in sepsis

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https://www.readbyqxmd.com/read/29230707/acute-kidney-injury-after-abdominal-aortic-aneurysm-repair-current-epidemiology-and-potential-prevention
#1
Liesa Zabrocki, Frank Marquardt, Klaus Albrecht, Stefan Herget-Rosenthal
PURPOSE: Acute kidney injury (AKI) is a severe complication after infrarenal abdominal aortic aneurysm (iAAA) repair. Little data are available whether endovascular aneurysm (EVAR) or open aortic repair (OAR) differs with respect to AKI frequency and severity, consecutive development of chronic kidney disease (CKD) and potentially preventable and modifiable risk factors of AKI. PATIENTS AND METHODS: We assessed AKI rates, AKI stages and CKD applying current, complete definitions from the kidney disease improving global outcomes initiative in propensity-score-matched cohorts of all patients with elective and urgent iAAA repair at our institution from 2007 to 2011...
December 11, 2017: International Urology and Nephrology
https://www.readbyqxmd.com/read/29217190/the-down-regulation-of-cardiac-contractile-proteins-underlies-myocardial-depression-during-sepsis-and-is-mitigated-by-carbon-monoxide
#2
Kana Unuma, Toshihiko Aki, Suguru Nagano, Ryo Watanabe, Koichi Uemura
The aim of this study is to investigate the mechanism underling cardiac dysfunction during sepsis, as well as the possible amelioration of this dysfunction by exogenous carbon monoxide (CO) administration. For this purpose, rats (six-weeks-old, male, Sprague-Dawley) were administered LPS (15 mg/kg body weight, i.p. 6 h) and/or CORM (30 mg/kg, i.p.). The decreased left ventricular ejection fraction (EF) observed in LPS group rats was recovered in the LSP + CORM group, confirming the protective role of CO against sepsis-induced myocardial depression...
December 4, 2017: Biochemical and Biophysical Research Communications
https://www.readbyqxmd.com/read/29215080/risk-predictors-and-outcomes-of-acute-kidney-injury-in-patients-admitted-to-intensive-care-units-in-egypt
#3
Samar Abd ElHafeez, Giovanni Tripepi, Robert Quinn, Yasmine Naga, Sherif Abdelmonem, Mohamed AbdelHady, Ping Liu, Matthew James, Carmine Zoccali, Pietro Ravani
Epidemiology of acute kidney injury (AKI) in developing countries is under-studied. We evaluated the risk and prognosis of AKI in patients admitted to intensive care units (ICUs) in Egypt. We recruited consecutive adults admitted to ICUs in Alexandria Teaching Hospitals over six months. We used the KDIGO criteria for AKI. We followed participants until the earliest of ICU discharge, death, day 30 from entry or study end. Of the 532 participants (median age 45 (Interquartile range [IQR]: 30-62) years, 41.7% male, 23...
December 7, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29212494/epidemiology-and-outcomes-of-children-with-renal-failure-in-the-pediatric-ward-of-a-tertiary-hospital-in-cameroon
#4
Marie Patrice Halle, Carine Tsou Lapsap, Esther Barla, Hermine Fouda, Hilaire Djantio, Beatrice Kaptue Moudze, Christophe Adjahoung Akazong, Eugene Belley Priso
BACKGROUND: Pediatric nephrology is challenging in developing countries and data on the burden of kidney disease in children is difficult to estimate due to absence of renal registries. We aimed to describe the epidemiology and outcomes of children with renal failure in Cameroon. METHODS: We retrospectively reviewed 103 medical records of children from 0 to 17 years with renal failure admitted in the Pediatric ward of the Douala General Hospital from 2004 to 2013...
December 6, 2017: BMC Pediatrics
https://www.readbyqxmd.com/read/29207668/genetic-or-pharmacologic-inhibition-of-egfr-ameliorates-sepsis-induced-aki
#5
Xuan Xu, Juan Wang, Ruhao Yang, Zheng Dong, Dongshan Zhang
Despite recent studies have demonstrated that the EGF receptor (EGFR) activation provided a renoprotective role during ischemic and folic acid-induced AKI, the role and regulation mechanism of EGFR in septic AKI remains unclear. Here, gefitinib, a highly selective EGFR inhibitor, abrogated LPS-induced phosphorylation of EGFR, ERK1/2, and STAT3 as well as expression of COX, eNOS, and proinflammatory cytokines in HK-2 cells. In addition, c-Src is an upstream of EGFR signaling pathway and mediates LPS-induced EGFR transactivation...
October 31, 2017: Oncotarget
https://www.readbyqxmd.com/read/29202260/interobserver-agreement-for-post-mortem-renal-histopathology-and-diagnosis-of-acute-tubular-necrosis-in-critically-ill-patients
#6
Neil J Glassford, Alison Skene, Maria B Guardiola, Matthew J Chan, Sean M Bagshaw, Rinaldo Bellomo, Kim Solez
BACKGROUND: The renal histopathology of critically ill patients dying with acute kidney injury (AKI) in intensive care units of high income countries remains uncertain. METHODS: Retrospective observational assessment of interobserver agreement in the reporting of renal post mortem histopathology, and the ability of pathologists blinded to the clinical context to independently identify the presence of pre-mortem AKI from digital images of histological sections from 34 critically ill patients dying in teaching hospitals in Australia and Canada...
December 2017: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/29201213/protective-role-of-tenuigenin-on-sepsis-induced-acute-kidney-injury-in-mice
#7
Yan Xu, Yan Jiang, Wentao Gai, Botao Yu
Acute kidney injury (AKI) is a severe complication of sepsis, which largely contributes to the associated high mortality rate. Tenuigenin (TNG) is a natural product isolated from Polygala tenuifolia root, which possesses anti-inflammatory and anti-oxidant properties. The present study investigated the effects of TNG on sepsis-associated AKI in mice subjected to cecal ligation and puncture (CLP). TNG was demonstrated to alleviate sepsis-induced AKI by reducing pathological changes and significantly decreasing the levels of blood urea nitrogen, serum creatinine and kidney coefficient...
November 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/29199512/long-term-renal-and-overall-survival-of-critically-ill-patients-with-acute-renal-injury-who-received-continuous-renal-replacement-therapy
#8
Lingping Wu, Ping Zhang, Yi Yang, Hua Jiang, Yongchun He, Chunping Xu, Huijuan Yan, Qi Guo, Qun Luo, Jianghua Chen
BACKGROUND: Acute kidney injury (AKI) is associated with the increased short-term mortality of critically ill patients on continuous renal replacement therapy (CRRT). The aim of this research was to evaluate the association of kidney function at discharge with the long-term renal and overall survival of critically ill patients with AKI who were on CRRT in an intensive care unit (ICU). METHODS: We retrospectively collected data for critically ill patients with AKI who were admitted to ICU on CRRT at a tertiary metropolitan hospital in China between 2008 and 2013...
November 2017: Renal Failure
https://www.readbyqxmd.com/read/29197350/effect-of-hyperchloremia-on-acute-kidney-injury-in-critically-ill-septic-patients-a-retrospective-cohort-study
#9
Lenar Yessayan, Javier A Neyra, Fabrizio Canepa-Escaro, George Vasquez-Rios, Michael Heung, Jerry Yee
BACKGROUND: Hyperchloremia is common in critically ill septic patients. The impact of hyperchloremia on the incidence of acute kidney injury (AKI) is not well studied. We investigated the association between hyperchloremia and AKI within the first 72 h of intensive care unit (ICU) admission. METHODS: 6490 ICU adult patients admitted with severe sepsis or septic shock were screened for eligibility. Exclusion criteria included: AKI on admission, baseline estimated glomerular filtration rate (eGFR) <15 ml/min/1...
December 2, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/29178943/high-volume-hemofiltration-in-adult-burn-patients-with-septic-shock-and-acute-kidney-injury-a-multicenter-randomized-controlled-trial
#10
Kevin K Chung, Elsa C Coates, David J Smith, Rachel A Karlnoski, William L Hickerson, Angela L Arnold-Ross, Michael J Mosier, Marcia Halerz, Amy M Sprague, Robert F Mullins, Daniel M Caruso, Marlene Albrecht, Brett D Arnoldo, Agnes M Burris, Sandra L Taylor, Steven E Wolf
BACKGROUND: Sepsis and septic shock occur commonly in severe burns. Acute kidney injury (AKI) is also common and often results as a consequence of sepsis. Mortality is unacceptably high in burn patients who develop AKI requiring renal replacement therapy and is presumed to be even higher when combined with septic shock. We hypothesized that high-volume hemofiltration (HVHF) as a blood purification technique would be beneficial in this population. METHODS: We conducted a multicenter, prospective, randomized, controlled clinical trial to evaluate the impact of HVHF on the hemodynamic profile of burn patients with septic shock and AKI involving seven burn centers in the United States...
November 25, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29178124/high-cut-off-membranes-in-acute-kidney-injury-and-continuous-renal-replacement-therapy
#11
Zaccaria Ricci, Stefano Romagnoli, Claudio Ronco
Innovation in continuous renal replacement therapies (CRRT) utilized to treat acute kidney injury (AKI) and sepsis, has brought new machines and techniques. Part of these new advances are due to the availability of innovative biomaterials and the construction of membranes with larger pores and wide distribution of pore sizes. This includes the creation of a new generation of high cut-off membranes whose utilization in clinical practice is promising for the wide spectrum of solutes that are removed during extracorporeal therapies...
November 24, 2017: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/29132515/acute-kidney-injury-in-the-critically-ill
#12
REVIEW
Robert A Maxwell, Christopher Michael Bell
Acute kidney injury (AKI) occurs frequently in the surgical intensive care unit and results in significant morbidity and mortality. AKI needs to be identified early and underlying causes treated or eliminated. Sepsis, major surgery such as coronary artery bypass, and hypovolemia are the most common causes and patients with underlying comorbidities have increased susceptibility. Treatment should begin by ensuring that patients are adequately resuscitated and all contributing causes are replaced or eliminated...
December 2017: Surgical Clinics of North America
https://www.readbyqxmd.com/read/29117994/role-of-adenosine-1a-receptor-signaling-on-gfr-early-after-the-induction-of-sepsis
#13
Jonathan M Street, Erik H Koritzinsky, Tiffany R Bellomo, Xuzhen Hu, Peter S T Yuen, Robert A Star
Sepsis and acute kidney injury (AKI) synergistically increase morbidity and mortality in the ICU. How sepsis reduces GFR and causes AKI is poorly understood; one proposed mechanism includes tubuloglomerular feedback (TGF). When sodium reabsorption by the proximal tubules is reduced in normal animals, the macula densa senses increased luminal sodium chloride, then adenosine 1a receptor (A1aR) signaling triggers tubuloglomerular feedback, reducing GFR through afferent arteriole vasoconstriction. We measured GFR and systemic hemodynamics early during cecal ligation and puncture-induced sepsis in wild-type and A1aR knockout mice...
November 8, 2017: American Journal of Physiology. Renal Physiology
https://www.readbyqxmd.com/read/29111542/a-call-to-action-to-develop-integrated-curricula-in-cardiorenal-medicine
#14
Claudio Ronco, Federico Ronco, Peter A McCullough
With the adoption of the new definition and classification of cardiorenal syndrome (CRS) and its relevant subtypes, much attention has been placed on elucidating the mechanisms of heart and kidney interactions. The pathophysiologic pathways are of great interest by which acute heart failure may result in acute kidney injury (AKI; type 1), chronic heart failure accelerates the progression of chronic kidney disease (CKD; type 2), AKI provokes cardiac events (type 3), and CKD increases the risk and severity of cardiovascular disease (type 4)...
2017: Reviews in Cardiovascular Medicine
https://www.readbyqxmd.com/read/29104728/oxidative-stress-and-acute-kidney-injury-in-critical-illness-pathophysiologic-mechanisms-biomarkers-interventions-and-future-perspectives
#15
REVIEW
Paraskevi Pavlakou, Vassilios Liakopoulos, Theodoros Eleftheriadis, Michael Mitsis, Evangelia Dounousi
Acute kidney injury (AKI) is a multifactorial entity that occurs in a variety of clinical settings. Although AKI is not a usual reason for intensive care unit (ICU) admission, it often complicates critically ill patients' clinical course requiring renal replacement therapy progressing sometimes to end-stage renal disease and increasing mortality. The causes of AKI in the group of ICU patients are further complicated from damaged metabolic state, systemic inflammation, sepsis, and hemodynamic dysregulations, leading to an imbalance that generates oxidative stress response...
2017: Oxidative Medicine and Cellular Longevity
https://www.readbyqxmd.com/read/29092740/preoperative-aldosterone-receptor-blockade-and-outcomes-of-cardiac-surgery-in-patients-with-chronic-kidney-disease%C3%A2
#16
Linda Shavit, Shuli Silberman, Rachel Tauber, Ofer Merin, Daniel Bitran, Daniel Fink
BACKGROUND AND AIMS: Recent clinical evidence demonstrates that chronic low-dose mineralocorticoid receptor antagonists (MRA), when added to optimal treatment, result in reductions in cardiovascular mortality. However, continuation of MRAs before cardiac surgery in patients with CKD has never been evaluated and its potential benefit or harm in this specific clinical setting is largely unknown. MATERIALS AND METHODS: This is an observational study that included adult CKD patients undergoing cardiac surgery...
October 26, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/29089579/transfemoral-transcatheter-aortic-valve-implantation-in-patients-with-end-stage-renal-disease-and-kidney-transplant-recipients
#17
Fadi Al-Rashid, Anja Bienholz, Heike Annelie Hildebrandt, Polycarpos-Christos Patsalis, Matthias Totzeck, Andreas Kribben, Daniel Wendt, Heinz Jakob, Alexander Lind, Rolf Alexander Jánosi, Tienush Rassaf, Philipp Kahlert
Transcatheter aortic valve implantation (TAVI) has evolved to a treatment of choice in high-risk patients and is therefore ideal for patients with advanced chronic kidney disease, as patients with end-stage renal disease and kidney transplant recipients. Especially, outcome of this special patient group is very important. 22 patients with chronic kidney disease stage 5 undergoing intermittent hemodialysis treatment (CKD 5D) and 8 kidney transplant recipients (KT) with severe aortic valve stenosis underwent transfemoral TAVI...
October 31, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29080804/blockade-of-cd38-diminishes-lipopolysaccharide-induced-macrophage-classical-activation-and-acute-kidney-injury-involving-nf-%C3%AE%C2%BAb-signaling-suppression
#18
Bingyan Shu, Ye Feng, Yuan Gui, Qingmiao Lu, Wei Wei, Xian Xue, Xiaoli Sun, Weichun He, Junwei Yang, Chunsun Dai
The CD38, possessing ADP-ribosyl cyclase (ADPR-cyclase) and cyclic ADP-ribose hydrolase (cADPR-hydrolase), is able to regulate a variety of cellular activities. However, the role and mechanisms for CD38 in macrophage activation and sepsis-induced acute kidney injury (AKI) remain to be determined. Here we report that in cultured macrophages, Lipopolysaccharide (LPS) could upregulate CD38 expression in time and dose dependent manner. Knocking down or blockade of CD38 in macrophages could inhibit LPS-induced macrophage M1 polarization accompanied by diminished NF-κB signaling activation...
November 11, 2017: Cellular Signalling
https://www.readbyqxmd.com/read/29076682/outcomes-of-intensive-care-patients-having-septic-shock-at-a-tertiary-care-hospital-of-islamabad
#19
Azmat Ali, Awais Saeed Abbasi, Maliha Sheikh
BACKGROUND: Septic shock is defined as sepsis with circulatory, cellular and metabolic abnormalities which are associated with greater mortality more than 40%. The objective of this study was to identify shortcomings and act promptly and adequately. METHODS: This case series included 32 patients over a period of 03 months, September to November 2016 done at ICU of KRL Hospital Islamabad. RESULTS: The study only enrolled patients who fulfilled the criteria of septic shock...
July 2017: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/29074644/extracellular-signal-regulated-kinase-1-2-regulates-kidney-injury-molecule-1-expression-physiologically-and-following-ischemic-and-septic-renal-injury
#20
Justin B Collier, Rick G Schnellmann
The upregulation of kidney injury molecule-1 (KIM-1) has been extensively studied in various renal diseases and following acute injury; however, the initial mechanisms controlling KIM-1 expression remain limited. In this study, KIM-1 expression was examined in mouse renal cell cultures and in two different models of acute kidney injury (AKI), ischemia-reperfusion (IR) and lipopolysaccharide (LPS)-induced sepsis. KIM-1 mRNA increased in both AKI models and pharmacological inhibition of extracellular signal-regulated kinase 1/2 (ERK1/2) signaling attenuated injury induced KIM-1 expression in the renal cortex...
October 26, 2017: Journal of Pharmacology and Experimental Therapeutics
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