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https://www.readbyqxmd.com/read/29145723/statin-initiation-and-renal-outcomes-following-isolated-coronary-artery-bypass-grafting-a-meta-analysis
#1
Yushu Wang, Sui Zhu, Rongsheng DU, Juteng Zhou, Yucheng Chen, Qing Zhang
BACKGROUND: The effects of preoperative statin therapy (PST) on renal outcomes in patients with isolated coronary artery bypass grafting (CABG) are in controversial. This study aimed to assess the effects of preoperative statin use on postoperative renal outcomes in patients undergoing isolated CABG. METHODS: PubMed, EMBASE, and Cochrane Library were searched for studies published up to February 2017. Pooled odds ratio (OR) and its corresponding 95% confidence interval (95% CI) were calculated...
November 16, 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/29145491/the-urine-biomarker-panel-igfbp7-x-timp-2-nephrocheck%C3%A2-parameter-does-not-correlate-with-igfbp7-and-timp-2-gene-expression-in-urinary-sediment
#2
Daniela Knafl, Markus Müller, Sahra Pajenda, Zeynep Genc, Manfred Hecking, Ludwig Wagner
BACKGROUND: Acute kidney injury (AKI) is frequently observed in serious infections, following nephrotoxic medication, surgery and trauma. Here we tested whether the detection of two recently identified biomarkers for AKI, Tissue Inhibitor of Metalloproteinase-2 (TIMP-2) and Insulin-Like Growth Factor Binding Protein 7 (IGFBP7), depends on the expression of these proteins in cells of the urinary sediment. METHOD: We collected urine samples of 33 kidney transplant recipients and 14 non-transplanted patients who all had AKI (stages 1-3 according to KDIGO), and measured [IGFBP7]x[TIMP-2] using the NephroCheck® Astute1 40 ™ meter...
2017: PloS One
https://www.readbyqxmd.com/read/29142963/understanding-electronic-aki-alerts-characterization-by-definitional-rules
#3
Jennifer Holmes, Gethin Roberts, Soma Meran, John D Williams, Aled O Phillips
Introduction: Automated acute kidney injury (AKI) electronic alerts are based on comparing creatinine with historic results. Methods: We report the significance of AKI defined by 3 "rules" differing in the time period from which the baseline creatinine is obtained, and AKI with creatinine within the normal range. Results: A total of 47,090 incident episodes of AKI occurred between November 2013 and April 2016. Rule 1 (>26 μmol/l increase in creatinine within 48 hours) accounted for 9...
May 2017: KI Reports
https://www.readbyqxmd.com/read/29142955/improving-the-prediction-of-cardiac-surgery-associated-acute-kidney-injury
#4
Jordan Crosina, Jordyn Lerner, Julie Ho, Navdeep Tangri, Paul Komenda, Brett Hiebert, Nora Choi, Rakesh C Arora, Claudio Rigatto
Introduction: Acute kidney injury (AKI) is a potentially fatal complication of cardiac surgery. The inability to predict cardiac surgery-associated AKI is a major barrier to prevention and early treatment. Current clinical risk models for the prediction of cardiac surgery-associated AKI are insufficient, particularly in patients with preexisting kidney dysfunction. Methods: To identify intraoperative variables that might improve the performance of a validated clinical risk score (Cleveland Clinic Score, CCS) for the prediction of cardiac surgery-associated AKI, we conducted a prospective cohort study in 289 consecutive elective cardiac surgery patients at a tertiary care center...
March 2017: KI Reports
https://www.readbyqxmd.com/read/29142491/impact-of-remote-ischemic-postconditioning-during-primary-percutaneous-coronary-intervention-on-left-ventricular-remodeling-after-anterior-wall-st-segment-elevation-myocardial-infarction-a-single-center-experience
#5
Ayman Elbadawi, Omar Awad, Ramy Raymond, Haytham Badran, Ahmad E Mostafa, Marwan Saad
The role of remote ischemic postconditioning (RIPostC) in improving left ventricular (LV) remodeling after primary percutaneous coronary intervention (PCI) is not well established. To determine the efficacy and safety of RIPostC in improving LV remodeling and cardiovascular outcomes after primary PCI for anterior ST-elevation myocardial infarction (STEMI). Seventy-one patients with anterior STEMI were randomized to primary PCI with RIPostC protocol ( n  = 36) versus conventional primary PCI ( n  = 35)...
December 2017: International Journal of Angiology: Official Publication of the International College of Angiology, Inc
https://www.readbyqxmd.com/read/29137024/effect-of-different-surgical-type-of-coronary-artery-bypass-grafting-on-kidney-injury-a-propensity-score-analysis
#6
Ming-Jen Chan, Cheng-Chia Lee, Shao-Wei Chen, Feng-Chun Tsai, Pyng-Jing Lin, Pei-Chun Fan, Hsiang-Hao Hsu, Ming-Yang Chang, Yung-Chang Chen, Chih-Hsiang Chang
Acute kidney injury (AKI) after coronary artery bypass grafting (CABG) is associated with a less favorable outcome. Off-pump surgery results in lower kidney dysfunction than conventional on-pump arrest surgery. On-pump arrest surgery results in a lower revascularization rate compared with off-pump surgery. On-pump beating heart (OPBH) CABG combines the advantages of beating heart surgery and cardiopulmonary bypass. This study compared the renal outcomes of 3 cardiac surgical methods. From January 2010 to December 2012, 373 patients who underwent on-pump CABG were enrolled...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29136724/-expert-consensus-for-the-diagnosis-and-treatment-of-patients-with-renal-impairment-of-multiple-myeloma
#7
(no author information available yet)
Renal impairment (RI) is a common complication of multiple myeloma (MM), which is presented as chronic kidney disease (CKD) or acute kidney injury (AKI). The typical pathological feature is cast nephropathy. Presently international system staging (ISS) is used in evaluating MM. Although the classic Durie-Salmon staging system could be still used in clinical practice, it may miss out some patients with renal impairment. For evaluations of RI in MM patients with CKD, it's recommended to assess the estimated glomerular filtration rate (eGFR) by creatinine based formula CKD-epidemiology collaboration (EPI) or modification of diet in renal disease(MDRD) and to stage the renal injuries according to 2013 Kidney Disease Improving Global Outcomes (KDIGO) CKD guidelines...
November 1, 2017: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
https://www.readbyqxmd.com/read/29136619/risk-factor-analysis-for-aki-including-laboratory-indicators-a-nationwide-multicenter-study-of-hospitalized-patients
#8
Sasa Nie, Zhe Feng, Li Tang, Xiaolong Wang, Yani He, Jingai Fang, Suhua Li, Yibin Yang, Huijuan Mao, Jundong Jiao, Wenhu Liu, Ning Cao, Wenge Wang, Jifeng Sun, Fengmin Shao, Wenge Li, Qiang He, Hongli Jiang, Hongli Lin, Ping Fu, Xinzhou Zhang, Yinghong Liu, Yonggui Wu, ChunSheng Xi, Meng Liang, Zhijie Qu, Jun Zhu, Guangli Wu, Yali Zheng, Yu Na, Ying Li, Wei Li, Guangyan Cai, Xiangmei Chen
BACKGROUND/AIMS: Risk factor studies for acute kidney injury (AKI) in China are lacking, especially those regarding non-traditional risk factors, such as laboratory indicators. METHODS: All adult patients admitted to 38 tertiary and 22 secondary hospitals in China in any one month between July and December 2014 were surveyed. AKI patients were screened according to the Kidney Disease: Improving Global Outcomes' definition of AKI. Logistic regression was used to analyze the risk factors for AKI, and Cox regression was used to analyze the risk of in-hospital mortality for AKI patients; additionally, a propensity score analysis was used to reconfirm the risk factors among laboratory indicators for mortality...
October 24, 2017: Kidney & Blood Pressure Research
https://www.readbyqxmd.com/read/29136086/intraoperative-oliguria-predicts-acute-kidney-injury-after-major-abdominal-surgery
#9
T Mizota, Y Yamamoto, M Hamada, S Matsukawa, S Shimizu, S Kai
Background: The threshold of intraoperative urine output below which the risk of acute kidney injury (AKI) increases is unclear. The aim of this retrospective cohort study was to investigate the relationship between intraoperative urine output during major abdominal surgery and the development of postoperative AKI and to identify an optimal threshold for predicting the differential risk of AKI. Methods: Perioperative data were collected retrospectively on 3560 patients undergoing major abdominal surgery (liver, colorectal, gastric, pancreatic, or oesophageal resection) at Kyoto University Hospital...
October 9, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29132705/il-17a-improves-the-efficacy-of-mesenchymal-stem%C3%A2-cells-in-ischemic-reperfusion-renal-injury%C3%A2-by%C3%A2-increasing-treg-percentages-by-the%C3%A2-cox-2-pge2%C3%A2-pathway
#10
Ming Bai, Li Zhang, Bo Fu, Jiuxu Bai, Yingjie Zhang, Guangyan Cai, Xueyuan Bai, Zhe Feng, Shiren Sun, Xiangmei Chen
Mesenchymal stem cells (MSCs) are effective for the management of experimental ischemia-reperfusion acute kidney injury (IRI-AKI). Immune modulation is one of the important mechanisms of MSCs treatment. Interleukin-17A (IL-17A) pretreated MSCs are more immunosuppressive with minimal changes in immunogenicity in vitro. Here, we demonstrated that administration of IL-17A-pretreated MSCs resulted in significantly lower acute tubular necrosis scores, serum creatinine, and BUN of mice with IRI-AKI, compared with the administration of MSCs...
November 11, 2017: Kidney International
https://www.readbyqxmd.com/read/29132515/acute-kidney-injury-in-the-critically-ill
#11
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/29132469/-clinical-characteristics-and-prognostic-analysis-of-children-with-congenital-heart-disease-complicated-by-postoperative-acute-kidney-injury
#12
Lian Duan, Guo-Huang Hu, Meng Jiang, Cheng-Liang Zhang
OBJECTIVE: To analyze the perioperative clinical data of children with congenital heart disease complicated by acute kidney injury (AKI) after cardiopulmonary bypass (CPB) surgery, and to explore potential factors influencing the prognosis. METHODS: A retrospective analysis was performed among 118 children with congenital heart disease who developed AKI within 48 hours after CPB surgery. RESULTS: In the 118 patients, 18 died after 48 hours of surgery...
November 2017: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
https://www.readbyqxmd.com/read/29132411/an-isolated-elevation-in-blood-urea-level-is-not-uraemia-and-not-an-indication-for-renal-replacement-therapy-in-the-icu
#13
EDITORIAL
Jack Mackenzie, Bobby Chacko
The decision to initiate renal replacement therapy (RRT) and the optimal timing for commencement is a difficult decision faced by clinicians when treating acute kidney injury (AKI) in the intensive care setting. Without clinically significant ureamic symptoms or emergent indications (electrolyte abnormalities, volume overload) the timing of RRT initiation remains contentious and inconsistent across health providers. Current trends of initiating RRT in the ICU are often based on isolated blood urea levels without clear guidelines demonstrating an upper limit for treatment...
November 13, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29132321/the-role-of-the-specialized-team-in-the-operation-of-continuous-renal-replacement-therapy-a-single-center-experience
#14
Harin Rhee, Gum Sook Jang, Miyeun Han, In Seong Park, Il Young Kim, Sang Heon Song, Eun Young Seong, Dong Won Lee, Soo Bong Lee, Ihm Soo Kwak
BACKGROUND: The requirement of continuous renal replacement therapy (CRRT) is increasing with the growing incidence of acute kidney injury (AKI). The decision to initiate CRRT is not difficult if an adequate medical history is obtained. However, the handling and maintenance of CRRT constitute a labor-intensive intervention that requires specialized skills. For these reasons, our center organized a specialized CRRT team in March 2013. The aim of this study is to report on the role of a specialized CRRT team and to evaluate the team's outcome...
November 13, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/29132132/care-of-the-acute-kidney-injury-survivor
#15
Ron Wald, Abhijat Kitchlu, Ziv Harel, Samuel A Silver
While the short-term implications of acute kidney injury (AKI) have been known for many years, far less attention has been paid to the health of AKI survivors. This was perhaps fueled by a prevailing wisdom that if a patient was fortunate enough to survive the primary illness associated with AKI, the prognosis for future health was auspicious. More recently, this dogma was challenged by data suggesting that after an episode of AKI, patients remain at risk of experiencing multiple adverse health outcomes. Greater recognition and appreciation of the risks faced by AKI survivors have led to the development of quality improvement initiatives that are supposed to enrich this vulnerable population...
November 13, 2017: Nephron
https://www.readbyqxmd.com/read/29131707/plasma-neutrophil-gelatinase-associated-lipocalin-measured-immediately-after-restoration-of-spontaneous-circulation-predicts-acute-kidney-injury-in-cardiac-arrest-survivors-who-underwent-therapeutic-hypothermia
#16
Dong Hun Lee, Byung Kook Lee, Yong Soo Cho, Yong Hun Jung, Sung Min Lee, Jung Soo Park, Kyung Woon Jeung
Early diagnosis of acute kidney injury (AKI) after cardiac arrest (CA) is challenging. We aimed to identify the diagnostic and prognostic performance of neutrophil gelatinase-associated lipocalin (NGAL) for AKI and its clinical outcomes. A retrospective observational study, involving adult comatose CA survivors treated with therapeutic hypothermia between May 2013 and December 2016, was conducted. AKI was classified according to the guidelines of Kidney Disease Improving Global Outcomes. NGAL levels were measured after return of spontaneous circulation (ROSC)...
November 13, 2017: Therapeutic Hypothermia and Temperature Management
https://www.readbyqxmd.com/read/29131132/points-of-concern-in-post-acute-kidney-injury-management
#17
Jill Vanmassenhove, Raymond Vanholder, Norbert Lameire
The incidence of acute kidney injury (AKI) will in the future remain high, partly due to an increase in comorbidities and other AKI favoring factors such as the rise in high-risk diagnostic and therapeutic interventions. AKI has emerged as a major public health concern with high human and financial costs. It has recently been demonstrated that patients surviving an AKI episode show increased all-cause mortality, chronic kidney disease (CKD), ESRD, cardiovascular events, and reduced quality of life. Although it is important to acknowledge that, after an AKI episode, the risk of dying by far exceeds the risk of developing incident or progressive CKD and/or entering a maintenance renal replacement therapy (RRT) program, currently only a minority of patients are referred for renal follow-up, even after AKI-requiring RRT...
November 2, 2017: Nephron
https://www.readbyqxmd.com/read/29128923/fluid-overload-independent-of-acute-kidney-injury-predicts-poor-outcomes-in-neonates-following-congenital-heart-surgery
#18
Kenneth E Mah, Shiying Hao, Scott M Sutherland, David M Kwiatkowski, David M Axelrod, Christopher S Almond, Catherine D Krawczeski, Andrew Y Shin
BACKGROUND: Fluid overload (FO) is common after neonatal congenital heart surgery and may contribute to mortality and morbidity. It is unclear if the effects of FO are independent of acute kidney injury (AKI). METHODS: This was a retrospective cohort study which examined neonates (age < 30 days) who underwent cardiopulmonary bypass in a university-affiliated children's hospital between 20 October 2010 and 31 December 2012. Demographic information, risk adjustment for congenital heart surgery score, surgery type, cardiopulmonary bypass time, cross-clamp time, and vasoactive inotrope score were recorded...
November 11, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/29128487/elevated-pulse-pressure-intraoperative-hemodynamic-perturbations-and-acute-kidney-injury-after-coronary-artery-bypass-grafting-surgery
#19
Alan M Smeltz, Mary Cooter, Srikar Rao, Jörn A Karhausen, Mark Stafford-Smith, Manuel L Fontes, Miklos D Kertai
OBJECTIVE: To explore whether baseline pulse pressure (PP) confers an increased risk for acute kidney injury (AKI) independent of intraoperative hypotension or hypertension in patients who undergo coronary artery bypass grafting (CABG) surgery. DESIGN: Retrospective study. SETTING: Single academic center. PARTICIPANTS: 5,808 patients who underwent CABG surgery. MEASUREMENTS AND MAIN RESULTS: Baseline arterial blood pressure was defined as the mean of the first 5 measurements recorded by the automated record keeping system before anesthesia was induced...
August 14, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29128485/neutrophil-lymphocyte-and-platelet-counts-and-acute-kidney-injury-after-cardiovascular-surgery
#20
Chang-Hoon Koo, Dhong Eun Jung, Yoon Sang Park, Jungil Bae, Youn Joung Cho, Won Ho Kim, Jae-Hyon Bahk
OBJECTIVE: Postoperative low platelet count and perioperative high neutrophil/lymphocyte (N/L) ratio are associated with acute kidney injury (AKI) and mortality after cardiac surgery. The authors investigated whether (1) their combination neutrophil/lymphocyte × platelet (N/LP) ratio is an independent predictor of AKI and postoperative mortality and (2) whether the N/LP ratio increases predictive ability compared with the N/L ratio or platelet nadir. DESIGN: This was a retrospective and observational study...
August 24, 2017: Journal of Cardiothoracic and Vascular Anesthesia
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