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Acute kidney injury and sepsis

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https://www.readbyqxmd.com/read/28099643/balanced-crystalloids-for-septic-shock-resuscitation
#1
Thiago Domingos Corrêa, Alexandre Biasi Cavalcanti, Murillo Santucci Cesar de Assunção
Timely fluid administration is crucial to maintain tissue perfusion in septic shock patients. However, the question concerning which fluid should be used for septic shock resuscitation remains a matter of debate. A growing body of evidence suggests that the type, amount and timing of fluid administration during the course of sepsis may affect patient outcomes. Crystalloids have been recommended as the first-line fluids for septic shock resuscitation. Nevertheless, given the inconclusive nature of the available literature, no definitive recommendations about the most appropriate crystalloid solution can be made...
October 2016: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/28099637/factors-associated-with-maternal-death-in-an-intensive-care-unit
#2
Suzanne Vieira Saintrain, Juliana Gomes Ramalho de Oliveira, Maria Vieira de Lima Saintrain, Zenilda Vieira Bruno, Juliana Lima Nogueira Borges, Elizabeth De Francesco Daher, Geraldo Bezerra da Silva
Objective: To identify factors associated with maternal death in patients admitted to an intensive care unit. Methods: A cross-sectional study was conducted in a maternal intensive care unit. All medical records of patients admitted from January 2012 to December 2014 were reviewed. Pregnant and puerperal women were included; those with diagnoses of hydatidiform mole, ectopic pregnancy, or anembryonic pregnancy were excluded, as were patients admitted for non-obstetrical reasons...
October 2016: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/28097012/pharmacokinetics-and-pharmacodynamics-of-antibiotics-in-critically-ill-acute-kidney-injury-patients
#3
REVIEW
Welder Zamoner, Fernanda M de Freitas, Durval S S Garms, Mariele Gobo de Oliveira, André L Balbi, Daniela Ponce
Sepsis is the most common cause of death in critically ill patients and is associated with multiorgan failure, including acute kidney injury (AKI). This situation can require acute renal support and increase mortality. Therefore, it is essential to administer antimicrobials in doses that achieve adequate serum levels, avoiding both overdosing and drug toxicity as well as underdosing and the risk of antibiotic resistance and higher mortality. Currently, there are no validated guidelines on antibiotic dose adjustments in septic patients with AKI...
December 2016: Pharmacology Research & Perspectives
https://www.readbyqxmd.com/read/28091436/acute-kidney-injury-in-lagos-pattern-outcomes-and-predictors-of-in-hospital-mortality
#4
B T Bello, A A Busari, C O Amira, Y R Raji, R W Braimoh
CONTEXT: The pattern of acute kidney injury (AKI) differs significantly between developed and developing countries. AIMS: The aim of th study was to determine the pattern and clinical outcomes of AKI in Lagos, Southwest Nigeria. SETTINGS AND DESIGN: A retrospective review of hospital records of all patients with a diagnosis of AKI over a 20-month period. SUBJECTS AND METHODS: Records of 54 patients were reviewed. Information retrieved included, bio-data, etiology of AKI, results of laboratory investigations, and patient outcomes...
February 2017: Nigerian Journal of Clinical Practice
https://www.readbyqxmd.com/read/28090081/metabolic-reprogramming-and-tolerance-during-sepsis-induced-aki
#5
REVIEW
Hernando Gómez, John A Kellum, Claudio Ronco
The host defence against infection is an adaptive response in which several mechanisms are deployed to decrease the pathogen load, limit tissue injury and restore homeostasis. In the past few years new evidence has suggested that the ability of the immune system to limit the microbial burden - termed resistance - might not be the only defence mechanism. In fact, the capacity of the host to decrease its own susceptibility to inflammation- induced tissue damage - termed tolerance - might be as important as resistance in determining the outcome of the infection...
January 16, 2017: Nature Reviews. Nephrology
https://www.readbyqxmd.com/read/28089174/neonatal-acute-kidney-injury-severity-and-recovery-prediction-and-the-role-of-serum-and-urinary-biomarkers
#6
Deirdre U Sweetman
Neonatal acute kidney injury is common, in part due to incomplete renal maturation and also due to frequent exposure to risk factors for acute kidney injury such as perinatal asphyxia, extracorporeal-membrane-oxygenation, cardiac surgery, sepsis, prematurity and nephrotoxicity. However the current method by which acute kidney injury is diagnosed is sub-optimal and not universally accepted which impairs the accurate estimation of the true incidence of neonatal acute kidney injury. Serum Cystatin-C, urinary NGAL, KIM-1 and IL-18 are promising neonatal acute kidney injury biomarkers however the diagnosis of acute kidney injury remains serum creatinine/urine output-based in many studies...
January 11, 2017: Early Human Development
https://www.readbyqxmd.com/read/28088183/incidence-aetiology-and-outcome-of-community-acquired-acute-kidney-injury-in-medical-admissions-in-malawi
#7
Rhys D R Evans, Ulla Hemmilä, Alison Craik, Mwayi Mtekateka, Fergus Hamilton, Zuze Kawale, Christopher J Kirwan, Hamish Dobbie, Gavin Dreyer
BACKGROUND: Epidemiological data on Acute Kidney Injury (AKI) from low-income countries is sparse. The aim of this study was to establish the incidence, severity, aetiology, and outcomes of community-acquired AKI in Malawi. METHODS: We conducted a prospective observational study of general medical admissions to a tertiary hospital in Blantyre between 27(th) April and 17(th) July 2015. All patients were screened on admission with a serum creatinine; those with creatinine above laboratory reference range were managed by the nephrology team...
January 14, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28063928/mir-107-induces-tnf-%C3%AE-secretion-in-endothelial-cells-causing-tubular-cell-injury-in-patients-with-septic-acute-kidney-injury
#8
Shanshan Wang, Zengdi Zhang, Jun Wang, Hongjun Miao
Activation of endothelial cells plays a key role in septic acute kidney injury (AKI). This study investigated the role of miRNA in endothelial-induced tubular cell injury in sepsis. Circulating endothelial cells (CECs) from septic AKI, non-septic AKI, septic non-AKI patients and healthy volunteers were isolated and cultured, and HK2 cells were exposed to CEC-conditioned medium. CEC-conditioned medium prepared from septic AKI patients led to cell shrinkage, decreased E-cadherin, the release of NAG and cell apoptosis in HK2 cells...
January 4, 2017: Biochemical and Biophysical Research Communications
https://www.readbyqxmd.com/read/28063688/crystalloid-fluid-choice-and-clinical-outcomes-in-pediatric-sepsis-a-matched-retrospective-cohort-study
#9
Scott L Weiss, Luke Keele, Fran Balamuth, Neika Vendetti, Rachael Ross, Julie C Fitzgerald, Jeffrey S Gerber
OBJECTIVE: To test the hypothesis that resuscitation with balanced fluids (lactated Ringer [LR]) is associated with improved outcomes compared with normal saline (NS) in pediatric sepsis. STUDY DESIGN: We performed matched analyses using data from 12 529 patients <18 years of age with severe sepsis/septic shock at 382 US hospitals between 2000 and 2013 to compare outcomes with vs without LR as part of initial resuscitation. Patients receiving LR were matched 1:1 to patients receiving only NS (NS group), including separate matches for any (LR-any group) or exclusive (LR-only group) LR use...
January 4, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28061889/urinary-exosomal-activating-transcriptional-factor-3-as-the-early-diagnostic-biomarker-for-sepsis-induced-acute-kidney-injury
#10
Tanaporn Panich, Wiwat Chancharoenthana, Poorichaya Somparn, Jiraphorn Issara-Amphorn, Nattiya Hirankarn, Asada Leelahavanichkul
BACKGROUND: An early sepsis-induced acute kidney injury (sepsis-AKI) biomarker is currently in needed. Urinary neutrophil gelatinase-associated lipocalin (uNGAL) is a candidate of sepsis-AKI biomarker but with different cut-point values. Urinary exosomal activating transcriptional factor 3 (uATF3) has been mentioned as an interesting biomarker. METHODS: We conducted experiments in mice and a prospective, multicenter study in patients as a proof of concept that urine exosome is an interesting biomarker...
January 7, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28056039/prediction-models-and-their-external-validation-studies-for-mortality-of-patients-with-acute-kidney-injury-a-systematic-review
#11
Tetsu Ohnuma, Shigehiko Uchino
OBJECTIVES: To systematically review AKI outcome prediction models and their external validation studies, to describe the discrepancy of reported accuracy between the results of internal and external validations, and to identify variables frequently included in the prediction models. METHODS: We searched the MEDLINE and Web of Science electronic databases (until January 2016). Studies were eligible if they derived a model to predict mortality of AKI patients or externally validated at least one of the prediction models, and presented area under the receiver-operator characteristic curves (AUROC) to assess model discrimination...
2017: PloS One
https://www.readbyqxmd.com/read/28052874/inhibition-of-hdac6-protects-against-rhabdomyolysis-induced-acute-kidney-injury
#12
Shi Yingfeng, Xu Liuqing, Tang Jinhua, Fang Lu, Ma Shuchen, Ma Xiaoyan, Nie Jing, Pi Xiaoling, Qiu Andong, Zhuang Shougang, Liu Na
Histone deacetylase 6 (HDAC6) inhibition has been reported to protect against ischemic stroke and prolong survival after sepsis in animal models. However, it remains unknown whether HDAC6 inhibition offers a renoprotective effect after acute kidney injury (AKI). In this study, we examined the therapeutic effect of tubastatin A (TA), a highly selective inhibitor of HDAC6, on AKI in a murine model of glycerol (GL) injection-induced rhabdomyolysis. Following GL injection, the mice developed severe acute tubular injury as indicated by renal dysfunction, expression of neutrophil gelatinase-associated lipocalin (NGAL), an injury marker of renal tubules and increase of TUNEL positive tubular cells...
January 4, 2017: American Journal of Physiology. Renal Physiology
https://www.readbyqxmd.com/read/28050898/impact-of-transfusion-on-patients-with-sepsis-admitted-in-intensive-care-unit-a-systematic-review-and-meta-analysis
#13
REVIEW
Claire Dupuis, Romain Sonneville, Christophe Adrie, Antoine Gros, Michael Darmon, Lila Bouadma, Jean-François Timsit
Red blood cell transfusion (RBCT) threshold in patients with sepsis remains a matter of controversy. A threshold of 7 g/dL for stabilized patients with sepsis is commonly proposed, although debated. The aim of the study was to compare the benefit and harm of restrictive versus liberal RBCT strategies in order to guide physicians on RBCT strategies in patients with severe sepsis or septic shock. Four outcomes were assessed: death, nosocomial infection (NI), acute lung injury (ALI) and acute kidney injury (AKI)...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28045915/alkalosis-in-critically-ill-patients-with-severe-sepsis-and-septic-shock
#14
Simon Kreü, Allan Jazrawi, Jan Miller, Amir Baigi, Michelle Chew
INTRODUCTION: Although metabolic alkalosis is a common occurrence in intensive care units (ICUs), no study has evaluated its prevalence or outcomes in patients with severe sepsis or septic shock. METHODS: This is a retrospective cohort study of critically ill patients suffering from severe sepsis and septic shock admitted to the ICUs of Halmstad and Varberg County hospitals. From 910 patient records, 627 patients met the inclusion criteria. We investigated the relationship between metabolic alkalosis and mortality...
2017: PloS One
https://www.readbyqxmd.com/read/28029146/protective-effects-of-luteolin-on-lipopolysaccharide-induced-acute-renal-injury-in-mice
#15
Shao-Bin Xin, Hao Yan, Jing Ma, Qiang Sun, Li Shen
BACKGROUND Sepsis can cause serious acute kidney injury in bacterium-infected patients, especially in intensive care patients. Luteolin, a bioactive flavonoid, has renal protection and anti-inflammatory effects. This study aimed to investigate the effect and underlying mechanism of luteolin in attenuating lipopolysaccharide (LPS)-induced renal injury. MATERIAL AND METHODS ICR mice were treated with LPS (25 mg/kg) with or without luteolin pre-treatment (40 mg/kg for three days). The renal function, histological changes, degree of oxidative stress, and tubular apoptosis in these mice were examined...
December 28, 2016: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28013574/predictive-value-of-serum-albumin-level-for-the-prognosis-of-severe-sepsis-without-exogenous-human-albumin-administration
#16
Mei Yin, Lei Si, Weidong Qin, Chen Li, Jianning Zhang, Hongna Yang, Hui Han, Fan Zhang, Shifang Ding, Min Zhou, Dawei Wu, Xiaomei Chen, Hao Wang
BACKGROUND: The prognostic significance of serum albumin levels in patients with sepsis has previously been reported; however, these studies have not excluded the potential confounding effect of exogenous albumin administration. In this study, we investigate the predictive value of serum albumin for the prognosis of severe sepsis without the interference of exogenous albumin administration. METHODS: A prospective cohort study was conducted from April to November 2014 in the internal and surgical intensive care units of a tertiary care hospital...
January 1, 2016: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28013315/baicalin-inhibits-renal-cell-apoptosis-and-protects-against-acute-kidney-injury-in-pediatric-sepsis
#17
Yanping Zhu, Yanxia Fu, Hairong Lin
BACKGROUND Pediatric sepsis has high morbidity in children, may lead to acute kidney injury (AKI), and further aggravate the disease. Baicalin is a kind of flavonoid in Scutellaria baicalensis Georgi and has been reported to protect against several diseases, but its roles in septic AKI remain unclear. This study aimed to uncover the effects of baicalin in AKI during pediatric sepsis. MATERIAL AND METHODS Blood urea nitrogen (BUN) and serum creatinine (Cr) levels were detected in 50 pediatric patients, who underwent basic therapy with or without baicalin adjunctive therapy...
December 25, 2016: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28012971/effects-of-a-human-recombinant-alkaline-phosphatase-during-impaired-mitochondrial-function-in-human-renal-proximal-tubule-epithelial-cells
#18
Esther Peters, Tom Schirris, Alexander H van Asbeck, Jelle Gerretsen, Jennifer Eymael, Angel Ashikov, Merel J W Adjobo-Hermans, Frans Russel, Peter Pickkers, Rosalinde Masereeuw
Sepsis-associated acute kidney injury is a multifactorial syndrome in which inflammation and renal microcirculatory dysfunction play a profound role. Subsequently, renal tubule mitochondria reprioritize cellular functions to prevent further damage. Here, we investigated the putative protective effects of human recombinant alkaline phosphatase (recAP) during inhibition of mitochondrial respiration in conditionally immortalized human proximal tubule epithelial cells (ciPTEC). Full inhibition of mitochondrial oxygen consumption was obtained after 24h antimycin A treatment, which did not affect cell viability...
December 22, 2016: European Journal of Pharmacology
https://www.readbyqxmd.com/read/28006779/cardiorenal-syndrome-type-5-in-sepsis-role-of-endotoxin-in-cell-death-pathways-and-inflammation
#19
Grazia Maria Virzì, Anna Clementi, Alessandra Brocca, Massimo de Cal, Stefano Marcante, Claudio Ronco
BACKGROUND/AIMS: Cardiorenal Syndrome Type 5 (CRS Type 5) is characterized by concomitant cardiac and renal dysfunction in the setting of different systemic disorders, such as sepsis. In this study, we investigated the possible relationship between endotoxin levels, renal cell death and inflammation in septic patients with CRS Type 5. METHODS: We enrolled 11 patients with CRS Type 5. CRS Type 5 was defined according to the current classification system. AKI was defined by Acute Kidney Injury Network (AKIN) criteria...
2016: Kidney & Blood Pressure Research
https://www.readbyqxmd.com/read/28003866/sirt1-3-activation-by-resveratrol-attenuates-acute-kidney-injury-in-a-septic-rat-model
#20
Siqi Xu, Youguang Gao, Qin Zhang, Siwei Wei, Zhongqing Chen, Xingui Dai, Zhenhua Zeng, Ke-Seng Zhao
Sepsis often results in damage to multiple organ systems, possibly due to severe mitochondrial dysfunction. Two members of the sirtuin family, SIRT1 and SIRT3, have been implicated in the reversal of mitochondrial damage. The aim of this study was to determine the role of SIRT1/3 in acute kidney injury (AKI) following sepsis in a septic rat model. After drug pretreatment and cecal ligation and puncture (CLP) model reproduction in the rats, we performed survival time evaluation and kidney tissue extraction and renal tubular epithelial cell (RTEC) isolation...
2016: Oxidative Medicine and Cellular Longevity
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