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Pediatric acute kidney injury

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https://www.readbyqxmd.com/read/28616708/comparison-of-different-definitions-of-acute-kidney-injury-in-extremely-low-birth-weight-infants
#1
Vikas Chowdhary, Ramya Vajpeyajula, Mohit Jain, Syeda Maqsood, Rupesh Raina, Deepak Kumar, Maroun J Mhanna
BACKGROUND: The definition of acute kidney injury (AKI) has evolved over the years, and three definitions have been adapted including pediatric risk injury failure, loss of kidney function (pRIFLE), Acute Kidney Injury Network (AKIN), and Neonatal Modified Kidney Disease Improving Global Outcomes (KDIGO). We sought to report the prevalence and outcome of (AKI) according to the three existing definitions in extremely low birth weight (ELBW) infants. METHODS: In a retrospective cohort study, medical records of all ELBW infants (<1000 g) admitted to our neonatal intensive care unit (NICU) between Jan 2002 and Dec 2011 were reviewed...
June 14, 2017: Clinical and Experimental Nephrology
https://www.readbyqxmd.com/read/28604760/developing-a-neonatal-acute-kidney-injury-research-definition-a-report-from-the-niddk-neonatal-aki-workshop
#2
Michael Zappitelli, Namasivayam Ambalavanan, David J Askenazi, Marva M Moxey-Mims, Paul L Kimmel, Robert A Star, Carolyn L Abitbol, Patrick D Brophy, Guillermo Hidalgo, Mina Hanna, Catherine M Morgan, Tonse N K Raju, Patricio Ray, Zayhara Reyes-Bou, Amani Roushdi, Stuart L Goldstein
Normal developmental changes during postnatal life hinder the development of an AKI definition and advancement of neonatal AKI research. This report summarizes the expert discussion at a National Institute of Diabetes and Digestive and Kidney Diseases sponsored neonatal AKI workshop, on knowledge gaps in defining neonatal AKI. The most important knowledge gaps and neonatal AKI definition research recommendations were agreed upon and defined. Several challenges were identified in defining neonatal AKI using serum creatinine (SCr) and urine output criteria applied in adults and children...
June 12, 2017: Pediatric Research
https://www.readbyqxmd.com/read/28601936/acute-kidney-injury-emerging-pharmacotherapies-in-current-clinical-trials
#3
Stefanie Woolridge Benoit, Prasad Devarajan
Acute kidney injury (AKI) is a significant source of morbidity and mortality in pediatric patients, affecting more than one quarter of critically ill children. Despite significant need, there are no targeted therapies to reliably prevent or treat AKI. Recent advances in our understanding of renal injury and repair signaling pathways have enabled the development of several targeted pharmaceuticals. Here we review emerging pharmacotherapies for AKI that are currently in clinical trials. Categorized by their general mechanism of action, the therapies discussed include anti-inflammatory agents (recAP, AB103, ABT-719), antioxidants (iron chelators, heme arginate), vasodilators (levosimendan), apoptosis inhibitors (QPI-1002), and repair agents (THR-184, BB-3, mesenchymal stem cells)...
June 10, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28579134/the-impact-of-obesity-on-pediatric-inpatients-with-urinary-tract-infections-in-the-united-states
#4
Yusuke Okubo, Atsuhiko Handa
INTRODUCTION: Urinary tract infections (UTI) are common infectious disorders, and obesity is an increasing public health problem worldwide. Several studies have suggested that childhood obesity may be associated with the development of UTI. However, the potential effects of obesity on the clinical outcomes of UTI in children remain unknown. MATERIALS AND METHODS: Hospital discharge records for patients aged 18 years or younger with a diagnosis of UTI were extracted from the 2012 Kids' Inpatient Database...
May 24, 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28578358/incidence-and-outcome-of-acute-kidney-injury-by-the-prifle-criteria-for-children-receiving-extracorporeal-membrane-oxygenation-after-heart-surgery
#5
Raja Abou Elella, Eiad Habib, Pavla Mokrusova, Princy Joseph, Hani Aldalaty, Mamdouh Al Ahmadi, Zohair Al Halees
BACKGROUND: Acute kidney injury (AKI) is common in patients treated with extracorporeal membrane oxygenation (ECMO). The RIFLE criteria demonstrate clinical relevance for diagnosing AKI and classifying its severity. OBJECTIVES: To systematically define the incidence, clinical course and outcome of AKI using the pediatric pRIFLE criteria. DESIGN: Retrospective, medical records review. SETTINGS: Pediatric cardiac surgical intensive care units at a tertiary care hospital in Riyadh...
May 2017: Annals of Saudi Medicine
https://www.readbyqxmd.com/read/28557999/treatment-of-aki-in-developing-and-developed-countries-an-international-survey-of-pediatric-dialysis-modalities
#6
Rupesh Raina, Abigail M Chauvin, Timothy Bunchman, David Askenazi, Akash Deep, Michael J Ensley, Vinod Krishnappa, Sidharth Kumar Sethi
HYPOTHESIS: Acute kidney injury (AKI) is a common cause of morbidity and mortality worldwide, with a pediatric incidence ranging from 19.3% to 24.1%. Treatment of pediatric AKI is a source of debate in varying geographical regions. Currently CRRT is the treatment for pediatric AKI, but limitations due to cost and accessibility force use of adult equipment and other therapeutic options such as peritoneal dialysis (PD) and hemodialysis (HD). It was hypothesized that more cost-effective measures would likely be used in developing countries due to lesser resource availability...
2017: PloS One
https://www.readbyqxmd.com/read/28552392/diagnostic-accuracy-and-prognostic-valued-of-plasmatic-cystatin-c-in-children-undergoing-pediatric-cardiac-surgery
#7
Massimiliano Cantinotti, Raffaele Giordano, Marco Scalese, Sabrina Molinaro, Simona Storti, Bruno Murzi, Vitali Pak, Vincenzo Poli, Giorgio Iervasi, Aldo Clerico
BACKGROUND: Diagnosis and treatment of acute kidney injury (AKI) is often delayed in children after cardiac surgery due to the lack of an early biomarker of renal damage. Our aim was to evaluate the diagnostic accuracy of plasma cystatin-C as an early biomarker of AKI and its prognostic value in pediatric cardiac surgery. METHODS: Cystatin-C and creatinine were measured pre-operatively and at 2-6-12h post-surgery. The primary outcome was: AKI (defined as an increase of ≥1...
May 26, 2017: Clinica Chimica Acta; International Journal of Clinical Chemistry
https://www.readbyqxmd.com/read/28536123/randomized-controlled-trial-of-mineralocorticoid-receptor-blockade-in-children-with-chronic-kidney-allograft-nephropathy
#8
Mara Medeiros, Luis Velásquez-Jones, Ana M Hernández, Guillermo Ramón-García, Saúl Valverde, Yolanda Fuentes, Arindal Vargas, Mauricio Patiño, Rosalba Pérez-Villalva, Juan Antonio Ortega-Trejo, Jonatan Barrera-Chimal, Norma A Bobadilla
BACKGROUND AND OBJECTIVES: We showed that mineralocorticoid receptor blockade (MRB) prevented acute and chronic cyclosporine nephropathy (CsA-Nx) in the rat. The aim of this translational study was to investigate the effect of long-term eplerenone administration on renal allograft function in children with biopsy-proven chronic allograft nephropathy (CAN). DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Renal transplant children <18 years, biopsy-proven CAN, and a GFR>40 ml/min per 1...
May 23, 2017: Clinical Journal of the American Society of Nephrology: CJASN
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/28515693/rolipram-improves-outcome-in-a-rat-model-of-infant-sepsis-induced-cardiorenal-syndrome
#10
Clark R Sims, Sharda P Singh, Shengyu Mu, Neriman Gokden, Dala Zakaria, Trung C Nguyen, Philip R Mayeux
While the mortality rate associated with sepsis in children has fallen over the years, it still remains unacceptably high. The development of both acute cardiac dysfunction and acute kidney injury during severe sepsis is categorized as type 5 cardiorenal syndrome (CRS) and is poorly understood in infants. To address this lack of understanding and the need for an appropriate animal model in which to conduct relevant preclinical studies, we developed a model of infant sepsis-induced CRS in rat pups then evaluated the therapeutic potential of the phosphodiesterase (PDE) 4 inhibitor, rolipram...
2017: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/28515370/acute-kidney-injury-following-cardiopulmonary-bypass-in-children%C3%A3-risk-factors-and-outcomes
#11
Seon Hwa Lee, Soo-Jin Kim, Hyung Joong Kim, Jae Sung Son, Ran Lee, Tae Gyoon Yoon
BACKGROUND: Acute kidney injury (AKI) is the most common and most serious complication following heart surgery. We aimed to determine the prevalence of, and risk factors for, AKI following pediatric cardiac surgery.Methods and Results:We retrospectively analyzed 135 patients aged ≤18 years who underwent cardiac surgery for congenital heart defects; by RACHS-1 category, 58 patients (43%) had an operative risk score ≥3. AKI was defined and classified using the pediatric pRIFLE criteria (Pediatric Risk, Injury, Failure, Loss, and End-stage Kidney Disease); 19 patients (14...
May 17, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28492399/acute-kidney-injury-after-pediatric-cardiac-surgery-a-secondary-analysis-of-the-safe-pediatric-euglycemia-after-cardiac-surgery-trial
#12
Joshua J Blinder, Lisa A Asaro, David Wypij, David T Selewski, Michael S D Agus, Michael Gaies, Michael A Ferguson
OBJECTIVES: To understand the effect of tight glycemic control on cardiac surgery-associated acute kidney injury. DESIGN: Secondary analysis of data from the Safe Pediatric Euglycemia after Cardiac Surgery trial of tight glycemic control versus standard care. SETTING: Pediatric cardiac ICUs at University of Michigan, C.S. Mott Children's Hospital, and Boston Children's Hospital. PATIENTS: Children 0-36 months old undergoing congenital cardiac surgery...
May 10, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28491318/recovery-of-methotrexate-induced-anuric-acute-kidney-injury-after-glucarpidase-therapy
#13
James Harms, Ayaz Khawaja, Maria Taylor, Xiaosi Han, Michal Mrug
OBJECTIVES: This case report describes two cases of high-dose methotrexate-induced nephrotoxicity: death in the case of conventional supportive care and successful renal function recovery in a patient treated with glucarpidase and continuous dialysis. METHODS: High dose methotrexate is widely used for management of adult and pediatric malignancies. However, high-dose methotrexate-induced renal nephrotoxicity may cause severe, even lethal complications. Here we present examples of such outcomes...
2017: SAGE open medical case reports
https://www.readbyqxmd.com/read/28486440/electronic-health-record-based-predictive-models-for-acute-kidney-injury-screening-in-pediatric-inpatients
#14
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 is associated with increased morbidity, mortality, and length of stay. Its 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 aged 28 days through 21 years with sufficient serum creatinine measurements to determine AKI status...
May 31, 2017: Pediatric Research
https://www.readbyqxmd.com/read/28485097/hematopoietic-stem-cell-transplantation-and-acute-kidney-injury-in-children-a-comprehensive-review
#15
REVIEW
Rupesh Raina, Nicholas Herrera, Vinod Krishnappa, Sidharth Kumar Sethi, Akash Deep, Wei-Ming Kao, Timothy Bunchman, Rolla Abu-Arja
AKI in the setting of HSCT is commonly investigated among adult patients. In the same way, malignancies requiring treatment with HSCT are not limited to the adult patient population, AKI following HSCT is frequently encountered within pediatric patient populations. However, inadequate information regarding epidemiology and pathophysiology specific to pediatric patients prevents development of appropriate and successful therapeutic strategies for those afflicted. Addressing AKI in the context of sinusoidal obstruction syndrome, chemotherapy, thrombotic microangiopathy and hypertension post chemotherapy, glomerulonephritis, and graft versus host disease provides greater insight into renal impairment associated with these HSCT-related ailments...
June 2017: Pediatric Transplantation
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
#16
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/28481830/dose-prescription-and-delivery-in-neonates-with-congenital-heart-diseases-treated-with-continuous-veno-venous-hemofiltration
#17
Zaccaria Ricci, Francesco Guzzi, Germana Tuccinardi, Luca Di Chiara, William Clark, Stuart L Goldstein, Claudio Ronco
OBJECTIVES: Renal replacement therapy may be required for acute kidney injury treatment in neonates with complex cardiac conditions. Continuous veno-venous hemofiltration is applied safely in this population but no published recommendations for dose prescription in neonates currently exist. The aim of our study was to evaluate the effects of a relatively small dialysis dose on critically ill neonates. DESIGN: Retrospective analysis of clinical charts. SETTING: Pediatric Cardiac ICU...
May 5, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28480100/the-burden-and-outcome-of-pediatric-renal-admissions-at-the-federal-teaching-hospital-abakaliki-a-3-year-review-2011-2013
#18
V U Muoneke, A F Una, C B Eke, O U Anyanwu
BACKGROUND: Renal diseases are important causes of morbidity and mortality in children worldwide particularly in the resource-poor countries of sub-Saharan Africa. Adequate data on these diseases in children in our setting are limited as a result of late/nonpresentation. AIM: The aim of the study is to review the pattern and outcome of pediatric renal admissions at the Federal Teaching Hospital (FETH) Abakaliki over a 3-year period. SUBJECTS AND METHODS: This was a retrospective observational review of all childhood renal admissions in FETH, Abakaliki, Ebonyi state between 2011 and 2013...
July 2016: Annals of Medical and Health Sciences Research
https://www.readbyqxmd.com/read/28460120/post-neonatal-tetanus-in-a-picu-of-a-developing-economy-intensive-care-needs-outcome-and-predictors-of-mortality
#19
Suresh Kumar Angurana, Muralidharan Jayashree, Arun Bansal, Sunit Singhi, Karthi Nallasamy
Objectives: To evaluate pediatric intensive care unit (PICU) needs, outcome and predictors of mortality in post-neonatal tetanus. Materials and methods: Review of 30 consecutive post-neonatal tetanus cases aged 1 months to 12 years admitted to a PICU in north India over a period of 10 years (January 2006 to December 2015). Results: Chronic suppurative otitis media was the commonest portal of entry. All received tetanus toxoid, human tetanus immunoglobulin (HTIG) and appropriate antibiotics; 7 (23...
April 27, 2017: Journal of Tropical Pediatrics
https://www.readbyqxmd.com/read/28452978/risk-factors-for-acute-kidney-injury-in-a-pediatric-intensive-care-unit-a-retrospective-cohort-study
#20
Lina María Serna-Higuita, John Fredy Nieto-Ríos, Jorge Eduardo Contreras-Saldarriaga, Juan Felipe Escobar-Cataño, Luz Adriana Gómez-Ramírez, Juan Diego Montoya-Giraldo, Elizabeth Parra-Rodas, Luisa María Parra-Rodas, Johana Catalina Valderrama-Torres, Fabián Jaimes
BACKGROUND: The incidence of acute kidney injury in the pediatric population and its associated risk factors are currently not clear. OBJECTIVES: The objective of the study was to assess the incidence of acute kidney injury in critically ill pediatric patients and to determine its associated risk factors. METHODS: We conducted a retrospective study of pediatric patients (<14 years old) admitted to a tertiary pediatric intensive care unit...
April 27, 2017: Medwave
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