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Sepsis biomarkers dialysis

Mark Cartwright, Martin Rottman, Nathan I Shapiro, Benjamin Seiler, Patrick Lombardo, Nazita Gamini, Julie Tomolonis, Alexander L Watters, Anna Waterhouse, Dan Leslie, Dana Bolgen, Amanda Graveline, Joo H Kang, Tohid Didar, Nikolaos Dimitrakakis, David Cartwright, Michael Super, Donald E Ingber
BACKGROUND: Blood cultures, and molecular diagnostic tests that directly detect pathogen DNA in blood, fail to detect bloodstream infections in most infected patients. Thus, there is a need for a rapid test that can diagnose the presence of infection to triage patients, guide therapy, and decrease the incidence of sepsis. METHODS: An Enzyme-Linked Lectin-Sorbent Assay (ELLecSA) that uses magnetic microbeads coated with an engineered version of the human opsonin, Mannose Binding Lectin, containing the Fc immunoglobulin domain linked to its carbohydrate recognition domain (FcMBL) was developed to quantify pathogen-associated molecular patterns (PAMPs) in whole blood...
July 2016: EBioMedicine
Paul D Weyker, Xosé L Pérez, Kathleen D Liu
Acute kidney injury (AKI) is an abrupt decrease in kidney function that takes place over hours to days. Sepsis is the leading cause of AKI and portends a particularly high morbidity and mortality, although the severity may vary from a transient rise in serum creatinine to end-stage renal disease. With regard to acid-base management in septic AKI, caution should be used with hyperchloremic crystalloid solutions, and dialysis is often used in the setting of severe acidosis. In the future, biomarkers may help clinicians identify AKI earlier and allow for potential interventions before the development of severe AKI...
June 2016: Clinics in Chest Medicine
Nattachai Srisawat, Kearkiat Praditpornsilpa, Kanitha Patarakul, Malee Techapornrung, Tinnapop Daraswang, Theerapon Sukmark, Kamol Khositrangsikun, Apinya Fakthongyoo, Petchdee Oranrigsupak, Laksamon Praderm, Ummarit Suwattanasilpa, Sadudee Peerapornratana, Passisd Loahaveeravat, Nattachai Suwachittanont, Thaksa-on Wirotwan, Chayanat Phonork, Sarinya Kumpunya, Khajohn Tiranathanagul, Chintana Chirathaworn, Somchai Eiam-ong, Kriang Tungsanga, Visith Sitprija, John A Kellum, Natavudh Townamchai
AKI is one of the most serious complications of leptospirosis, an important zoonosis in the tropics. Recently, NGAL, one of the novel AKI biomarkers, is extensively studied in various specific settings such as sepsis, cardiac surgery, and radiocontrast nephropathy. In this multicenter study, we aimed to study the role of NGAL as an early marker and an outcome predictor of leptospirosis associated AKI. Patients who presented with clinical suspiciousness of leptospirosis were prospectively enrolled in 9 centers from August 2012 to November 2014...
2015: PloS One
Amira-Peco-Antić, Dusan Paripović
Acute kidney injury (AKI) is a clinical condition considered to be the consequence of a sudden decrease (> 25%) or discontinuation of renal function. The term AKI is used instead of the previous term acute renal failure, because it has been demonstrated that even minor renal lesions may cause far-reaching consequences on human health. Contemporary classifications of AKI (RIFLE and AKIN) are based on the change of serum creatinine and urinary output. In the developed countries, AKI is most often caused by renal ischemia, nephrotoxins and sepsis, rather than a (primary) diffuse renal disease, such as glomerulonephritis, interstitial nephritis, renovascular disorder and thrombotic microangiopathy...
May 2014: Srpski Arhiv za Celokupno Lekarstvo
T Clark Powell, Stephen L Powell, Bryant K Allen, Russell L Griffin, David G Warnock, Henry E Wang
OBJECTIVE: Acute kidney injury (AKI) is a sequela of sepsis associated with increased morbidity and mortality. We sought to determine if individuals with elevated baseline levels of inflammation and endothelial cell activation are at increased risk for future AKI after sepsis. METHODS: We conducted an analysis of individuals developing sepsis in the national 30,239 subject REGARDS cohort. Biomarkers measured at the beginning of an 8-year observation period included high-sensitivity C-reactive protein (hsCRP), interleukin-6 (IL-6), tumor necrosis factor (TNF-α), E-selectin, inter-cellular adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1), and urinary Albumin-to-creatinine ratio (ACR)...
2014: SpringerPlus
Raghavan Murugan, Xiaoyan Wen, Nilesh Shah, Minjae Lee, Lan Kong, Francis Pike, Christopher Keener, Mark Unruh, Kevin Finkel, Anitha Vijayan, Paul M Palevsky, Emil Paganini, Melinda Carter, Michele Elder, John A Kellum
BACKGROUND: Survivors of critical illness complicated by acute kidney injury requiring renal replacement therapy (RRT) are at an increased risk of dialysis dependence and death but the mechanisms are unknown. METHODS: In a multicenter, prospective, cohort study of 817 critically ill patients receiving RRT, we examined association between Day 1 plasma inflammatory [interleukin (IL)-1β, IL-6, IL-8, IL-10 and IL-18; macrophage migration inhibitory factor (MIF) and tumor necrosis factor]; apoptosis [tumor necrosis factor receptor (TNFR)-I and TNFR-II and death receptor (DR)-5]; and growth factor (granulocyte macrophage colony stimulating factor) biomarkers and renal recovery and mortality at Day 60...
October 2014: Nephrology, Dialysis, Transplantation
Sung Phil Kim, Sun Ok Park, Sang Jong Lee, Seok Hyun Nam, Mendel Friedman
Endotoxemia (sepsis, septic shock) is an inflammatory, virulent disease that results mainly from bacterial infection. The present study investigates the inhibitory effect of a bioprocessed polysaccharide (BPP) isolated from the edible Lentinus edodes liquid mycelial mushroom culture supplemented with black rice bran against murine endotoxemia induced by the Salmonella lipopolysaccharide and d-galactosamine (LPS/GalN). BPP was obtained after dialysis against water using a cellulose tube with a molecular weight cutoff of 10000...
November 20, 2013: Journal of Agricultural and Food Chemistry
Tibor Fülöp, Mihály Tapolyai, Naseem A Qureshi, Vikram R Beemidi, Kamel A Gharaibeh, S Mehrdad Hamrahian, Tibor Szarvas, Csaba P Kovesdy, Eva Csongrádi
BACKGROUND: Some nephrologists remove tunneled hemodialysis catheters (TDC) at the bedside, but this practice has never been formally studied. Our hypothesis was that bedside removal of TDC is a safe and effective procedure affording prompt removal, including in cases of suspected infection. METHODS: We reviewed our consecutive 3-year experience (2007-2009) with bedside TDC removal at the University of Mississippi Renal Fellowship Program. Data were collected on multiple patients and procedure-related variables, success and complication rates...
October 2013: Renal Failure
John W Pickering, Zoltan H Endre
BACKGROUND AND AIM: Neutrophil gelatinase-associated lipocalin (NGAL) is derived from the distal tubule and is both reabsorbed and filtered and also shed into the urine after tubular injury. Plasma NGAL is unique amongst the candidate biomarkers of acute kidney injury (AKI) since elevated concentrations may reflect either a change in renal glomerular function or in structural tubular injury or both. In this study, we compared the performance of plasma NGAL in the diagnosis of functional changes and in the diagnosis of structural injury...
2013: Blood Purification
Zoltan H Endre, John A Kellum, Salvatore Di Somma, Kent Doi, Stuart L Goldstein, Jay L Koyner, Etienne Macedo, Ravindra L Mehta, Patrick T Murray
Acute kidney injury (AKI) is a common but complex clinical syndrome with multiple etiologies. These etiologies target different sites and pathways within the kidney. Novel biomarkers of 'kidney damage' (which can be tubular or glomerular) can be used to diagnose AKI, even in the absence of an increase in serum creatinine or oliguria. These biomarkers of kidney damage can be combined with biomarkers of kidney function to facilitate classification of AKI. A comprehensive review of the literature was performed using the published methodology of the Acute Dialysis Quality Initiative (ADQI) working group and used to establish consensus statements regarding the use of biomarkers in the differential diagnosis of AKI...
2013: Contributions to Nephrology
Peter A McCullough, Andrew D Shaw, Michael Haase, Josee Bouchard, Sushrut S Waikar, Edward D Siew, Patrick T Murray, Ravindra L Mehta, Claudio Ronco
Acute kidney injury (AKI) commonly occurs in hospitalized patients and is independently and strongly associates with morbidity and mortality. The clinical benefits of a timely and definitive diagnosis of AKI have not been fully realized due to limitations imposed by the use of serum creatinine and urine output to fulfill diagnostic criteria. These restrictions often lead to diagnostic delays, potential misclassification of actual injury status, and provide little information regarding underlying cause. Novel biomarkers of damage have shown ability to reflect ongoing kidney injury and help further refine existing Risk, Injury, Failure, Loss, End-stage kidney disease (RIFLE) and Acute Kidney Injury Network (AKIN) diagnostic criteria...
2013: Contributions to Nephrology
Tariq Shafi, Stephen M Sozio, Laura C Plantinga, Bernard G Jaar, Edward T Kim, Rulan S Parekh, Michael W Steffes, Neil R Powe, Josef Coresh, Elizabeth Selvin
OBJECTIVE: Assays for serum total glycated proteins (fructosamine) and the more specific glycated albumin may be useful indicators of hyperglycemia in dialysis patients, either as substitutes or adjuncts to standard markers such as hemoglobin A1c, as they are not affected by erythrocyte turnover. However, their relationship with long-term outcomes in dialysis patients is not well described. RESEARCH DESIGN AND METHODS: We measured fructosamine and glycated albumin in baseline samples from 503 incident hemodialysis participants of a national prospective cohort study, with enrollment from 1995-1998 and median follow-up of 3...
June 2013: Diabetes Care
Helmut Schiffl, Susanne M Lang
Acute kidney injury (AKI) represents a common disorder in hospitalized patients, and its incidence is rising at an alarming rate. Despite significant improvements in critical care and renal replacement therapies (RRT), the outcome of critically ill patients with AKI necessitating RRT remains unacceptably dismal. In current clinical practice, the diagnosis and severity classification of AKI is based on a rise in serum creatinine levels, which may occur 2-3 days after the initiating renal insult and delay potentially effective therapies that are limited to the early stage...
August 1, 2012: Molecular Diagnosis & Therapy
Peter Pickkers, Suzanne Heemskerk, Jeroen Schouten, Pierre-François Laterre, Jean-Louis Vincent, Albertus Beishuizen, Philippe G Jorens, Herbert Spapen, Michael Bulitta, Wilbert H M Peters, Johannes G van der Hoeven
INTRODUCTION: To evaluate whether alkaline phosphatase (AP) treatment improves renal function in sepsis-induced acute kidney injury (AKI), a prospective, double-blind, randomized, placebo-controlled study in critically ill patients with severe sepsis or septic shock with evidence of AKI was performed. METHODS: Thirty-six adult patients with severe sepsis or septic shock according to Systemic Inflammatory Response Syndrome criteria and renal injury defined according to the AKI Network criteria were included...
January 23, 2012: Critical Care: the Official Journal of the Critical Care Forum
Lyubov Chaykovska, Oleg Tsuprykov, Berthold Hocher
The mortality of end-stage renal disease (ESRD) patients on dialysis remains high despite great improvement of dialysis technologies in the past decades. These patients die due to infectious diseases (mainly sepsis), cardiovascular diseases such as myocardial infarction, heart failure, stroke, and, in particular, sudden cardiac death. End stage renal disease is a complex condition, where the failure of kidney function is accompanied by numerous metabolic changes affecting almost all organ systems of the human body...
2011: Clinical Laboratory
Norbert Lameire, Wim Vanbiesen, Raymond Vanholder
Earlier initiation of dialysis may have a beneficial impact on survival of critically ill patients with acute kidney injury (AKI). A retrospective analysis in the previous issue of Critical Care showed that early initiation of renal replacement therapy (RRT), as defined by RIFLE criteria, was not associated with a reduction in hospital mortality. The retrospective character of many studies describing the results of early RRT initiation and the validity of RIFLE criteria to determine the need for dialysis can be questioned, in particular when urinary output is not considered...
July 8, 2011: Critical Care: the Official Journal of the Critical Care Forum
G Spasovski
(Full text is available at Nephrologists and internists who work in the field of renal replacement therapy with dialysis had an opportunity to attend the continuing medical (nephrology) education (CME) on the subject of: Diagnostic and treatment options in CKD in the new millennium. The course was held on 25 April 2009, in the premises of the Macedonian Academy of Sciences and Arts, in honour of the 70th anniversary of Academician Momir Polenakovic, one of the founders of the Macedonian nephrology...
July 2010: Prilozi
Nathan I Shapiro, Stephen Trzeciak, Judd E Hollander, Robert Birkhahn, Ronny Otero, Tiffany M Osborn, Eugene Moretti, H Bryant Nguyen, Kyle Gunnerson, David Milzman, David F Gaieski, Munish Goyal, Charles B Cairns, Kenneth Kupfer, Seok-Won Lee, Emanuel P Rivers
STUDY OBJECTIVE: We assess the diagnostic accuracy of plasma neutrophil gelatinase-associated lipocalin (NGAL) to predict acute kidney injury in emergency department (ED) patients with suspected sepsis. METHODS: We conducted a secondary analysis of a prospective observational study of a convenience sample of patients from 10 academic medical center EDs. Inclusion criteria were adult patients aged 18 years or older, with suspected infection or a serum lactate level greater than 2...
July 2010: Annals of Emergency Medicine
S Gonçalves, R Fernandez-Sanchez, M D Sanchez-Niño, A Tejedor, F Neria, J Egido, M Ruiz-Ortega, A Ortiz
Acute kidney injury (AKI) is a syndrome characterized by an acute renal cell injury that leads to sudden loss of renal function. There are currently no clinically validated treatments for AKI besides substituting renal function by dialysis. However, new biomarkers will allow an earlier diagnosis, thus providing a window of opportunity for therapeutic intervention. Tyrphostins are a family of compounds originally designed as protein tyrosine kinase inhibitors. However, some molecules of this family have additional actions, such as inhibition of guanylate and adenylate cyclases, mitochondrial uncoupling or antioxidant effects...
2010: Current Medicinal Chemistry
Philipp Kümpers, Carsten Hafer, Alexander Lukasz, Ralf Lichtinghagen, Korbinian Brand, Danilo Fliser, Robert Faulhaber-Walter, Jan T Kielstein
INTRODUCTION: Neutrophil gelatinase-associated lipocalin (NGAL) is a promising novel biomarker that correlates with the severity and outcome of acute kidney injury (AKI). However, its prognostic utility during the late course of AKI, especially in patients that require renal replacement therapy (RRT) remains unknown. The aim of this study was to evaluate the predictive value of serum NGAL in patients with established AKI at inception of RRT in the intensive care unit (ICU). METHODS: Serum NGAL (ELISA methodology) was measured in 109 critically ill patients with AKI at inception of RRT in 7 ICUs of a tertiary care university hospital...
2010: Critical Care: the Official Journal of the Critical Care Forum
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