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Sepsis nephrology

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
Heng-Chih Pan, Pei-Chen Wu, Vin-Cent Wu, Ya-Fei Yang, Tao-Min Huang, Chih-Chung Shiao, Te-Chuan Chen, Der-Cherng Tarng, Jui-Hsiang Lin, Wei-Shun Yang, Chiao-Yin Sun, Chan-Yu Lin, Tzong-Shinn Chu, Mai-Szu Wu, Kwan-Dun Wu, Yung-Chang Chen, Chiu-Ching Huang
Acute kidney injury (AKI) is a common complication in hospitalized patients. The International Society of Nephrology implemented the "0 by 25" initiative aimed at preventing deaths from treatable AKI worldwide by 2025 and conducted a global snapshot survey in 2014. We joined in the project and conducted this study to compare the epidemiology, risk factors, and prognosis between patients with pure AKI and those with acute-on-chronic kidney disease (ACKD). In this study, we prospectively collected demographic parameters and data on clinical characteristics, baseline comorbidities, management, and outcomes of 201 AKI patients in 18 hospitals in Taiwan from September 2014 to November 2014...
September 2016: Medicine (Baltimore)
Omer Atis, Mustafa Keles, Erdem Cankaya, Hasan Dogan, Hulya Aksoy, Fatih Akcay
CONTEXT: Endocan is a marker showing endothelial dysfunction and inflammation. Significantly increased endocan levels have been observed in serum of patients with sepsis and cancer. OBJECTIVE: Our aim was to investigate the relationship between vitamin D treatment and serum endocan and high-sensitivity C-reactive protein (hs-CRP) levels as inflammatory markers in transplant patients. DESIGN: Prospective. SETTING: Nephrology clinic...
August 23, 2016: Progress in Transplantation
John Feehally
The International Society of Nephrology's (ISN) 0by25 initiative aims to prevent avoidable deaths from acute kidney injury (AKI) by 2025, most of which occur in low and lower middle-income countries (LLMICs). To increase evidence about the epidemiology of AKI, especially in LLMICs, ISN conducted a 'Global Snapshot', a multinational, cross-sectional study in which 322 physicians from 72 countries in 6 continents identified 3,664 adults and 354 children with AKI who were under their care of which 45% were from LLMICs, nevertheless low-income countries were under-represented...
2016: Annals of Nutrition & Metabolism
Nagaraju Sarabu, Mahboob Rahman
Acute kidney injury (AKI) refers to any acute decrease in glomerular filtration rate, regardless of etiology. Staging of AKI has been recommended to stratify AKI patients according to severity of the condition, based on serum creatinine level and urine output. Classification of AKI into prerenal, intrinsic renal, and postrenal etiologies is helpful in differential diagnosis and management. AKI in hospitalized patients typically occurs due to decreased renal perfusion. Drug-induced, contrast-associated, postoperative, and sepsis-associated AKI also can occur...
May 2016: FP Essentials
Chris Lata, Louis Girard, Michael Parkins, Matthew T James
PURPOSE OF THE REVIEW: Patients with end-stage renal disease (ESRD) are at a high risk of bacterial infection. We reviewed publications on risk factors, prevention, and treatment paradigms, as well as outcomes associated with bacterial infection in end-stage kidney disease. We focused in particular on studies conducted in Canada where rates of haemodialysis catheter use are high. SOURCES OF INFORMATION: We included original research articles in English text identified from MEDLINE using search terms 'chronic kidney failure', 'renal dialysis', or 'chronic renal insufficiency', and 'bacterial infection'...
2016: Canadian Journal of Kidney Health and Disease
Harshad G Gurnaney, John E Fiadjoe, L Scott Levin, Benjamin Chang, Heather Delvalle, Jorge Gálvez, Mohamed A Rehman
PURPOSE: The purpose of this case report is to describe the anesthetic and case management of the first vascularized composite allograft pediatric bilateral hand transplant. CLINICAL DETAILS: Our patient was an eight-year-old male with a medical history of Staphylococcus aureus sepsis at one year of age that resulted in end-stage renal disease as well as bilateral upper and lower extremity amputations. After referral for bilateral hand transplantation, the transplantation team, with expertise in all aspects of perioperative care (surgery, anesthesiology, nephrology, renal transplantation, pediatric intensive care, and therapeutic pharmacy), was consulted to help develop anesthetic and other perioperative protocols for surgery...
June 2016: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
Zaccaria Ricci, Stefano Romagnoli, Claudio Ronco
During the last few years, due to medical and surgical evolution, patients with increasingly severe diseases causing multiorgan dysfunction are frequently admitted to intensive care units. Therapeutic options, when organ failure occurs, are frequently nonspecific and mostly directed towards supporting vital function. In these scenarios, the kidneys are almost always involved and, therefore, renal replacement therapies have become a common routine practice in critically ill patients with acute kidney injury...
2016: F1000Research
Adanze O Asinobi, Adebowale D Ademola, Michael A Alao
BACKGROUND: Acute kidney injury (AKI) is an important cause of preventable mortality among children. Management of AKI may require renal replacement therapy (RRT) but access to RRT for children in low resource settings is limited. Our study explored the role of haemodialysis in the management of children with AKI in a low resource setting in terms of aetiology and outcomes. METHODS: A review of patients managed in the Paediatric Nephrology Unit, University College Hospital Ibadan, South-West Nigeria, who underwent haemodialysis for AKI from January 2006 to December 2014...
February 2016: Clinical Kidney Journal
Sudheer Kumar Reddy, Afsana Jahan, Swasti Chaturvedi, Indira Agarwal
BACKGROUND: Outcome data in paediatrics regarding the use of plasmapheresis for immunological kidney disease are scarce. OBJECTIVES: We aimed to evaluate the role of plasmapheresis in children presenting with severe renal impairment secondary to immunological kidney diseases. METHODS: A retrospective chart review of children admitted between January 2009 and August 2013 to the Paediatric Nephrology Unit, Christian Medical College, Vellore, India, and requiring plasma exchange was undertaken...
December 2015: Clinical Kidney Journal
R Hemachandar
BACKGROUND: Vascular access is the key in successful management of chronic haemodialysis (HD) patients. Though native arteriovenous fistula (AVF) is considered the access of choice, many patients in our country initiate haemodialysis through central venous catheter (CVC). There is paucity of data on vascular access in haemodialysis patients from southern India. AIM: Aim of the present study was to review our experience of vascular access in Haemodialysis patients (both central venous catheters and arteriovenous fistula) and to assess its success rate and common complications...
October 2015: Journal of Clinical and Diagnostic Research: JCDR
Francois Folefack Kaze, Forbin Elias Ekokobe, Marie Patrice Halle, Hermine Fouda, Alain Patrick Menanga, Gloria Ashuntantang
INTRODUCTION: Kidney diseases are a growing worldwide problem and one of the major public health threats. We analyzed the spectrum of kidney diseases seen over a five-year period in the nephrology in-patient unit of the Yaounde general hospital. METHODS: This was a retrospective analysis of 225 medical records of patients admitted from January 2005 to December 2009 in the unit with a discharge diagnosis of kidney and urinary tract diseases. The first hospitalization was considered for patients admitted several times for the same disease...
2015: Pan African Medical Journal
Yongfang Qin, Qian Xu, Tingwei Xu, Hai Yuan, Fengqi Hu
OBJECTIVE: To analyze clinical characteristics and prognostic factors of patients with malignancies combined with acute kidney injury (AKI), providing a basis for clinical AKI prevention and prognosis improvement. METHOD: Hospitalized patients in the Central Hospital of Nephrology from January 2008 to December 2013 were screened by electronic medical record system; Statistical analysis formalignant tumor patients associated with AKI was conducted. The clinical features of these patients in 6 years were analyzed and compared, and Logistic regression analysis was used to analyze the risk factors of hospitalized mortality in patients with and malignant tumor and AKI...
2015: International Journal of Clinical and Experimental Medicine
Fariz Safhan Mohd Nor, Che Rosle Draman, Mohd Ramli Seman, Norasmiza Abd Manaf, Azril Shahreez Abd Ghani, Khairul Anuar Hassan
Acute kidney injury (AKI) is a common diagnosis among critically ill patients. Although the etiology of AKI will determine the appropriate initial management, the definitive management of established AKI is still debatable. This is a retrospective, observational, single-center analysis of a cohort of patients referred to the nephrology unit for AKI from 1st August 2010 to 31st January 2011. Those patients with indications for dialysis were treated with continuous renal replacement therapy, intermittent hemodialysis or stiff-catheter peritoneal dialysis as determined by their hemodynamic status and the technical availability of the method...
July 2015: Saudi Journal of Kidney Diseases and Transplantation
Aida Hamzic-Mehmedbasic, Damir Rebic, Merima Balavac, Alma Muslimovic, Jasminka Dzemidzic
INTRODUCTION: Acute kidney injury is characterized by a rapid loss of renal excretory function with the increase of nitrogen compounds in the blood and with different outcome. OBJECTIVE: Since descriptions of the risk factors and sequelae of acute kidney injury (AKI) remain relatively limited, the objective of this study was to determine etiology and clinical characteristics of AKI, as well as risk factors for adverse outcome of renal function and death in AKI patients...
April 2015: Materia Socio-medica
Aida Hamzic-Mehmedbasic, Senija Rasic, Damir Rebic, Azra Durak-Nalbantic, Alma Muslimovic, Jasminka Dzemidzic
AIM: The objective of this study was to evaluate prognostic impact of clinical factors on outcome of renal function in septic and non-septic acute kidney injury (AKI) patients. METHODS: The prospective, observational, clinical study was performed at Nephrology Clinic and Clinic for Infectious Diseases, University Clinical Centre Sarajevo. One hundred patients with diagnosis of AKI were enrolled in the study, and divided into two groups: septic and non-septic AKI patients...
April 2015: Medical Archives
Farah Gul Khan, Ejaz Ahmed
OBJECTIVE: To study the causes and outcome of Acute renal failure (ARF) in diabetes mellitus. METHODS: This prospective study was conducted at nephrology unit of SIUT Karachi, Pakistan from November 2012 to May 2013. All adult patients with known underlying diabetes presenting with suspected ARF were included in the study. The treatment options were conservative and dialysis. Renal biopsy was performed in selected patients. All patients were followed for a period of six weeks for outcome of renal failure i...
February 2015: JPMA. the Journal of the Pakistan Medical Association
Lorien S Dalrymple, Yi Mu, Patrick S Romano, Danh V Nguyen, Glenn M Chertow, Cynthia Delgado, Barbara Grimes, George A Kaysen, Kirsten L Johansen
BACKGROUND: Infection is a common cause of hospitalization in adults receiving hemodialysis. Limited data are available about downstream events resulting from or following these hospitalizations. STUDY DESIGN: Retrospective cohort study using the US Renal Data System. SETTING & PARTICIPANTS: Medicare beneficiaries initiating in-center hemodialysis therapy in 2005 to 2008. FACTORS: Demographics, dual Medicare/Medicaid eligibility, body mass index, comorbid conditions, initial vascular access type, nephrology care prior to dialysis therapy initiation, residence in a care facility, tobacco use, biochemical measures, and type of infection...
May 2015: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Sergio Pinto de Souza, Rodrigo Santos Matos, Luisa Leite Barros, Paulo Novis Rocha
INTRODUCTION: Sepsis is a leading precipitant of Acute Kidney Injury (AKI) in intensive care unit (ICU) patients, and is associated with a high mortality rate. OBJECTIVE: We aimed to evaluate the risk factors for dialysis and mortality in a cohort of AKI patients of predominantly septic etiology. METHODS: Adult patients from an ICU for whom nephrology consultation was requested were included. End-stage chronic renal failure and kidney transplant patients were excluded...
October 2014: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
Tarig Mohammed Abkur, Waleed Mohammed, Mohamed Ali, Liam Casserly
INTRODUCTION: 5-oxoproline (pyroglutamic acid), an organic acid intermediate of the gamma-glutamyl cycle, is a rare cause of high anion gap metabolic acidosis. Acetaminophen and several other drugs have been implicated in the development of transient 5-oxoprolinemia in adults. We believe that reporting all cases of 5-oxoprolinemia will contribute to a better understanding of this disease. Here, we report the case of a patient who developed transient 5-oxoprolinemia following therapeutic acetaminophen use...
2014: Journal of Medical Case Reports
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