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Acute kidney injury and sepsis

Hitesh Soni, Adebowale Adebiyi
Apoptosis of renal tubular and glomerular cells during kidney disease involves activation of Fas ligand (FasL)-dependent death pathway. The significance of FasL in neonates with septic acute kidney injury (AKI) is unresolved, but an increase in renal FasL production, and/or infiltration of circulating FasL into the kidneys may occur following initial septic insult. Here, we examined whether soluble Fas ligand (sFasL) levels are altered during early phase of septic AKI in neonates. Six hours of polymicrobial sepsis elicited by cecal ligation and puncture (CLP) elevated serum C-reactive protein (CRP) (a bacteremia and sepsis marker) concentration in anesthetized and mechanically ventilated neonatal pigs...
October 21, 2016: Renal Failure
Vina Tresa, Afshan Yaseen, Ali Asghar Lanewala, Seema Hashmi, Sabeeta Khatri, Irshad Ali, Muhammed Mubarak
BACKGROUND: The reported prevalence rates and etiologies of acute kidney injury (AKI) are quite variable in different regions of the world. The current study was planned to determine the etiology, clinical profile, and short-term outcome of pediatric AKI at our hospital. METHODS: A prospective, observational study was carried out from April 2014 to March 2015. All pediatric patients (1 month to ≤15 years) diagnosed as AKI using modified pRIFLE criteria were studied and followed for 3 months to document short-term outcome...
October 21, 2016: Renal Failure
Ara Ko, Lia Aquino, Nicolas Melo, Rodrigo F Alban
BACKGROUND: The relationship between failure-to-rescue (FTR) after colectomy is not well understood, particularly in teaching institutions. We sought to examine this relationship using a large national database. METHODS: Patients undergoing colectomy from 2010 to 2012 were identified in the Nationwide Inpatient Sample database. FTR events were defined as deaths following deep vein thrombosis or pulmonary embolism, sepsis, gastrointestinal bleed, acute myocardial infarction, acute kidney injury, pneumonia, respiratory failure, shock...
September 30, 2016: American Journal of Surgery
John A Kellum
PURPOSE OF REVIEW: Acute kidney injury is common and is associated with increased morbidity and mortality. Rates of acute kidney injury in most settings remain high and in some settings are increasing. Moreover, outcomes associated with acute kidney injury remain relatively poor. This review focuses on recent advances in understanding of acute kidney injury and discusses possible interventions based on these advances. RECENT FINDINGS: Acute kidney injury is not a disease with a single etiology and clinical course but rather a loose collection of syndromes whose unifying phenotype is an acute loss of glomerular filtration...
October 18, 2016: Current Opinion in Critical Care
Xingui Dai, Tao Li, Zhenhua Zeng, Chunlai Fu, Shengbiao Wang, Yeping Cai, Zhongqing Chen
BACKGROUND: It is known that continuous venonenous hemofiltration (CVVH) does not affect the plasma level of neutrophil gelatinase-associated lipocalin (pNGAL) in acute kidney injury (AKI) patients. However, because of the unique pathophysiology underlying AKI caused by sepsis, the effect of CVVH on pNGAL in this clinical setting is less certain. The purpose of this study was to determine the effect of CVVH on pNGAL in sepsis-induced AKI patients. METHODS: Between August 1, 2014, and December 31, 2014, 42 patients with sepsis-induced AKI underwent CVVH in the general intensive care unit of our institution and were consecutively enrolled in this study...
October 19, 2016: BMC Nephrology
Esther Peters, Bülent Ergin, Asli Kandil, Ebru Gurel-Gurevin, Andrea van Elsas, Rosalinde Masereeuw, Peter Pickkers, Can Ince
Two small clinical trials indicated that administration of bovine intestinal alkaline phosphatase (AP) improves renal function in critically ill patients with sepsis-associated acute kidney injury (AKI), for which the mechanism of action is not completely understood. Here, we investigated the effects of a newly developed human recombinant AP (recAP) on renal oxygenation and hemodynamics and prevention of kidney damage and inflammation in two in vivo AKI models. To induce AKI, male Wistar rats (n=18) were subjected to renal ischemia (30min) and reperfusion (I/R), or sham-operated...
October 16, 2016: Toxicology and Applied Pharmacology
Hiroaki Kitamura, Daisuke Nakano, Zhang Yifan, Akira Nishiyama
OBJECTIVE: Carperitide, alpha-human atrial natriuretic peptide, is used in expectation of protecting the kidney during sepsis in internal care unit; however, the detailed mechanism of action has not been clarified yet. As septic acute kidney injury (AKI) does not induce characteristic histological damage, we aimed assess the effects of carperitide treatment on the decline of renal function during lipopolysaccharide-induced AKI by using real-time intravital imaging technique. DESIGN AND METHOD: The renal function was analyzed by the bolus-shot FITC-inulin kinetics method that visualizes the tubular flow after free filtration from glomeruli...
September 2016: Journal of Hypertension
Prasad Devarajan, Rajit K Basu
No abstract text is available yet for this article.
October 13, 2016: Jornal de Pediatria
Corey J Langer, Shirish M Gadgeel, Hossein Borghaei, Vassiliki A Papadimitrakopoulou, Amita Patnaik, Steven F Powell, Ryan D Gentzler, Renato G Martins, James P Stevenson, Shadia I Jalal, Amit Panwalkar, James Chih-Hsin Yang, Matthew Gubens, Lecia V Sequist, Mark M Awad, Joseph Fiore, Yang Ge, Harry Raftopoulos, Leena Gandhi
BACKGROUND: Limited evidence exists to show that adding a third agent to platinum-doublet chemotherapy improves efficacy in the first-line advanced non-small-cell lung cancer (NSCLC) setting. The anti-PD-1 antibody pembrolizumab has shown efficacy as monotherapy in patients with advanced NSCLC and has a non-overlapping toxicity profile with chemotherapy. We assessed whether the addition of pembrolizumab to platinum-doublet chemotherapy improves efficacy in patients with advanced non-squamous NSCLC...
October 10, 2016: Lancet Oncology
Ramachandran Rameshkumar, Sriram Krishnamurthy, Rajesh Nachiappa Ganesh, Subramanian Mahadevan, Parameswaran Narayanan, Ponnarmeni Satheesh, Puneet Jain
BACKGROUND: Septic acute kidney injury (AKI) accounts for more than half of all cases of AKI in critically ill children. The renal histology was found to alter the management in more than two-third of cases of adult acute renal failure. Better insight into the pathogenesis of pediatric septic AKI could be based on developing a clearer appreciation of the histopathological changes. No comprehensive study of the histopathological features of septic AKI in critically ill children has yet been performed...
October 13, 2016: Clinical and Experimental Nephrology
Suvi T Vaara, Maija Hollmén, Anna-Maija Korhonen, Mikael Maksimow, Tero Ala-Kokko, Marko Salmi, Sirpa Jalkanen, Ville Pettilä
BACKGROUND: CD73 dephosphorylates adenosine monophosphate to adenosine that is an anti-inflammatory molecule inhibiting immune activation and vascular leakage. Therefore, CD73 could be an interesting mediator both in sepsis and acute kidney injury (AKI). We aimed to explore the soluble CD73 (sCD73) levels and their evolution in critically ill patients with severe sepsis and, second, to scrutinize the potential association of sCD73 levels with AKI and 90-day mortality. METHODS: This was a post-hoc laboratory analysis of the prospective, observational FINNAKI study conducted in 17 Finnish ICU during 5 months in 2011-2012...
2016: PloS One
H B Chandrashekhara, Mohammed Ghouse Shariff, Ravichandra Ns
No abstract text is available yet for this article.
January 2016: Journal of the Association of Physicians of India
Muhammad Abdul Mabood Khalil, Muhammad Salman Ghazni, Jackson Tan, Nazish Naseer, Muhammad Ashhad Ullah Khalil
Ovarian hyperstimulation syndrome (OHSS) was first described in 1960. It may occur as a complication of gonadotropin hormone therapy during assisted pregnancy or for primary infertility. A 26-year-old female patient with polycystic ovarian syndrome and primary infertility was treated to conceive. She received intravenous gonadotropin-releasing hormone (GnRH) along with follicle-stimulating hormone in an outside private clinic. She presented to the emergency department with abdominal and chest pain, loose stool, vomiting, shortness of breath and decreasing urine output...
May 2016: Case Reports in Gastroenterology
Nicholas M Donin, Sandra Duarte, Andrew T Lenis, Randy Caliliw, Cristobal Torres, Anthony Smithson, Dalit Strauss-Ayali, Yael Agmon-Gerstein, Nadav Malchi, Jonathan Said, Steven S Raman, Stuart Holden, Allan Pantuck, Arie S Belldegrun, Karim Chamie
OBJECTIVE: To evaluate the safety and feasibility of single and serial instillations of MitoGel™ into the upper urinary tract using a preclinical swine animal model. MitoGel™ is a novel sustained release formulation of MMC based on RTGel™, a proprietary thermosensitive hydrogel technology. MitoGel™ is liquid at cold temperatures and solidifies to gel state at body temperature. It is intended as a treatment for UTUC given its ability to provide sustained release of MMC in the upper urinary tract...
October 5, 2016: Urology
Gianluca Villa, Mauro Neri, Rinaldo Bellomo, Jorge Cerda, A Raffaele De Gaudio, Silvia De Rosa, Francesco Garzotto, Patrick M Honore, John Kellum, Anna Lorenzin, Didier Payen, Zaccaria Ricci, Sara Samoni, Jean-Louis Vincent, Julia Wendon, Marta Zaccaria, Claudio Ronco
This article reports the conclusions of the second part of a consensus expert conference on the nomenclature of renal replacement therapy (RRT) techniques currently utilized to manage acute kidney injury and other organ dysfunction syndromes in critically ill patients. A multidisciplinary approach was taken to achieve harmonization of definitions, components, techniques, and operations of the extracorporeal therapies. The article describes the RRT techniques in detail with the relevant technology, procedures, and phases of treatment and key aspects of volume management/fluid balance in critically ill patients...
October 10, 2016: Critical Care: the Official Journal of the Critical Care Forum
Bandarn Suetrong, Chawika Pisitsak, John H Boyd, James A Russell, Keith R Walley
BACKGROUND: Acute kidney injury and hyperchloremia are commonly present in critically ill septic patients. Our study goal was to evaluate the association of hyperchloremia and acute kidney injury in severe sepsis and septic shock patients. METHODS: In this retrospective cohort study in a provincial tertiary care hospital, adult patients with severe sepsis or septic shock and serum chloride measurements were included. Serum chloride was measured on a daily basis for 48 hours...
October 6, 2016: Critical Care: the Official Journal of the Critical Care Forum
Nara Aline Costa, Ana Lúcia Gut, Paula Schmidt Azevedo, Suzana Erico Tanni, Natália Baraldi Cunha, Eloá Siqueira Magalhães, Graziela Biude Silva, Bertha Furlan Polegato, Leonardo Antonio Mamede Zornoff, Sergio Alberto Rupp de Paiva, André Luís Balbi, Daniela Ponce, Marcos Ferreira Minicucci
BACKGROUND: Oxidative stress is a key feature of sepsis and could be a common pathophysiological pathway between septic shock and acute kidney injury (AKI) Our objective was to evaluate the erythrocyte superoxide dismutase (SOD1) activity as predictor of AKI in patients with septic shock. METHODS: This is a prospective observational study that evaluated 175 consecutive patients over the age of 18 years with septic shock upon intensive care unit (ICU) admission...
December 2016: Annals of Intensive Care
Tracey Ying, Samantha Chan, Stephen Lane, Christine Somerville
AIM: To identify risk factors for acute kidney injury following major orthopaedic surgery. METHODS: We included all patients undergoing major orthopaedic surgery at University Hospital Geelong between 2008 and 2014 in the study. Out of 2188 surgeries audited, we identified cases of acute kidney injury using the RIFLE criteria and matched those to controls 2:1 for age, sex, procedure and chronic kidney disease stage. We reviewed their records for risk factors of postoperative acute kidney injury, including medications such as gentamicin, diuretics, non-steroidal anti-inflammatory drugs and angiotensin-converting enzyme inhibitor or angiotensin receptor blocker use...
October 5, 2016: Nephrology
Lukas Martin, Patrick Koczera, Elisabeth Zechendorf, Tobias Schuerholz
Sepsis is defined as a life-threatening organ dysfunction caused by a dysregulated host response to infection. The endothelial glycocalyx is one of the earliest sites involved during sepsis. This fragile layer is a complex network of cell-bound proteoglycans, glycosaminoglycan side chains, and sialoproteins lining the luminal side of endothelial cells with a thickness of about 1 to 3 μm. Sepsis-associated alterations of its structure affect endothelial permeability and result in the liberation of endogenous damage-associated molecular patterns (DAMPs)...
2016: BioMed Research International
Ben Oliveira, Sangita Chaterjee, Aine Burns
We describe the case of an 85-year-old woman who developed acute confusion, acute kidney injury and temperature spikes while on extended courses of beta-lactams for osteomyelitis. The cause of her deterioration was felt to be due to sepsis when in fact it was as a result of toxicity from antibiotics. This was demonstrated by a rapid resolution in her condition following haemodialysis. We also performed a literature review to appraise the neuro and nephrotoxicity of various antibiotics and how best to manage toxicity when it occurs...
October 2016: Clinical Medicine: Journal of the Royal College of Physicians of London
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