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Aki and pregnancy

Dalia E Yousif, Alice R Topping, Maha F Osman, Jochen G Raimann, Elfadil M Osman, Peter Kotanko, Omar I Abboud
BACKGROUND: The burden of acute kidney injury (AKI) is high in Africa. While there are no reliable statistics about AKI in Africa, the Global Snapshot Study of the 0by25 initiative of the International Society of Nephrology has determined dehydration, infections, animal envenomation, and complications during pregnancy as the main causes. METHODS: This study was conducted at the Soba University Hospital (SUH), Khartoum, Sudan, a tertiary referral center. We included all hemodialysis patients treated for AKI at SUH between -January 1, 2013 and December 31, 2014 in the study...
January 26, 2018: Blood Purification
Bo Åkerström, Lena Rosenlöf, Anneli Hägerwall, Sigurbjörg Rutardottir, Jonas Ahlstedt, Maria E Johansson, Lena Erlandsson, Maria Allhorn, Magnus G Gram
AIMS: Human A1M (α1-microglobulin) is an endogenous reductase and radical- and heme-binding protein with physiological antioxidant protective functions. Recombinant human A1M (rA1M) has been shown to have therapeutic properties in animal models of preeclampsia, a pregnancy disease associated with oxidative stress. Recombinant A1M, however, lacks glycosylation, and shows lower solubility and stability than A1M purified from human plasma. The aims of this work was to 1) use site-directed mutagenesis to improve the physicochemical properties of rA1M, 2) demonstrate that the physicochemically improved rA1M displays full in vitro cell protective effects as recombinant wild-type A1M (rA1M-wt), and 3) show its therapeutic potential in vivo against acute kidney injury (AKI), another disease associated with oxidative stress...
February 22, 2018: Antioxidants & Redox Signaling
William R Cooke, Ulla K Hemmilä, Alison L Craik, Chimwemwe J Mandula, Priscilla Mvula, Ausbert Msusa, Gavin Dreyer, Rhys Evans
BACKGROUND: Obstetric-related acute kidney injury (AKI) is thought to be a key contributor to the overall burden of AKI in low resource settings, causing significant and preventable morbidity and mortality. However, epidemiological data to corroborate these hypotheses is sparse. This prospective observational study aims to determine the incidence, aetiology and maternal-fetal outcomes of obstetric-related AKI in Malawi. METHODS: Women greater than 20 weeks gestation or less than 6 weeks postpartum admitted to obstetric wards at a tertiary hospital in Blantyre, Malawi, and at high-risk of AKI were recruited between 21st September and 11th December 2015...
February 2, 2018: BMC Nephrology
Aki Oride, Haruhiko Kanasaki, Tomomi Hara, Hiroko Ohta, Satoru Kyo
Purpose: To identify the factors that characterize cycles with empty zona pellucida (EZP). Methods: Thirty-six oocyte retrieval cycles from which EZP were collected and another 36 cycles from which no EZP was collected were compared. The patients were divided into three groups: those with no EZP collected during any cycle, those with EZP collected during all cycles, and those experiencing cycles both with and without EZP. Results: The mean number of oocytes collected per cycle was higher in the cycles with EZP than without EZP...
January 2018: Reproductive Medicine and Biology
Rhys D R Evans, William Cooke, Ulla Hemmila, Viviane Calice-Silva, Jochen Raimann, Alison Craik, Chimwemwe Mandula, Priscilla Mvula, Ausbert Msusa, Gavin Dreyer, Nathan W Levin, Roberto Pecoits-Filho
Introduction: Obstetric-related acute kidney injury (AKI) is associated with adverse outcomes for mother and fetus, particularly in low-income countries. However, laboratory-independent tools to facilitate diagnosis are lacking. We assessed the diagnostic performance of a salivary urea nitrogen (SUN) dipstick to detect obstetric-related acute kidney disease in Malawi. Methods: Women at high risk for AKI admitted to an obstetric unit in Blantyre, Malawi, were recruited between 21 September and 11 December 2015...
January 2018: KI Reports
Geraldo Bezerra da Silva Junior, Suzanne Vieira Saintrain, Gabriel de Castro Castelo, Vanessa Ribeiro de Vasconcelos, Juliana Gomes Ramalho de Oliveira, Amanda Maria Timbó Rocha, Adolfo Gomes Vasconcelos Júnior, Maria Vieira de Lima Saintrain, Elizabeth De Francesco Daher
INTRODUCTION: Acute kidney injury (AKI) is a complication still poorly studied in the setting of obstetric patients, which is associated with increased mortality. Objective: The aim of this study was to investigate the frequency and risk factors of AKI among critically ill obstetric patients. METHODS: A cross-sectional study was conducted with all patients admitted to an intensive care unit (ICU) due to obstetric complications, in Fortaleza, Brazil, in the period between January 2012 and December 2014...
October 2017: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
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
Satoshi Yokoyama, Takayuki Nukada, Yuka Ikeda, Shigeto Hara, Akira Yoshida
BACKGROUND: Peritoneal dialysis (PD) for acute kidney injury (AKI) of newborns has been performed safely. AKI occurs in 8 to 24% of extremely low birth weight (ELBW) infants. Although PD has only been used occasionally in ELBW infants, prognosis is poor for ELBW infants with AKI. Several reports have described successful PD in these infants, but no guideline-based evidence concerning indications for renal replacement therapy in ELBW infants are currently available. Here, we report on our experience with PD in an ELBW infant with AKI resulting from septic shock...
November 9, 2017: Surgical Case Reports
Shiyo Ota, Keisuke Ishii, Hiroshi Kawamura, Aki Mabuchi, Ryo Yamamoto, Shusaku Hayashi, Takeshi Kanagawa, Nobuaki Mitsuda
AIM: Iatrogenic premature rupture of membrane (PROM) is one of the major complications related to fetoscopic laser photocoagulation (FLP) for twin-twin transfusion syndrome (TTTS). However, amniotic fluid leakage (AFL) sometimes spontaneously disappears. This study evaluated the incidence and clinical characteristics of transient AFL after FLP. METHODS: We retrospectively reviewed pregnancies that underwent FLP for TTTS at a single center. Patients with apparent AFL within 2 weeks after FLP were divided into two groups: transient AFL, defined by the disappearance of fluid leakage within a week; and PROM, if AFL persisted continuously for more than a week or premature birth occurred, including miscarriage, within a week of the first symptom of AFL...
October 13, 2017: Journal of Obstetrics and Gynaecology Research
Margarita Ibarra-Hernández, Oralia Alejandra Orozco-Guillén, María Luz de la Alcantar-Vallín, Ruben Garrido-Roldan, María Patricia Jiménez-Alvarado, Kenia Benitez Castro, Francisco Villa-Villagrana, Mario Borbolla, Juan Manuel Gallardo-Gaona, Guillermo García-García, Norberto Reyes-Paredes, Giorgina Barbara Piccoli
The incidence of acute kidney injury in pregnancy (P-AKI) in developed countries is significantly lower than in developing ones, where it is estimated to range between 4 and 26%. Mortality in cases of P-AKI requiring dialysis is high, varying from 20 to 80%. In developing countries, clinical decisions are often based on the availability of services and not on needs. Prenatal surveillance in Mexico does not include serum creatinine, limiting the potential for early diagnosis of AKI and CKD and their differential diagnosis...
December 2017: Journal of Nephrology
Fadi Fakhouri, Clément Deltombe
The rate of pregnancy-associated acute kidney injury (P-AKI) has dwindled in high income countries mainly following the legalization of abortion in the seventies and early eighties and the general improvement in obstetrical care. P-AKI has not however disappeared from high income countries and several reports indicate that its frequency has even increased during the last decade. The reasons for such evolution are probably an improved surveillance and reporting of P-AKI and a more aggressive approach to the treatment of pregnancy complications, with unintended renal side effects...
December 2017: Journal of Nephrology
Wenyu Zhang, Wei Yuan, Ning Xu, Jinping Li, Wenxiu Chang
Icariin has previously been demonstrated to attenuate hyperglycemia‑induced renal injury, however the renoprotective effects of icariin in a rat model of pregnancy‑induced hypertension (PIH) remain to be elucidated. The present study aimed to investigate the effect of icariin on PIH‑induced acute kidney injury (AKI) and proteinuria. Following 18 days of icariin treatment between day 1 and day 18 of gestation, which was combined with NG‑nitro‑L‑arginine methyl ester (L‑NAME) treatment between day 12 and day 18 of gestation to induce PIH, the 24 h urine protein level, blood urea nitrogen and serum creatinine were measured by using the Coomassie Brilliant Blue method, a commercial enzymatic kit and the picric acid method, respectively...
November 2017: Molecular Medicine Reports
S U Ahammed, A A Chowdhury, A S Roy, M A Muqueet, M A Rahman, M S Kabir, M G Rabbani, M Asadujjaman, M B Hossain, M Akhtaruzzaman, S K Das, E H Khan, M A Islam, M J Hasan, M A Rahman, R K Talukder, J Ara, G C Barman, P P Roy, M K Saha, D Mondal
This prospective case control study was carried out in Mymensingh Medical College Hospital (MMCH) from April 2011 to March 2012. The main objective of the study was to determine the short term maternal outcome of pregnancy related Acute Kidney Injury and to identify aetiological factors and to observe clinical features of pregnancy related Acute Kidney Injury. Total 60 pregnant women with AKI were included in the study as sample and equal (60) number of pregnant women with normal renal function was taken as control...
July 2017: Mymensingh Medical Journal: MMJ
J Prakash, V C Ganiger
The incidence of acute kidney injury in pregnancy (P-AKI) has declined significantly over the last three decades in developing countries. However, it is still associated with significant fetomaternal mortality and morbidity. The diagnosis of P-AKI is based on the serum creatinine increase. The usual formulas for estimating glomerular filtration rate (GFR) are not validated in this population. The incidence of P-AKI with respect to total AKI cases has decreased in the last three decades from 25% in 1980s to 9% in 2000s at our centre...
July 2017: Indian Journal of Nephrology
Sarah E Cotner, W Cliff Rutter, Donna R Burgess, Katie L Wallace, Craig A Martin, David S Burgess
Limited literature is available assessing nephrotoxicity with prolonged β-lactam infusions. This study compared the incidence of acute kidney injury (AKI) associated with a prolonged β-lactam infusion or an intermittent infusion. This was a retrospective, matched-cohort study at an academic medical center from July 2006 to September 2015. Adult patients who received piperacillin-tazobactam (TZP), cefepime (FEP), or meropenem (MEM) for at least 48 h were evaluated. Patients were excluded for preexisting renal dysfunction or pregnancy...
October 2017: Antimicrobial Agents and Chemotherapy
Eunjeong Kang, Shin Hye Yoo, Doyeun Oh, Kwon Wook Joo, Yon Su Kim, Sung-Soo Yoon, Inho Kim, Seonyang Park, Hajeong Lee, Youngil Koh
Differential treatment strategies are applied in thrombotic microangiopathy (TMA) according to the sub-classifications. Hence, it is worthwhile to overview clinical manifestations and outcomes of overall TMA patients according to sub-classifications. We analyzed TMA patients whose serum lactate dehydrogenase levels >250 IU/L, with the presence of schistocytes in their peripheral blood smear, or with typical vascular pathologic abnormalities in their renal biopsy. We compared clinical manifestations including overall survival (OS) and renal survival according to TMA causes...
October 2017: Annals of Hematology
Youxia Liu, Xinxin Ma, Jie Zheng, Xiangchun Liu, Tiekun Yan
BACKGROUND: Presently, the matter of pregnancy outcomes of patients with pregnancy related AKI (PR-AKI) were disputed. Thus, we conducted a meta-analysis to evaluate the impact of PR-AKI on pregnancy outcomes. METHOD: We systematically searched MEDLINE, Embase, VIP, CNKI and Wanfang Databases for cohort or case-control studies in women with PR-AKI and those without AKI as a control group to assess the influence of PR-AKI on pregnancy outcomes and kidney outcome...
July 18, 2017: BMC Pregnancy and Childbirth
Belinda Jim, Vesna D Garovic
Pregnancy-related acute kidney injury (AKI) has declined in incidence in the last three decades, although it remains an important cause of maternal and fetal morbidity and mortality. Pregnancy-related causes of AKI such as preeclampsia, acute fatty liver of pregnancy, HELLP (Hemolysis, Elevated Liver function tests, Low Platelets) syndrome, and the thrombotic microangiopathies (thrombotic thrombocytopenic purpura, atypical hemolytic-uremic syndrome [HUS]) exhibit overlapping features and often present as diagnostic dilemmas...
July 2017: Seminars in Nephrology
Chihiro Nishiura, Akiko Nanri, Ikuko Kashino, Ai Hori, Chihiro Kinugawa, Motoki Endo, Noritada Kato, Aki Tomizawa, Akihiko Uehara, Makoto Yamamoto, Tohru Nakagawa, Shuichiro Yamamoto, Toru Honda, Teppei Imai, Akiko Okino, Toshiaki Miyamoto, Naoko Sasaki, Kentaro Tomita, Satsue Nagahama, Takeshi Kochi, Masafumi Eguchi, Hiroko Okazaki, Taizo Murakami, Chii Shimizu, Makiko Shimizu, Isamu Kabe, Tetsuya Mizoue, Tomofumi Sone, Seitaro Dohi
BACKGROUND: Long-term sick-leave is a major public health problem, but data on its incidence in Japan are scarce. We aimed to present reference data for long-term sick-leave among private sector employees in Japan. METHODS: The study population comprised employees of 12 companies that participated in the Japan Epidemiology Collaboration on Occupational Health Study. Details on medically certified sick-leave lasting ≥30 days were collected from each company. Age- and sex-specific incidence rate of sick-leave was calculated for the period of April 2012 to March 2014...
December 2017: Journal of Epidemiology
M M Mir, M S Najar, A M Chaudary, H Azad, A R Reshi, K A Banday, M A Bhat, I A Wani, M M Wani, M Ursilla
Pregnancy-related-acute kidney injury (PR-AKI) had decreased from 40% to 20% in 1960 to <10% in recent series, mostly due to meticulous antenatal management. Postpartum-AKI (PP-AKI) resulting from late obstetric complications has become more apparent after improvement in antenatal care and legalization of medical termination of pregnancy. Women with renal injury in peripartum period admitted to our hospital over a period of 2 years (April 2013 to May 2015) were studied. Of 713 patients of AKI admitted, 61 had PR-AKI with an incidence of 4...
May 2017: Indian Journal of Nephrology
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