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JOURNAL ARTICLE
Harin Rhee, Meeyoung Park, Il Young Kim
BACKGROUND: Acute kidney injury (AKI) is prevalent in critically ill patients and is associated with an increased risk of in-hospital mortality. Nephrology consultation may be protective, but this has rarely been evaluated in South Korea. METHODS: This multicenter retrospective study was based on the electronic medical records (EMRs) of two third-affiliated hospitals. We extracted the records of patients admitted to intensive care units (ICUs) between 2011 and 2020, and retrospectively detected AKI using the modified serum creatinine criteria of the Kidney Disease: Improving Global Outcomes (KDIGO) guidelines...
September 8, 2023: Kidney Research and Clinical Practice
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JOURNAL ARTICLE
Susan Kim, Amara Sarwal, Xin Tan Yee, Sebastian A Gandarillas Fraga, Vincent Campion, Isaiarasi Gnanasekaran
INTRODUCTION: Metformin is widely considered a first-line antiglycemic agent due to its cost-effectiveness and favorable adverse effect profile. However, its use is prohibited in patients with an estimated glomerular filtration rate <30 mL/min/1.73 m2 , due to the risk of potentially lethal metformin-associated lactic acidosis (MALA). We sought to evaluate MALA cases and outcomes at our institution. METHODS: In this observational, retrospective case series, we reviewed our EMR for all patients who had a metformin level drawn between January 2013 and May 2022 to identify individuals who met the diagnostic criteria for MALA...
September 30, 2023: Hemodialysis International
#23
JOURNAL ARTICLE
Mustafa Yalın, Fatih Gölgelioğlu
Background and Objectives : The current study aims to determine the impact of fasciotomy on mortality and morbidity in children and adults with crush-related AKI following the 2023 Kahramanmaraş earthquakes. Materials and Methods : The study included individuals who had suffered crush injuries after the 2023 Kahramanmaraş earthquakes and were identified as having an acute kidney injury (AKI). Patients with an AKI were divided into two groups based on age: those under 18 years and those over 18 years...
September 3, 2023: Medicina
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JOURNAL ARTICLE
Ruey-Hsing Chou, Shang-Feng Yang, Cheng-Hsueh Wu, Yi-Lin Tsai, Ya-Wen Lu, Jiun-Yu Guo, Po-Hsun Huang, Shing-Jong Lin
BACKGROUND: Angiotensin-converting enzyme inhibitors (ACEis) and angiotensin receptor blockers (ARBs) are commonly used for hypertension and cardiovascular diseases. However, whether their use increases the risk of acute kidney injury (AKI) and should be discontinued during acute illness remains controversial. METHODS: This retrospective study enrolled 952 dialysis-free patients who were admitted to intensive care units (ICUs) between 2015 and 2017, including 476 premorbid long-term (> 1 month) ACEi/ARB users...
September 2023: Acta Cardiologica Sinica
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JOURNAL ARTICLE
Pavel S Roshanov, Matthew T V Chan, Flavia K Borges, David Conen, C Y Wang, Denis Xavier, Otavio Berwanger, Maura Marcucci, Daniel I Sessler, Wojciech Szczeklik, Jessica Spence, Pablo Alonso-Coello, Carmen Fernández, Rupert M Pearse, German Malaga, Amit X Garg, Sadeesh K Srinathan, Michael J Jacka, Vikas Tandon, Michael McGillion, Ekaterine Popova, Alben Sigamani, Valsa Abraham, Bruce M Biccard, Juan Carlos Villar, Clara K Chow, Carísi A Polanczyk, Maria Tiboni, Richard Whitlock, Gareth L Ackland, Mohamed Panju, André Lamy, Robert Sapsford, Colin Williams, William Ka Kei Wu, Olga L Cortés, S Danielle MacNeil, Ameen Patel, Emilie P Belley-Côté, Sandra Ofori, William F McIntyre, Darryl P Leong, Diane Heels-Ansdell, Krysten Gregus, P J Devereaux
BACKGROUND: In previous analyses, myocardial injury after noncardiac surgery, major bleeding, and sepsis were independently associated with most deaths in the 30 days after noncardiac surgery, but most of these deaths occurred during the index hospitalization for surgery. The authors set out to describe outcomes after discharge from hospital up to 1 yr after inpatient noncardiac surgery and associations between predischarge complications and postdischarge death up to 1 yr after surgery...
January 1, 2024: Anesthesiology
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MULTICENTER STUDY
Wei Li, Shuwen Li, Jia Yuan, Xianjun Chen, Qimin Chen, Chuan Xiao, Qing Li, Lu Li, Ying Liu, Juan He, Lu Chen, Feng Shen
OBJECTIVE: The present study was designed to explore the association between serum sodium and mortality in patients with sepsis by using a large sample, multicenter MIMIC-IV database. METHODS: We extracted the data of 34 925 sepsis patients from the retrospective cohort mimicIV database. After adjusting the confounders, we explored the independent effects of serum sodium on 28-day mortality. RESULTS: A nonlinear relationship existed between serum sodium and 28-day mortality, of which a negative association was found between serum sodium and 28-day mortality (odds ratio: 0...
February 2024: Therapeutic Apheresis and Dialysis
#27
JOURNAL ARTICLE
Atrial Fibrillation after Descending Aorta Repair: Occurrence, Risk Factors, and Impact on Outcomes.
Akshat C Pujara, Marijan Koprivanac, Filip Stembal, Ashley M Lowry, Edward R Nowicki, Mina Chung, David V Wagoner, Eugene H Blackstone, Eric E Roselli
BACKGROUND: As risks of repairing the descending thoracic and thoracoabdominal aorta diminish, common complications that may prolong hospital stay, or actually increase risk, require attention. One such complication is postoperative atrial fibrillation (AF). Therefore, we characterized prevalence of, risk factors for, and effects of postoperative atrial fibrillation (PoAF) after descending and thoracoabdominal aorta repair. METHODS: From January 2000 to January 2011, 696 patients underwent open descending or thoracoabdominal aorta repair at Cleveland Clinic...
June 2023: Aorta (Stamford, Conn.)
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JOURNAL ARTICLE
Hernando Gómez, Alexander Zarbock, Stephen M Pastores, Gyorgy Frendl, Sven Bercker, Pierre Asfar, Steven A Conrad, Jaques Creteur, James Miner, Jean Paul Mira, Johan Motsch, Jean-Pierre Quenot, Thomas Rimmelé, Peter Rosenberger, Christophe Vinsonneau, Bob Birch, Fabienne Heskia, Julien Textoris, Luca Molinari, Louis M Guzzi, Claudio Ronco, John A Kellum
OBJECTIVES: To determine the feasibility, safety, and efficacy of a biomarker-guided implementation of a kidney-sparing sepsis bundle (KSSB) of care in comparison with standard of care (SOC) on clinical outcomes in patients with sepsis. DESIGN: Adaptive, multicenter, randomized clinical trial. SETTING: Five University Hospitals in Europe and North America. PATIENTS: Adult patients, admitted to the ICU with an indwelling urinary catheter and diagnosis of sepsis or septic shock, without acute kidney injury (acute kidney injury) stage 2 or 3 or chronic kidney disease...
August 2023: Critical care explorations
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JOURNAL ARTICLE
Conover Benjamin M, Wukich Dane K, Sambandam Senthil
BACKGROUND: Geriatric hip fractures are strongly correlated with increased morbidity. Even so, postoperative outcomes following surgical repair of hip fractures for patients with end stage renal disease lack extensive investigation. Chronic kidney disease (CKD) poses unique risks for surgical procedures as it has been associated with several complications. Little information is available regarding the outcomes of patients whose renal function decline necessitates dialysis usage. The purpose of this study was to compare post-surgical outcomes based on dialysis usage among CKD patients requiring hip fracture repair...
2023: Geriatric Orthopaedic Surgery & Rehabilitation
#30
JOURNAL ARTICLE
Chung-Shun Wong, Tzu-Ting Chen, Andrei R Akhmetzhanov, Ping-Jen Hu, Mai-Szu Wu, Mei-Yi Wu
BACKGROUND: Patients with sepsis-associated acute kidney injury (AKI) are at risk of kidney damage, potentially necessitating acute temporary or chronic dialysis. Our study aims to estimate the odds ratio (OR) of preceding sepsis among patients requiring their first dialysis. METHODS: A nationwide population-based case-only study was conducted using claims records from the National Health insurance database of Taiwan. All patients over 20 years of age who underwent their first dialysis between 2004 and 2016 were included in the study...
July 27, 2023: Journal of Clinical Medicine
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JOURNAL ARTICLE
Chia-Te Liao, Jia-Hong Lai, Yu-Wei Chen, Yung-Ho Hsu, Mei-Yi Wu, Cai-Mei Zheng, Chih-Cheng Hsu, Mai-Szu Wu, Shao-Yuan Chuang
In Taiwan, most first-time dialysis was started without the creation of an arteriovenous shunt. Here, we aimed to elucidate the transitions of dialysis status in the unplanned first dialysis patients and determine factors associated with their outcomes. A total of 50,315 unplanned first dialysis patients aged more than 18 years were identified from the National Health Insurance Dataset in Taiwan between 2001 and 2012. All patients were followed for 5 years for the transitions in dialysis status, including robust (dialysis-free), sporadic dialysis, continued dialysis, and death...
August 8, 2023: Scientific Reports
#32
JOURNAL ARTICLE
Honghao Lai, Guosheng Wu, Yu Zhong, Guangping Chen, Wei Zhang, Shengjun Shi, Zhaofan Xia
BACKGROUND: The predictive value of red blood cell distribution width (RDW) for mortality in patients with sepsis-induced acute kidney injury (SI-AKI) remains unclear. The present study aimed to investigate the potential association between RDW at admission and outcomes in patients with SI-AKI. METHODS: The Medical Information Mart for Intensive Care (MIMIC)-IV (version 2.0) database, released in June of 2022, provides medical data of SI-AKI patients to conduct our related research...
July 31, 2023: J Intensive Med
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JOURNAL ARTICLE
Tatu Juvonen, Mikko Jormalainen, Caius Mustonen, Till Demal, Antonio Fiore, Andrea Perrotti, Amélie Hervé, Enzo Mazzaro, Giuseppe Gatti, Matteo Pettinari, Sven Peterss, Joscha Buech, Francesco Nappi, Lenard Conradi, Angel G Pinto, Javier Rodriguez Lega, Marek Pol, Petr Kacer, Angelo M Dell'Aquila, Andreas Rukosujew, Konrad Wisniewski, Igor Vendramin, Daniela Piani, Luisa Ferrante, Mauro Rinaldi, Eduard Quintana, Robert Pruna-Guillen, Sebastien Gerelli, Dario Di Perna, Thierry Folliguet, Metesh Acharya, Mark Field, Manoj Kuduvalli, Francesco Onorati, Cecilia Rossetti, Timo Mäkikallio, Peter Raivio, Giovanni Mariscalco, Fausto Biancari
AIMS: In this study we evaluated the impact of direct aortic cannulation versus innominate/subclavian/axillary artery cannulation on the outcome after surgery for type A aortic dissection. METHODS: The outcomes of patients included in a multicenter European registry (ERTAAD) who underwent surgery for acute type A aortic dissection with direct aortic cannulation versus those with innominate/subclavian/axillary artery cannulation, i.e. supra-aortic arterial cannulation, were compared using propensity score matched analysis...
July 11, 2023: World Journal of Surgery
#34
MULTICENTER STUDY
Panagiotis Doukas, Jan Paul Frese, Thorsten Eierhoff, Gabriel Hellfritsch, Ben Raude, Michael J Jacobs, Andreas Greiner, Alexander Oberhuber, Alexander Gombert
Acute kidney injury (AKI) is a common complication after complex aortic procedures and it is associated with relevant mortality and morbidity. Biomarkers for early and specific AKI detection are lacking. The aim of this work is to investigate the reliability of the NephroCheck bedside system for diagnosing stage 3 AKI following open aortic surgery. In this prospective, multicenter, observational study,- https://clinicaltrials.gov/ct2/show/NCT04087161 -we included 45 patients undergoing open thoracoabdominal aortic repair...
July 9, 2023: Scientific Reports
#35
REVIEW
Alexander Zarbock, Jay L Koyner, Hernando Gomez, Peter Pickkers, Lui Forni
Sepsis is a host's deleterious response to infection, which could lead to life-threatening organ dysfunction. Sepsis-associated acute kidney injury (SA-AKI) is the most frequent organ dysfunction and is associated with increased morbidity and mortality. Sepsis contributes to ≈50% of all AKI in critically ill adult patients. A growing body of evidence has unveiled key aspects of the clinical risk factors, pathobiology, response to treatment and elements of renal recovery that have advanced our ability to detect, prevent and treat SA-AKI...
December 20, 2023: Nephrology, Dialysis, Transplantation
#36
JOURNAL ARTICLE
Giovanna Colantuono de Araújo, Andrea Pardini, Camila Lima
Sepsis is a disease with high mortality and morbidity despite advances in diagnostic procedures and therapeutic strategies. The aim of this study was to evaluate the profile and outcomes of community-onset sepsis. This retrospective, multicenter study included five 24-h health care units and was conducted from January 2018 to December 2021. Patients were diagnosed with sepsis or septic shock according to the Sepsis 3.0 criterion. A total of 2630 patients diagnosed as having sepsis (68.4%, 1800) or septic shock (31...
June 30, 2023: Scientific Reports
#37
JOURNAL ARTICLE
Anna Bandert, Miklós Lipcsey, Robert Frithiof, Anders Larsson, David Smekal
BACKGROUND: In intensive care, different central venous catheters (CVC) are often used for infusion of drugs. If a patient is treated with continuous renal replacement therapy (CRRT) a second catheter, a central venous dialysis catheter (CVDC), is needed. Placing the catheters close together might pose a risk that a drug infused in a CVC could be directly aspirated into a CRRT machine and cleared from the blood without giving the effect intended. The purpose of this study was to elucidate if drug clearance is affected by different catheter placement, during CRRT...
June 9, 2023: Intensive Care Medicine Experimental
#38
REVIEW
Matteo Marcello, Claudio Ronco
Acute liver failure and acute-on-chronic liver failure are conditions in which the loss of metabolic function of the liver leads to the accumulation of several toxins such as bilirubin. Patients with sepsis or multiple organ dysfunction syndrome have a greater risk of developing liver failure, and hyperbilirubinemia is associated with poor prognosis. Bilirubin removal may not only alleviate signs and symptoms of liver dysfunction but also act as an index of removal of albumin-bound toxins. Conjugated and unconjugated bilirubin, due to their molecular weight and albumin-binding capacity, respectively, cannot be removed by classic dialysis; therefore, different extracorporeal techniques have been developed to remove bilirubin from the blood...
2023: Contributions to Nephrology
#39
JOURNAL ARTICLE
Denis Georges Teuwafeu, Marie Patrice Halle, Nadine Aurore Kenfack, Cyrille Duquesne Nkouonlack, Hermine Fouda, Clovis Nkoke, Yacouba Mapoure Njankouo
BACKGROUND: End-stage kidney disease is an independent risk factor for stroke; however, the relationship between hemodialysis and stroke in Sub-Saharan Africa has not been established. OBJECTIVE: To evaluate the incidence, associated factors, and clinical outcome of stroke among patients undergoing maintenance hemodialysis in Cameroon. METHODS: A hospital-based retrospective study using data from the medical files of 1060 patients on maintenance hemodialysis (given twice a week) was conducted...
June 1, 2023: Hemodialysis International
#40
JOURNAL ARTICLE
Benjamin Coiffard, Hamid Merdji, Mohamed Boucekine, Julie Helms, Raphaël Clere-Jehl, Jean-Louis Mege, Ferhat Meziani
Biological rhythms are important regulators of immune functions. In intensive care unit (ICU), sepsis is known to be associated with rhythm disruption. Our objectives were to determine factors associated with rhythm disruption of the body temperature and to assess the relationship between temperature and mortality in septic shock patients; In a cohort of septic shock, we recorded body temperature over a 24-h period on day 2 after ICU admission. For each patient, the temperature rhythmicity was assessed by defining period and amplitude, and the adjusted average (mesor) of the temperature by sinusoidal regression and cosinor analysis...
April 22, 2023: Biology
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