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Risk Assessment of Acute Kidney Injury

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https://www.readbyqxmd.com/read/27919293/perioperative-statin-therapy-in-cardiac-surgery-a-meta-analysis-of-randomized-controlled-trials
#1
Alessandro Putzu, Bruno Capelli, Alessandro Belletti, Tiziano Cassina, Enrico Ferrari, Michele Gallo, Gabriele Casso, Giovanni Landoni
BACKGROUND: Several studies suggest beneficial effects of perioperative statin therapy on postoperative outcome after cardiac surgery. However, recent randomized controlled trials (RCTs) show potential detrimental effects. The objective of this systematic review is to examine the association between perioperative statin therapy and clinical outcomes in cardiac surgery patients. METHODS: Electronic databases were searched up to 1 November 2016 for RCTs of preoperative statin therapy versus placebo or no treatment in adult cardiac surgery...
December 5, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27915329/acute-kidney-injury-risk-assessment-and-the-nephrology-rapid-response-team
#2
Lilia Maria Rizo-Topete, Mitchell H Rosner, Claudio Ronco
Acute kidney Injury (AKI) is a serious medical condition affecting more than 10 million people around the world annually and resulting in poor outcomes. It has been suggested that late recognition of the syndrome may lead to delayed interventions with increased morbidity and mortality. Early diagnosis and timely therapeutic strategies may be the cornerstone of future improvement in outcomes. The purpose of this article is to provide a practical model to identify patients at high risk for AKI in different environments, with the goal to prevent AKI...
December 3, 2016: Blood Purification
https://www.readbyqxmd.com/read/27906719/diagnosis-of-cardiac-surgery-associated-acute-kidney-injury-from-functional-to-damage-biomarkers
#3
Wim Vandenberghe, Jorien De Loor, Eric A J Hoste
PURPOSE OF REVIEW: Acute kidney injury (AKI) occurs in up to 30% after cardiac surgery and is associated with adverse outcome. Currently, cardiac surgery-associated acute kidney injury (CSA-AKI) is diagnosed by Kidney Disease: Improving Global Outcomes criteria based on creatinine and urine output. To detect and treat AKI earlier, various biomarkers have been evaluated. This review addresses the current position of the two damage biomarkers neutrophil gelatinase-associated lipocalin (NGAL) and [TIMP-2] [IGFBP7] in clinical practice...
November 30, 2016: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/27903300/inhaled-nitric-oxide-and-the-risk-of-renal-dysfunction-in-patients-with-acute-respiratory-distress-syndrome-a-propensity-matched-cohort-study
#4
Sheng-Yuan Ruan, Hon-Yen Wu, Hsien-Ho Lin, Huey-Dong Wu, Chong-Jen Yu, Mei-Shu Lai
BACKGROUND: Inhaled nitric oxide (iNO) is a rescue therapy for severe hypoxemia in patients with acute respiratory distress syndrome (ARDS). Pooled data from clinical trials have signaled a renal safety warning for iNO therapy, but the significance of these findings in daily clinical practice is unclear. We used primary data to evaluate the risk of iNO-associated renal dysfunction in patients with ARDS. METHODS: We conducted a cohort study using data from a tertiary teaching hospital to evaluate the risk of incident renal replacement therapy (RRT) in iNO users compared with that of non-users...
November 30, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27893673/risk-factor-and-outcome-for-intra-abdominal-bleeding-in-patients-with-enterocutaneous-fistula
#5
Lei Wu, Jianan Ren, Qinjie Liu, Gefei Wang, Xiuwen Wu, Guosheng Gu, Guanwei Li, Kun Guo, Zhiwu Hong, Qiongyuan Hu, Huajian Ren, Jieshou Li
Intra-abdominal bleeding is a major and lethal complication in patients with enterocutaneous fistula (ECF) while few studies are involved in this aspect. In the present study, we aimed to investigate the risk factors and assessed the outcome for intra-abdominal bleeding in patients with ECF.A retrospective study was performed from October 2013 to October 2015. Medical records of 67 ECF patients with intra-abdominal bleeding and 134 ECF patients without intra-abdominal bleeding matched as controls were reviewed and analyzed...
November 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27886617/transcatheter-versus-surgical-aortic-valve-replacement-in-low-to-intermediate-risk-patients-a-meta-analysis-of-randomized-and-observational-studies
#6
Yijiang Zhou, Yanwei Wang, Yutao Wu, Jianhua Zhu
BACKGROUND: Transcatheter aortic valve replacement (TAVR) has become the treatment of choice for patients with aortic stenosis and the preferred alternative for high surgical risk patients. However, TAVR's suitability for patients at low to intermediate risk still remains controversial. METHODS: PubMed, MEDLINE and Clinical trials were systematically searched for randomized control trials and observational cohort studies which reported the clinical outcomes of TAVR versus surgical aortic valve replacement (SAVR) in patients at low to intermediate surgical risk...
November 12, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27884597/prediction-of-competing-mortality-for-decision-making-between-surgery-or-observation-in-elderly-patients-with-t1-kidney-cancer
#7
Alessandro Larcher, Vincent Trudeau, Paolo Dell'Oglio, Zhe Tian, Katharina Boehm, Nicola Fossati, Umberto Capitanio, Alberto Briganti, Francesco Montorsi, Pierre Karakiewicz
OBJECTIVES: To predict of the risk of cancer-specific [CSM] or other-cause mortality [OCM] for T1 kidney cancer patients aiming at identifying those who would benefit from surgery over observation. PATIENTS AND METHODS: 11,192 T1 kidney cancer patients treated with surgery or observation in the SEER-Medicare database were assessed. A competing risk regression [CRR] model was fitted to predict CSM and OCM after surgery or observation. Covariates consisted of age, gender, race, Charlson comorbidity index [CCI], history of acute kidney injury [AKI] or chronic kidney disease [CKD], tumour size and year of diagnosis...
November 21, 2016: Urology
https://www.readbyqxmd.com/read/27876521/increased-risk-of-renal-dysfunction-with-percutaneous-mechanical-thrombectomy-compared-with-catheter-directed-thrombolysis
#8
Katherine L Morrow, Ann H Kim, Steven A Plato, Andrew J Shevitz, Jerry Goldstone, Henry Baele, Vikram S Kashyap
OBJECTIVE: Percutaneous mechanical thrombectomy (PMT) is regularly used in the treatment of both venous and arterial thrombosis. Although there has been no formal report, PMT has been linked to cases of reversible postoperative acute kidney injury (AKI). The purpose of this study is to evaluate the risk of renal dysfunction in patients undergoing PMT vs catheter-directed thrombolysis (CDT) for treatment of an acute thrombus. METHODS: This study is a retrospective review of all patients in a single institution with a Current Procedural Terminology code for PMT or CDT from January 2009 through December 2014...
November 19, 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27875774/risk-factors-for-acute-kidney-injury-in-critically-ill-patients-with-complicated-intra-abdominal-infection
#9
Alejandro Suarez-de-la-Rica, Víctor Anillo, Ana Montero, Carmen Hernandez-Gancedo, Araceli Lopez-Tofiño, Fernando Gilsanz, Emilio Maseda
PURPOSE: The aim was to determine the factors related to acute kidney injury (AKI) in surgical septic patients with complicated intra-abdominal infection (CIAI) and mortality associated to AKI. METHODS: An observational study was performed in patients with CIAI requiring surgery and ICU admission (June 2011-June 2013). Factors at admission associated with developing of AKI and renal replacement therapy (RRT) and association between mortality and AKI and RRT were studied...
November 9, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/27865637/increased-risk-of-mortality-after-lower-extremity-bypass-in-individuals-with-acute-kidney-injury-in-the-vascular-quality-initiative
#10
Erica Flores, Juan Pablo Lewinger, Vincent L Rowe, Karen Woo, Fred A Weaver, David Shavelle, Leonardo Clavijo, Parveen K Garg
OBJECTIVE: The development of acute kidney injury (AKI) and its effect on prognosis after lower extremity bypass (LEB) surgery have not been well described. We determined risk factors associated with AKI in patients undergoing infrainguinal LEB surgery and whether individuals with AKI are at increased risk for cardiovascular events and mortality. METHODS: Data for 12,907 operations entered in the Vascular Quality Initiative (VQI) registry from January 2012 through April 2015 were retrospectively reviewed...
November 16, 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27863270/fluid-resuscitation-mediates-the-association-between-inhalational-burn-injury-and-acute-kidney-injury-in-the-major-burn-population
#11
Avinash B Kumar, William Andrews, Yaping Shi, Matthew S Shotwell, Scott Dennis, Jonathan Wanderer, Blair Summitt
BACKGROUND: It is known that acute respiratory distress syndrome and acute lung injury are independent risk factors for developing acute kidney injury (AKI) through complex pathophysiologic mechanisms. Our specific aim is to evaluate the risk factors for AKI postburn injury and whether inhalation thermal injury is an independent risk factor for developing AKI in the major burn population. METHODS: This is an institutional review board-approved, retrospective cohort study of patients admitted to a tertiary burn intensive care unit between 2011 and 2013...
October 19, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/27856153/acute-kidney-injury-after-cardiac-surgery-by-complete-kdigo-criteria-predicts-increased-mortality
#12
Liisa Petäjä, Suvi Vaara, Sasu Liuhanen, Raili Suojaranta-Ylinen, Leena Mildh, Sara Nisula, Anna-Maija Korhonen, Kirsi-Maija Kaukonen, Markku Salmenperä, Ville Pettilä
OBJECTIVES: Acute kidney injury (AKI) occurs frequently after cardiac surgery and is associated with increased mortality. The Kidney Disease: Improving Global Outcomes (KDIGO) criteria for diagnosing AKI include creatinine and urine output values. However, the value of the latter is debated. The authors aimed to evaluate the incidence of AKI after cardiac surgery and the independent association of KDIGO criteria, especially the urine output criterion, and 2.5-year mortality. DESIGN: Prospective, observational, cohort study...
August 26, 2016: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/27856091/a-clinical-risk-prediction-tool-for-6-month-mortality-after-dialysis-initiation-among-older-adults
#13
James P Wick, Tanvir C Turin, Peter D Faris, Jennifer M MacRae, Robert G Weaver, Marcello Tonelli, Braden J Manns, Brenda R Hemmelgarn
BACKGROUND: Information on an individual's risk for death following dialysis therapy initiation may inform the decision to initiate maintenance dialysis for older adults. We derived and validated a clinical risk prediction tool for all-cause mortality among older adults during the first 6 months of maintenance dialysis treatment. STUDY DESIGN: Prediction model using retrospective administrative and clinical data. SETTING & PARTICIPANTS: We linked administrative and clinical data to define a cohort of 2,199 older adults (age ≥ 65 years) in Alberta, Canada, who initiated maintenance dialysis therapy (excluding acute kidney injury) in May 2003 to March 2012...
November 14, 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/27854517/acute-kidney-injury-as-a-risk-factor-for-delirium-and-coma-during-critical-illness
#14
Edward D Siew, William H Fissell, Christina M Tripp, Jeffrey D Blume, Matthew D Wilson, Amanda J Clark, Andrew J Vincz, E Wesley Ely, Pratik P Pandharipande, Timothy D Girard
RATIONALE: Acute kidney injury may contribute to distant organ dysfunction. Few studies have examined kidney injury as a risk factor for delirium and coma. OBJECTIVE: To examine whether acute kidney injury is associated with delirium and coma in critically ill adults. METHODS: In a prospective cohort study of ICU patients with respiratory failure and/or shock, we examined the association between acute kidney injury and daily mental status using multinomial transition models adjusting for demographics, non-renal organ failure, sepsis, prior mental status, and sedative exposure...
November 17, 2016: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/27852590/development-and-validation-of-a-risk-score-for-prediction-of-acute-kidney-injury-in-patients-with-acute-decompensated-heart-failure-a%C3%A2-prospective-cohort-study-in-china
#15
Li Zhi Zhou, Xiao Bing Yang, Ying Guan, Xing Xu, Ming T Tan, Fan Fan Hou, Ping Yan Chen
BACKGROUND: Although several risk factors for acute kidney injury (AKI) have been identified, early detection of AKI in acute decompensated heart failure patients remains a challenge. The aim of this study was to develop and validate a risk score for early prediction of AKI in acute decompensated heart failure patients. METHODS AND RESULTS: A total of 676 consecutive acute decompensated heart failure participants were prospectively enrolled from 6 regional central hospitals...
November 16, 2016: Journal of the American Heart Association
https://www.readbyqxmd.com/read/27832559/balancing-the-risks-and-benefits-of-using-emergency-diagnostic-radiocontrast-studies-to-diagnose-life-threatening-illness-in-critically-ill-patients-a-decision-analysis
#16
K M Ho
Diagnosis of many life-threatening illnesses, including acute pulmonary embolism, aortic dissection, and ischaemic bowel disease, requires confirmatory radiological imaging with radiocontrast. It is well established that radiocontrast can induce acute kidney injury, especially in patients with pre-existing renal impairment. The decision to proceed with a radiological study with radiocontrast to confirm or exclude a life-threatening, but potentially reversible, illness in patients with renal impairment is difficult...
November 2016: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/27832187/risk-factors-for-acute-kidney-injury-after-congenital-cardiac-surgery-in-infants-and-children-a-retrospective-observational-study
#17
Sun-Kyung Park, Min Hur, Eunhee Kim, Won Ho Kim, Jung Bo Park, Youngwon Kim, Ji-Hyuk Yang, Tae-Gook Jun, Chung Su Kim
Acute kidney injury (AKI) after pediatric cardiac surgery is associated with high morbidity and mortality. Modifiable risk factors for postoperative AKI including perioperative anesthesia-related parameters were assessed. The authors conducted a single-center, retrospective cohort study of 220 patients (aged 10 days to 19 years) who underwent congenital cardiac surgery between January and December 2012. The incidence of AKI within 7 days postoperatively was determined using the Kidney Disease: Improving Global Outcomes (KDIGO) criteria...
2016: PloS One
https://www.readbyqxmd.com/read/27831955/ce-preventing-contrast-induced-acute-kidney-injury
#18
Yvonne Gallegos, Asma Ali Taha, Dana N Rutledge
: Diagnostic radiographic imaging scans using intravascular iodinated contrast media can lead to various complications. The most salient of these is contrast-induced acute kidney injury (CI-AKI) or contrast-induced nephropathy, a potentially costly and serious patient safety concern. Prevention strategies are the cornerstone of evidence-based clinical management for patients receiving contrast agents. These include preprocedure screening, stratification of patients based on risk factors, and protective interventions, the most important of which is hydration both before and after the radiographic imaging scan...
December 2016: American Journal of Nursing
https://www.readbyqxmd.com/read/27821641/effects-of-ischaemic-conditioning-on-major-clinical-outcomes-in-people-undergoing-invasive-procedures-systematic-review-and-meta-analysis
#19
Louisa Sukkar, Daqing Hong, Muh Geot Wong, Sunil V Badve, Kris Rogers, Vlado Perkovic, Michael Walsh, Xueqing Yu, Graham S Hillis, Martin Gallagher, Meg Jardine
OBJECTIVE:  To summarise the benefits and harms of ischaemic conditioning on major clinical outcomes in various settings. DESIGN:  Systematic review and meta-analysis. DATA SOURCES:  Medline, Embase, Cochrane databases, and International Clinical Trials Registry platform from inception through October 2015. STUDY SELECTION:  All randomised controlled comparisons of the effect of ischaemic conditioning on clinical outcomes were included...
November 7, 2016: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/27821094/outcomes-risk-factors-and-health-burden-of-contrast-induced-acute-kidney-injury-an-observational-study-of-one-million-hospitalizations-with-image-guided-cardiovascular-procedures
#20
Pierre Aubry, Georges Brillet, Laura Catella, Aurélie Schmidt, Stève Bénard
BACKGROUND: Despite the use of low-osmolar contrast media that have significantly reduced the occurrence of severe adverse reactions, contrast-induced (CI) acute kidney injury (AKI) remains the third cause of AKI in hospitals. We sought to estimate the frequency of CI-AKI among hospitalized patients undergoing image-guided cardiovascular procedures, to quantify the effect of risk factors on the development of this complication and to assess relative organizational and economic burden in healthcare...
November 8, 2016: BMC Nephrology
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