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Pediatric acute kidney injury

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https://www.readbyqxmd.com/read/28774273/thrombotic-microangiopathy-associated-with-valproic-acid-toxicity
#1
Sean A Hebert, Timothy P Bohan, Christian L Erikson, Rita D Swinford
BACKGROUND: Thrombotic microangiopathy (TMA) is a serious, sometimes life-threatening disorder marked by the presence of endothelial injury and microvascular thrombi. Drug-induced thrombotic microangiopathy (DI-TMA) is one specific TMA syndrome that occurs following drug exposure via drug-dependent antibodies or direct tissue toxicity. Common examples include calcineurin inhibitors Tacrolimus and Cyclosporine and antineoplastics Gemcitabine and Mitomycin. Valproic acid has not been implicated in DI-TMA...
August 3, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28766021/acute-kidney-injury-after-pediatric-liver-transplantation-incidence-risk-factors-and-association-with-outcome
#2
Miho Hamada, Shino Matsukawa, Satoshi Shimizu, Shinichi Kai, Toshiyuki Mizota
PURPOSE: Data on the incidence of, risk factors for, and association with outcomes of acute kidney injury (AKI) after pediatric liver transplantation are scarce. We conducted a retrospective cohort study to determine the incidence of AKI after pediatric liver transplantation. In addition, we examined risk factors for AKI and association of AKI with outcomes. METHODS: This study included 156 children aged between 3 months and 18 years undergoing liver transplantation at Kyoto University Hospital...
August 1, 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/28755073/urinary-biomarkers-of-cell-cycle-arrest-are-delayed-predictors-of-acute-kidney-injury-after-pediatric-cardiopulmonary-bypass
#3
Liqun Dong, Qing Ma, Michael Bennett, Prasad Devarajan
BACKGROUND: Several novel biomarkers that predict acute kidney injury (AKI) have recently been proposed. We have evaluated the sequential patterns of biomarker elevation after pediatric cardiopulmonary bypass (CPB) and determined their diagnostic accuracy. METHODS: We measured the ability of neutrophil gelatinase-associated lipocalin (NGAL), interleukin-18 (IL-18), liver type fatty-acid binding protein (L-FABP), kidney injury molecule-1 (KIM-1), tissue inhibitor of metalloproteinase-2 (TIMP-2), and insulin-like growth factor binding protein 7 (IGFBP7), to predict AKI (≥50% increase in serum creatinine from baseline)...
July 28, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28749627/acute-kidney-injury-in-pediatric-patients-diagnosis-and-management-in-the-emergency-department-digest
#4
Daniel Mohrer, Melissa Langhan, Pradip Chaudhari
Pediatric acute kidney injury is a condition that is underdiagnosed among children seen in the emergency department, and it has been associated with significant morbidity and mortality, including increased risk for chronic kidney disease. The most common etiologies in pediatric patients are now known to be due to hypovolemia, sepsis, shock, and cardiac dysfunction. This issue compares 3 classification systems for the diagnosis and staging of acute kidney injury and reviews the etiologies that lead to kidney injury in children...
May 22, 2017: Pediatric Emergency Medicine Practice
https://www.readbyqxmd.com/read/28737594/identifying-risk-for-acute-kidney-injury-in-infants-and-children-following-cardiac-arrest
#5
Tara M Neumayr, Jeff Gill, Julie C Fitzgerald, Avihu Z Gazit, Jose A Pineda, Robert A Berg, J Michael Dean, Frank W Moler, Allan Doctor
OBJECTIVES: Our goal was to identify risk factors for acute kidney injury in children surviving cardiac arrest. DESIGN: Retrospective analysis of a public access dataset. SETTING: Fifteen children's hospitals associated with the Pediatric Emergency Care Applied Research Network. PATIENTS: Two hundred ninety-six subjects between 1 day and 18 years old who experienced in-hospital or out-of-hospital cardiac arrest between July 1, 2003, and December 31, 2004...
July 21, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28729908/aki-after-pediatric-cardiac-surgery-for-congenital-heart-diseases-recent-developments-in-diagnostic-criteria-and-early-diagnosis-by-biomarkers
#6
REVIEW
Yuichiro Toda, Kentaro Sugimoto
BACKGROUND: Acute kidney injury (AKI) after cardiac surgery in children with congenital heart disease is a common complication. AKI is also associated with high morbidity and mortality. The Kidney Diseases Improving Global Outcomes (KDIGO) criteria for AKI classification are now widely used for the definition of AKI. It is noteworthy that a statement about children was added to the criteria. Many studies aimed at finding useful biomarkers are now being performed by using these criteria...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/28721515/prolonged-intermittent-renal-replacement-therapy-in-children
#7
REVIEW
Rajiv Sinha, Sidharth Kumar Sethi, Timothy Bunchman, Valentine Lobo, Rupesh Raina
Wide ranges of age and weight in pediatric patients makes renal replacement therapy (RRT) in acute kidney injury (AKI) challenging, particularly in the pediatric intensive care unit (PICU), wherein children are often hemodynamically unstable. Standard hemodialysis (HD) is difficult in this group of children and continuous veno-venous hemofiltration/dialysis (CVVH/D) has been the accepted modality in the developed world. Unfortunately, due to cost constraints, CVVH/D is often not available and peritoneal dialysis (PD) remains the common mode of RRT in resource-poor facilities...
July 18, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28717937/clinical-presentation-and-outcomes-of-childhood-onset-membranous-lupus-nephritis
#8
Maria Pereira, Eyal Muscal, Karen Eldin, M John Hicks, Anna Carmela P Sagcal-Gironella, Marietta DeGuzman, Scott E Wenderfer
BACKGROUND: Best practices for managing childhood-onset membranous lupus nephritis (MLN) are not yet established. Most studies involve primarily or exclusively adult cohorts or pediatric cohorts with combinations of pure or mixed membranous and proliferative nephritis. METHODS: We performed a single-center cohort study of consecutively diagnosed children with pure MLN from 1990 and 2016. Patients received care in Houston, Texas, one of the most diverse metropolitan areas in North America...
July 17, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28709596/be-on-alert-for-pediatric-aki
#9
Nicholas M Selby, Rachel Lennon
Acute kidney injury in children is associated with adverse outcomes, although much of our current understanding originates from studies in intensive care units. Holmes et al. used an automated acute kidney injury detection method to obtain epidemiologic data on pediatric acute kidney injury at a national level in outpatient, inpatient, and intensive care unit settings. We discuss the impact of these important results and the considerations needed with this approach.
August 2017: Kidney International
https://www.readbyqxmd.com/read/28700489/the-effect-of-intraoperative-dexmedetomidine-on-acute-kidney-injury-after-pediatric-congenital-heart-surgery-a-prospective-randomized-trial
#10
RANDOMIZED CONTROLLED TRIAL
Youn Yi Jo, Ji Young Kim, Ji Yeon Lee, Chang Hu Choi, Young Jin Chang, Hyun Jeong Kwak
BACKGROUND: Dexmedetomidine has been reported to have a renal protective effect after adult open heart surgery. The authors hypothesized that intraoperative infusion of dexmedetomidine would attenuate the decrease in renal function after pediatric open heart surgery. METHODS: Twenty-nine pediatric patients (1-6 years) scheduled for atrial or ventricular septal defect repair were randomly assigned to receive either continuous infusion of normal saline (control group, n = 14) or dexmedetomidine (a bolus dose of 0...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28699323/intra-procedural-continuous-dialysis-to-facilitate-interventional-catheterization-in-pediatric-patients-with-severe-renal-failure
#11
Angeline D Opina, Athar M Qureshi, Eileen Brewer, Ewa Elenberg, Sarah Swartz, Mini Michael, Henri Justino
BACKGROUND: Interventional catheterization procedures may be needed for patients with severe renal failure who are dependent on dialysis. To avoid the risk of fluid overload and electrolyte derangement during complex procedures in this oliguric/anuric patient population, we performed intra-procedural dialysis, either continuous renal replacement therapy (CRRT) or continous cycling peritoneal dialysis (CCPD). METHODS: We performed a retrospective review of a cohort of pediatric patients, ages 0-18 years, with dialysis-dependent renal failure who received CRRT or CCPD during catheterization procedures from January 2013 to March 2016...
July 12, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28672079/acute-kidney-injury-in-congenital-cardiac-surgery-comparison-of-prifle-akin
#12
Murat Tanyildiz, Mesiha Ekim, Tanil Kendirli, Ercan Tutar, Zeynep Eyileten, Zeynep Birsin Ozcakar, Asli Kavaz, Fatos Yalcınkaya, Adnan Uysalel, Semra Atalay
BACKGROUND: Acute kidney injury (AKI) is associated with an increased risk of mortality especially in pediatric intensive care units. The aim of this study is to determine the risk factors of AKI in children undergoing cardiac surgery for congenital heart disease and compare two different classification systems: pRIFLE and AKIN. METHODS: We retrospectively analyzed 145 patient undergoing pediatric congenital heart surgery who were between 1 month and 18 years and treated by the cardiovascular surgery department from January 2009 to October 2011...
July 3, 2017: Pediatrics International: Official Journal of the Japan Pediatric Society
https://www.readbyqxmd.com/read/28670579/assessment-of-circulating-protein-signatures-for-kidney-transplantation-in-pediatric-recipients
#13
Tara K Sigdel, Minnie M Sarwal
Identification and use of non-invasive biomarkers for kidney transplantation monitoring is an unmet need. A total of 121 biobanked sera collected from 111 unique kidney transplant (KT) patients (children and adolescent) and 10 age-matched healthy normal controls were used to profile serum proteins using semi-quantitative proteomics. The proteomics data were analyzed to identify panels of serum proteins that were specific to various transplant injuries, which included acute rejection (AR), BK virus nephropathy (BKVN), and chronic allograft nephropathy (CAN)...
2017: Frontiers in Medicine
https://www.readbyqxmd.com/read/28669107/outcomes-and-costs-of-cardiac-surgery-in-adults-with-congenital-heart-disease
#14
Viviane G Nasr, David Faraoni, Anne Marie Valente, James A DiNardo
Advances in pediatric cardiac surgical and medical care have led to increased survival of patients with congenital heart disease (CHD). Consequently, many CHD patients survive long enough to require cardiac surgery as adults. Using the 2013 Nationwide Inpatient Sample (NIS) database, we compared costs and outcomes for adult patients undergoing surgery for treatment of CHD to a reference population of adults undergoing CABG. Patients were identified using International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9 CM) procedure codes...
July 1, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28660497/mcardle-disease-a-pediatric-disorder-presenting-in-an-adult-with-acute-kidney-injury
#15
Xixi Zhao, Angela Li, Madhu Soni, Michael J Muriello, Carolyn H Jones, William L Whittier
Rhabdomyolysis is characterized by the acute breakdown of skeletal muscle, resulting in the release of muscle cell contents, subsequent myoglobinuria, and in severe cases, acute renal failure. A number of etiologies have been identified in acute rhabdomyolysis, in which drugs and trauma account for the majority of cases. One etiological category that is commonly overlooked in the adult population is an underlying genetic defect. This may be challenging to diagnose due to its rarity in the adult demographic and the marked heterogeneity, often requiring a high level of clinical suspicion before investigation is pursued...
June 28, 2017: CEN Case Reports
https://www.readbyqxmd.com/read/28656931/community-acquired-acute-kidney-injury-in-critically-ill-children-as-seen-in-the-emergency-unit-of-a-tertiary-hospital-in-enugu-southeast-nigeria
#16
C C Obichukwu, O I Odetunde, J M Chinawa, H U Okafor, D K Adiele, B C Ibe
BACKGROUND: Acute kidney injury (AKI) has been shown to be common in critically ill patients with associated very poor outcome. There is paucity of data regarding its epidemiology, particularly in developing countries. This study aims to assess the presence of AKI among critically ill children to determine its prevalence, outcome, and outcome determinants in children suffering from AKI. PATIENTS AND METHODS: This is a cross-sectional observational study of critically ill children admitted to the children emergency unit of University of Nigeria Teaching Hospital, Ituku Ozalla, Enugu...
June 2017: Nigerian Journal of Clinical Practice
https://www.readbyqxmd.com/read/28616708/comparison-of-different-definitions-of-acute-kidney-injury-in-extremely-low-birth-weight-infants
#17
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
#18
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
#19
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
#20
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
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