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CKD sepsis

Yu Zhang, Li Jiang, Baomin Wang, Xiuming Xi
BACKGROUND: Although there were studies to investigate the risk factors for acute kidney injury (AKI) after surgery, most of them focused on one specific type of surgeries. The risk factors for postoperative AKI in patients undergoing all surgeries in intensive care units (ICU) have not been reported. METHODS: Data from 1731 patients undergoing surgery in 30 ICUs of 28 tertiary hospitals in Beijing from March to August 2012 were prospectively collected. AKI was defined and staged by the KDIGO criteria...
February 26, 2018: International Urology and Nephrology
Jordi Bover, Pablo Ureña, Armando Aguilar, Sandro Mazzaferro, Silvia Benito, Víctor López-Báez, Alejandra Ramos, Iara daSilva, Mario Cozzolino
Alkaline phosphatases (APs) remove the phosphate (dephosphorylation) needed in multiple metabolic processes (from many molecules such as proteins, nucleotides, or pyrophosphate). Therefore, APs are important for bone mineralization but paradoxically they can also be deleterious for other processes, such as vascular calcification and the increasingly known cross-talk between bone and vessels. A proper balance between beneficial and harmful activities is further complicated in the context of chronic kidney disease (CKD)...
February 14, 2018: Calcified Tissue International
Stefan Büttner, Andrea Stadler, Christoph Mayer, Sammy Patyna, Christoph Betz, Christian Senft, Helmut Geiger, Oliver Jung, Fabian Finkelmeier
PURPOSE: Acute kidney injury (AKI) is a severe complication in medical and surgical intensive care units accounting for a high morbidity and mortality. Incidence, risk factors, and prognostic impact of this deleterious condition are well established in this setting. Data concerning the neurocritically ill patients is scarce. Therefore, aim of this study was to determine the incidence of AKI and elucidate risk factors in this special population. METHODS: Patients admitted to a specialized neurocritical care unit between 2005 and 2011 with a length of stay above 48 hours were analyzed retrospectively for incidence, cause, and outcome of AKI (AKI Network-stage ≥2)...
January 1, 2018: Journal of Intensive Care Medicine
Michael Hultström, Mediha Becirovic-Agic, Sofia Jönsson
Acute kidney injury (AKI) is a syndrome of reduced glomerular filtration rate and urine production caused by a number of different diseases. It is associated with renal tissue damage. This tissue damage can cause tubular atrophy and interstitial fibrosis that leads to nephron loss and progression of chronic kidney disease (CKD). This review describes the in-common mechanisms behind tissue damage in AKI caused by different underlying diseases. Comparing six high-quality microarray studies of renal gene expression after AKI in disease models (gram-negative sepsis, gram-positive sepsis, ischemia-reperfusion, malignant hypertension, rhabdomyolysis, and cisplatin toxicity) identified 5,254 differentially expressed genes in at least one of the AKI models; 66% of genes were found only in one model, showing that there are unique features to AKI depending on the underlying disease...
March 1, 2018: Physiological Genomics
Jai Prakash, Vivek C Ganiger, Suraj Prakash, Mohammad Iqbal, Deba Prasad Kar, Usha Singh, Ashish Verma
INTRODUCTION: There are numerous reports in the literature describing acute kidney injury in pregnancy (P-AKI) due to various obstetric complications. However, there is a dearth of studies on AKI related to pregnancy-specific disorders from India. We aimed to analyze clinical features and outcome of P-AKI related to pregnancy-specific disorders compared to total pregnancy, in India. METHOD: All pregnant women attending the department of Obstetrics and Gynecology from November 2014 to July 2016 were screened for AKI based on: (1) sudden elevation of serum creatinine ≥ 1 mg/dl; (2) oligoanuria for > 12 h; and (3) need for dialysis...
January 4, 2018: Journal of Nephrology
Faisal M Sanai, Abdullah S Alghamdi, Ahmad A Afghani, Khalid Alswat, Adnan AlZanbagi, Mosfer N Alghamdi, Abdallah AlMousa, Mohammed Aseeri, Abdullah M Assiri, Mohamed A Babatin
Limited data has shown high efficacy of co-formulated ombitasvir/paritaprevir/ritonavir (OBV/PTV/r) in the treatment of hepatitis C virus (HCV) genotype (GT)-4, and combined with dasabuvir (DSV) in GT1 patients, with chronic kidney disease (CKD) stage 4-5 (<30 mL/min/1.73 m2 ). We assessed real-world safety and efficacy of OBV/PTV/r ± DSV in GT1 and 4-infected patients. METHODS: In this observational cohort (n=67), we enrolled stage 4-5 CKD treatment-naïve or Peginterferon/RBV-experienced GT4-infected patients (n=32) treated for 12-24 weeks with OBV/PTV/r ± RBV, and plus DSV in GT1 patients (n=35, including 3 with GT1/4 co-infection)...
December 29, 2017: Liver International: Official Journal of the International Association for the Study of the Liver
Marie Patrice E Halle, Ndjifoum Moselle Chipekam, Gérard Beyiha, Hermine Fouda, Aminata Coulibaly, Romuald Hentchoya, Folefack Francois Kaze, Namme Henry Luma, Gloria Ashuntantang
OBJECTIVE: There are limited data on AKI in sub-Saharan Africa. We aim to determine the incidence, characteristics and prognosis of AKI in Cameroon. PATIENTS AND METHODS: A prospective study including all consenting acute admissions in the internal medicine and the ICU of a tertiary referral hospital in Cameroon from January 2015 to June 2016. Serum creatinine assay was done on admission, days 2 and 7 to diagnose AKI. For patients with AKI, serum creatinine was done on discharge, days 30, 60 and 90...
November 2018: Renal Failure
Melissa A Frick, Arpit M Chhabra, Liyong Lin, Charles B Simone Ii
Limited therapeutic options exist for inoperable bilateral kidney tumors. We report the first ever use of proton therapy to treat primary renal cell carcinoma (RCC) and the first report of proton stereotactic body radiation therapy (SBRT) for RCC in an inoperable patient with synchronous RCCs treated with proton SBRT. The patient is a 47-year-old 450-pound female with multiple medical comorbidities, including Stage 3 chronic kidney disease (CKD), who was found to have bilateral renal masses during work-up for cellulitis and sepsis...
October 24, 2017: Curēus
Chih-Hung Chen, Ben-Chung Cheng, Kuan-Hung Chen, Pei-Lin Shao, Pei-Hsun Sung, Hsin-Ju Chiang, Chih-Chao Yang, Kun-Chen Lin, Cheuk-Kwan Sun, Jiunn-Jye Sheu, Hsueh-Wen Chang, Mel S Lee, Hon-Kan Yip
Combined therapy with exendin-4 (Ex4) and allogenic adipose-derived mesenchymal stem cells (ADMSC) was tested against either therapy alone for protecting kidney function against chronic kidney disease (CKD) complicated by sepsis syndrome (SS) [i.e., by intraperitoneal injection of cecal-derived bacteria (1.0 × 104) cells/milliliter/total 5.0 cc].Adult-male-Sprague Dawley rats (n=36) were equally divided into group 1 (sham-control), group 2 (CKD), group 3 (CKD-SS), group 4 (CKD-SS-Ex4), group 5 (CKD-SS-ADMSC) and group 6 (CKD-SS-Ex4-ADMSC)...
November 21, 2017: Oncotarget
Liesa Zabrocki, Frank Marquardt, Klaus Albrecht, Stefan Herget-Rosenthal
PURPOSE: Acute kidney injury (AKI) is a severe complication after infrarenal abdominal aortic aneurysm (iAAA) repair. Little data are available whether endovascular aneurysm (EVAR) or open aortic repair (OAR) differs with respect to AKI frequency and severity, consecutive development of chronic kidney disease (CKD) and potentially preventable and modifiable risk factors of AKI. PATIENTS AND METHODS: We assessed AKI rates, AKI stages and CKD applying current, complete definitions from the kidney disease improving global outcomes initiative in propensity-score-matched cohorts of all patients with elective and urgent iAAA repair at our institution from 2007 to 2011...
February 2018: International Urology and Nephrology
Vedant A Gupta, Matthew Sousa, Nathan Kraitman, Rahul Annabathula, Olga Vsevolozhskaya, Steve W Leung, Vincent L Sorrell
PURPOSE: Sepsis is a highly prevalent and fatal condition, with reported cardiovascular event rates as high as 25-30% at 1year. Risk stratification in septic patients has been extremely limited. MATERIAL AND METHODS: 267 septic patients with detectable troponin levels, APACHE II scores, and CT scans of the chest or abdomen were assessed. Patients with a recent cardiac intervention were excluded. Coronary artery calcification (CAC) was identified as present or absent on body CT scans...
April 2018: Journal of Critical Care
Marie Patrice Halle, Carine Tsou Lapsap, Esther Barla, Hermine Fouda, Hilaire Djantio, Beatrice Kaptue Moudze, Christophe Adjahoung Akazong, Eugene Belley Priso
BACKGROUND: Pediatric nephrology is challenging in developing countries and data on the burden of kidney disease in children is difficult to estimate due to absence of renal registries. We aimed to describe the epidemiology and outcomes of children with renal failure in Cameroon. METHODS: We retrospectively reviewed 103 medical records of children from 0 to 17 years with renal failure admitted in the Pediatric ward of the Douala General Hospital from 2004 to 2013...
December 6, 2017: BMC Pediatrics
Claudio Ronco, Federico Ronco, Peter A McCullough
With the adoption of the new definition and classification of cardiorenal syndrome (CRS) and its relevant subtypes, much attention has been placed on elucidating the mechanisms of heart and kidney interactions. The pathophysiologic pathways are of great interest by which acute heart failure may result in acute kidney injury (AKI; type 1), chronic heart failure accelerates the progression of chronic kidney disease (CKD; type 2), AKI provokes cardiac events (type 3), and CKD increases the risk and severity of cardiovascular disease (type 4)...
2017: Reviews in Cardiovascular Medicine
Linda Shavit, Shuli Silberman, Rachel Tauber, Ofer Merin, Daniel Bitran, Daniel Fink
BACKGROUND AND AIMS: Recent clinical evidence demonstrates that chronic low-dose mineralocorticoid receptor antagonists (MRA), when added to optimal treatment, result in reductions in cardiovascular mortality. However, continuation of MRAs before cardiac surgery in patients with CKD has never been evaluated and its potential benefit or harm in this specific clinical setting is largely unknown. MATERIALS AND METHODS: This is an observational study that included adult CKD patients undergoing cardiac surgery...
October 26, 2017: Clinical Nephrology
Fadi Al-Rashid, Anja Bienholz, Heike Annelie Hildebrandt, Polycarpos-Christos Patsalis, Matthias Totzeck, Andreas Kribben, Daniel Wendt, Heinz Jakob, Alexander Lind, Rolf Alexander Jánosi, Tienush Rassaf, Philipp Kahlert
Transcatheter aortic valve implantation (TAVI) has evolved to a treatment of choice in high-risk patients and is therefore ideal for patients with advanced chronic kidney disease, as patients with end-stage renal disease and kidney transplant recipients. Especially, outcome of this special patient group is very important. 22 patients with chronic kidney disease stage 5 undergoing intermittent hemodialysis treatment (CKD 5D) and 8 kidney transplant recipients (KT) with severe aortic valve stenosis underwent transfemoral TAVI...
October 31, 2017: Scientific Reports
Claudio Ronco, Federico Ronco, Peter A McCullough
With the adoption of the new definition and classification of cardiorenal syndrome (CRS) and its relevant subtypes, much attention has been placed on elucidating the mechanisms of heart and kidney interactions. Of great interest are the pathophysiological pathways by which acute heart failure may result in acute kidney injury (AKI; type 1), chronic heart failure accelerating the progression of chronic kidney disease (CKD; type 2), AKI provoking cardiac events (type 3), and CKD increasing the risk and severity of cardiovascular disease (type 4)...
October 25, 2017: Blood Purification
Valérian Bunel, Yasmina Tournay, Thomas Baudoux, Eric De Prez, Marie Marchand, Zita Mekinda, Raphaël Maréchal, Thierry Roumeguère, Marie-Hélène Antoine, Joëlle L Nortier
BACKGROUND: Renal toxicity induced by cisplatin (CisPt) is a clinical issue in patients with or without chronic kidney disease (CKD). Proximal tubular injury can result in acute kidney injury (AKI), which may compromise the course of chemotherapy and the prognosis. The purpose of this study was to investigate the time course of urinary markers of acute tubulotoxicity and to assess the usefulness of such monitoring in a routine clinical setting. METHODS: This work is an open prospective pilot study carried out among 23 patients receiving a platinum-based chemotherapy...
October 2017: Clinical Kidney Journal
Rajeev Jeeha, David Lee Skinner, Kim De Vasconcellos, Nombulelo Princess Magula
AIM: To determine whether admission procalcitonin (PCT) was associated with the subsequent development of AKI in a general population of critically ill patients. METHODS: The study was a retrospective observational study conducted in a multidisciplinary intensive care unit (ICU) over a period of 1 year. Adult patients who had a PCT performed on admission and who did not have CKD or AKI on admission, were evaluated for the development of AKI within the first week of ICU admission, according to the KDIGO criteria...
October 2, 2017: Nephrology
Yanbei Sun, Lijuan Jiang, Xiaonan Shao
PURPOSE: To investigate the predictive value of procalcitonin (PCT) in patients with stage 1-4 and stage 5 chronic kidney disease (CKD). METHODS: Five hundred and forty-one CKD inpatients were retrospectively analyzed and divided into CKD stage 1-4 (CKD1-4) and CKD stage 5 (CKD5) groups. Each group was further divided into non-infection, local infection, and sepsis subgroups. The clinical characteristics and inflammatory indexes of each subgroup including PCT, C-reactive protein (CRP), white blood cell count (WBC), and neutrophil percentage (N%) were compared, and the receiver operating characteristic curves to predict local infection and sepsis were plotted...
December 2017: International Urology and Nephrology
Mohamed Jemaà, Myriam Fezai, Rosi Bissinger, Florian Lang
Suicidal erythrocyte death or eryptosis contributes to or even accounts for anemia in a wide variety of clinical conditions, such as iron deficiency, dehydration, hyperphosphatemia, vitamin D excess, chronic kidney disease (CKD), hemolytic-uremic syndrome, diabetes, hepatic failure, malignancy, arteriitis, sepsis, fever, malaria, sickle-cell disease, beta-thalassemia, Hb-C and G6PD-deficiency, Wilsons disease, as well as advanced age. Moreover, eryptosis is triggered by a myriad of xenobiotics and endogenous substances including cytotoxic drugs and uremic toxins...
2017: Cellular Physiology and Biochemistry
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