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Risk Assessment of Acute Kidney Injury

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https://www.readbyqxmd.com/read/29149864/kinetic-estimated-glomerular-filtration-rate-in-critically-ill-patients-beyond-the-acute-kidney-injury-severity-classification-system
#1
Flávio de Oliveira Marques, Saulo Aires Oliveira, Priscila Ferreira de Lima E Souza, Wandervânia Gomes Nojoza, Maiara da Silva Sena, Taynara Muniz Ferreira, Bruno Gabriele Costa, Alexandre Braga Libório
BACKGROUND: Although significant advances have been achieved in acute kidney injury (AKI) research following its classification, potential pitfalls can be identified in clinical practice. The nonsteady-state (kinetic) estimated glomerular filtration rate (KeGFR) could add clinical and prognostic information in critically ill patients beyond the current AKI classification system. METHODS: This was a retrospective analysis using data from the Multiparameter Intelligent Monitoring in Intensive Care II project...
November 18, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29149189/perioperative-body-weight-change-is-associated-with-in-hospital-mortality-in-cardiac-surgical-patients-with-postoperative-acute-kidney-injury
#2
Chih-Chung Shiao, Ya-Ting Huang, Tai-Shuan Lai, Tao-Min Huang, Jian-Jhong Wang, Chun-Te Huang, Pei-Chen Wu, Che-Hsiung Wu, I-Jung Tsai, Li-Jung Tseng, Chih-Hsien Wang, Tzong-Shinn Chu, Kwan-Dun Wu, Vin-Cent Wu
BACKGROUND: Postoperative acute kidney injury (AKI) is common following cardiac surgery (CS). Body weight (BW) may be an amenable variable by representing the summation of the nutritional and the fluid status. However, the predictive role of perioperative BW changes in CS patients with severe postoperative AKI is never explored. This study aimed to evaluate this association. METHODS: This study was conducted using a prospectively collected multicenter cohort, NSARF (National Taiwan University Hospital Study Group on Acute Renal Failure) database...
2017: PloS One
https://www.readbyqxmd.com/read/29148021/routine-adoption-of-timp2-and-igfbp7-biomarkers-in-cardiac-surgery-for-early-identification-of-acute-kidney-injury
#3
Chiara Levante, Fiorenza Ferrari, Chiara Manenti, Faeq Husain-Syed, Marta Scarpa, Tommaso Hinna Danesi, Massimo De Cal, Valentina Corradi, Grazia M Virzì, Alessandra Brendolan, Federico Nalesso, Pércia Bezerra, Salvador Lopez-Giacoman, Sara Samoni, Mara Senzolo, Davide Giavarina, Loris Salvador, Raffaele Bonato, Silvia De Rosa, Enrico Rettore, Claudio Ronco
BACKGROUND AND PURPOSE: Acute Kidney Injury (AKI) is a severe complication affecting many hospitalized patients after cardiac surgery, with negative impacts on short- and long-term clinical outcomes and on healthcare costs. Recently, clinical interest has been aimed at defining and classifying AKI, identifying risk factors and developing diagnostic strategies to identify patients at risk early on. Achieving an early and accurate diagnosis of AKI is a crucial issue, because prevention and timely detection may help to prevent negative clinical outcomes and avoid AKI-associated costs...
November 16, 2017: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/29147470/retrospective-analysis-of-inferior-vena-cava-collapsibility-with-point-of-care-ultrasound-and-urine-sodium-and-fena-in-patients-with-early-stage-acute-kidney-injury
#4
Faizan Babar, Gurkeerat Singh, Mustafa Noor, Bruce Sabath
Early stage acute kidney injury (AKI) is an independent risk factor for an increase in mortality. Accurate assessment of volume status is a major challenge during the early stages of acute renal injury. Determining volume status based on the history and physical exam lacks accuracy. Urine sodium and free excretion of sodium (FENa) provide objective evidence of intravascular volume status when interpreted carefully and is helpful to delineate prerenal from intrinsic renal failure. In recent years point of care ultrasound has been used to assess volume status...
2017: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/29145723/statin-initiation-and-renal-outcomes-following-isolated-coronary-artery-bypass-grafting-a-meta-analysis
#5
Yushu Wang, Sui Zhu, Rongsheng DU, Juteng Zhou, Yucheng Chen, Qing Zhang
BACKGROUND: The effects of preoperative statin therapy (PST) on renal outcomes in patients with isolated coronary artery bypass grafting (CABG) are in controversial. This study aimed to assess the effects of preoperative statin use on postoperative renal outcomes in patients undergoing isolated CABG. METHODS: PubMed, EMBASE, and Cochrane Library were searched for studies published up to February 2017. Pooled odds ratio (OR) and its corresponding 95% confidence interval (95% CI) were calculated...
November 16, 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/29142987/prospective-study-of-routine-heparin-avoidance-hemodialysis-in-a-tertiary-acute-care-inpatient-practice
#6
Sami Safadi, Robert C Albright, John J Dillon, Amy W Williams, Fares Alahdab, Julie K Brown, Amanda L Severson, Walter K Kremers, Mary Ann Ryan, Marie C Hogan
Introduction: Extracorporeal circuit (EC) anticoagulation with heparin is a key advance in hemodialysis (HD), but anticoagulation is problematic in inpatients at risk of bleeding. We prospectively evaluated a heparin-avoidance HD protocol, clotting of the EC circuit (CEC), impact on dialysis efficiency, and associated risk factors in our acute care inpatients who required HD (January 17, 2014 to May 31, 2015). Methods: HD sessions without routine EC heparin were performed using airless dialysis tubing...
July 2017: KI Reports
https://www.readbyqxmd.com/read/29136619/risk-factor-analysis-for-aki-including-laboratory-indicators-a-nationwide-multicenter-study-of-hospitalized-patients
#7
Sasa Nie, Zhe Feng, Li Tang, Xiaolong Wang, Yani He, Jingai Fang, Suhua Li, Yibin Yang, Huijuan Mao, Jundong Jiao, Wenhu Liu, Ning Cao, Wenge Wang, Jifeng Sun, Fengmin Shao, Wenge Li, Qiang He, Hongli Jiang, Hongli Lin, Ping Fu, Xinzhou Zhang, Yinghong Liu, Yonggui Wu, ChunSheng Xi, Meng Liang, Zhijie Qu, Jun Zhu, Guangli Wu, Yali Zheng, Yu Na, Ying Li, Wei Li, Guangyan Cai, Xiangmei Chen
BACKGROUND/AIMS: Risk factor studies for acute kidney injury (AKI) in China are lacking, especially those regarding non-traditional risk factors, such as laboratory indicators. METHODS: All adult patients admitted to 38 tertiary and 22 secondary hospitals in China in any one month between July and December 2014 were surveyed. AKI patients were screened according to the Kidney Disease: Improving Global Outcomes' definition of AKI. Logistic regression was used to analyze the risk factors for AKI, and Cox regression was used to analyze the risk of in-hospital mortality for AKI patients; additionally, a propensity score analysis was used to reconfirm the risk factors among laboratory indicators for mortality...
October 24, 2017: Kidney & Blood Pressure Research
https://www.readbyqxmd.com/read/29128438/renin-angiotensin-system-blockers-and-statins-are-associated-with-lower-in-hospital-mortality-in-very-elderly-hypertensives
#8
Francesco Spannella, Federico Giulietti, Paolo Balietti, Guido Cocci, Laura Landi, Francesca Elena Lombardi, Elisabetta Borioni, Beatrice Bernardi, Giulia Rosettani, Valentina Bordoni, Riccardo Sarzani
OBJECTIVES: Cardiovascular diseases are mainly related to hypertension and dyslipidemia and increase with aging because of the larger time span for these risk factors to damage arterial blood vessels. The impact of cardiovascular drug therapy on outcomes in the very elderly hospitalized is still not well established. The aim of our study was to evaluate the associations between cardiovascular therapy and in-hospital mortality in very elderly hypertensives. DESIGN: Prospective observational study...
November 8, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/29126653/perioperative-levosimendan-in-cardiac-surgery-a-systematic-review-with-meta-analysis-and-trial-sequential-analysis
#9
Alessandro Putzu, Sara Clivio, Alessandro Belletti, Tiziano Cassina
BACKGROUND: Several studies suggested beneficial effects of perioperative levosimendan on postoperative outcome after cardiac surgery. However, three large randomized controlled trials (RCTs) have been recently published and presented neutral results. We performed a systematic review with meta-analysis and trial sequential analysis (TSA) to assess benefits and harms of perioperative levosimendan therapy in cardiac surgery. METHODS: Electronic databases were searched up to September 2017 for RCTs on preoperative levosimendan versus any type of control...
October 21, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/29119923/drug-induced-nephrotoxicity-pathogenic-mechanisms-biomarkers-and-prevention-strategies
#10
Jiaguo Huang, Huizi Wu
Overdosing of the drugs, drug-drug interaction or drug related adverse effects are the risk factors of drug-induced nephrotoxicity. Since the use of some nephrotoxic drugs is still unavoidable in clinic, to understand the pathogenic mechanisms of nephrotoxicity of these drugs is critical to decrease the incidence of kidney injury. Early detection of drug-induced nephrotoxicity and reduce the therapeutic side effects are still accessible approaches to avoid the end stage of renal failure. Therefore, the discovery or development of the early and accurate diagnostic biomarkers is an effective prevention strategy for drug-induced kidney impairment...
November 8, 2017: Current Drug Metabolism
https://www.readbyqxmd.com/read/29112081/predictors-prevalence-and-outcomes-of-early-crystalloid-responsiveness-among-initially-hypotensive-patients-with-sepsis-and-septic-shock
#11
Daniel E Leisman, Martin E Doerfler, Sandra M Schneider, Kevin D Masick, Jason A D'Amore, John K D'Angelo
OBJECTIVES: The prevalence of responsiveness to initial fluid challenge among hypotensive sepsis patients is unclear. To avoid fluid overload, and unnecessary treatment, it is important to differentiate these phenotypes. We aimed to 1) determine the proportion of hypotensive sepsis patients sustaining favorable hemodynamic response after initial fluid challenge, 2) determine demographic and clinical risk factors that predicted refractory hypotension, and 3) assess the association between timeliness of fluid resuscitation and refractoriness...
November 3, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/29110930/determinants-of-acute-kidney-injury-and-renal-function-decline-after-endovascular-abdominal-aortic-aneurysm-repair
#12
Randolph G Statius van Eps, Banne Nemeth, Ronne T A Mairuhu, Jan J Wever, Hugo T C Veger, Hans van Overhagen, Lukas C van Dijk, Bob Knippenberg
OBJECTIVE/BACKGROUND: Endovascular aneurysm repair (EVAR) may be associated with renal injury and more insight is needed into potential risk factors. The aim was to identify clinical, anatomical, and peri-procedural parameters as potential risk factors for the occurrence of acute kidney injury (AKI) and to evaluate chronic kidney disease (CKD) after EVAR. METHODS: A cohort of 212 consecutive patients who underwent elective EVAR for abdominal aortic aneurysm from January 2009 to October 2016 was included...
October 27, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/29108311/remote-ischemic-conditioning-for-the-prevention-of-contrast-induced-acute-kidney-injury-in-patients-undergoing-intravascular-contrast-administration-a-meta-analysis-and-trial-sequential-analysis-of-16-randomized-controlled-trials
#13
Chang-Cheng Zhou, Wen-Tao Yao, Yu-Zheng Ge, Lu-Wei Xu, Ran Wu, Xiao-Fei Gao, Kai-Wei Song, Xiao-Min Jiang, Min Wang, Wen-Juan Huang, Yun-Peng Zhu, Liang-Peng Li, Liu-Hua Zhou, Zhong-Le Xu, Sheng-Li Zhang, Jia-Geng Zhu, Wen-Cheng Li, Rui-Peng Jia
Objective: We conducted this meta-analysis to examine the effect of remote ischemic conditioning (RIC) on contrast-induced acute kidney injury (CI-AKI) in patients undergoing intravascular contrast administrationon. Methods: Pubmed, Embase, and Cochrane Library were comprehensively searched to identify all eligible studies by 15th March, 2017. Risk ratio (RR) and weighted mean difference with the corresponding 95% confidence intervals (CI) were used to examine the treatment effect...
October 3, 2017: Oncotarget
https://www.readbyqxmd.com/read/29098634/pre-and-postoperative-anemia-acute-kidney-injury-and-mortality-after-coronary-artery-bypass-grafting-surgery-a-retrospective-observational-study
#14
Adriana D Oprea, J Mauricio Del Rio, Mary Cooter, Cynthia L Green, Jörn A Karhausen, Patrick Nailer, Nicole R Guinn, Mihai V Podgoreanu, Mark Stafford-Smith, Jacob N Schroder, Manuel L Fontes, Miklos D Kertai
BACKGROUND: Preoperative and postoperative anemia have been identified individually as potential risk factors for postoperative complications after coronary artery bypass grafting (CABG) surgery. Their interrelationship with acute kidney injury (AKI) and long-term mortality, however, has not been clearly defined and was the purpose of this study. METHODS: We retrospectively evaluated 6,130 adult patients undergoing CABG surgery performed at a single large academic medical center...
November 2, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/29098438/acute-kidney-injury-in-patients-with-nephrotic-syndrome-undergoing-contrast-enhanced-ct-for-suspected-venous-thromboembolism-a-propensity-score-matched-retrospective-cohort-study
#15
Shu Min Tao, Xiang Kong, U Joseph Schoepf, Julian L Wichmann, Darby C Shuler, Chang Sheng Zhou, Guang Ming Lu, Long Jiang Zhang
OBJECTIVES: To determine whether intravenous iodinated contrast material administration increases the risk of acute kidney injury (AKI) in patients with nephrotic syndrome undergoing contrast-enhanced CT. METHODS: Patients with nephrotic syndrome undergoing contrast-enhanced CT were retrospectively identified (n = 701). Control group consisted of patients with nephrotic syndrome receiving non-contrast CT (n = 1053). Two different 1:1 propensity score matching models using three or 10 variables were developed for each estimated glomerular filtration (eGFR) subgroup...
November 2, 2017: European Radiology
https://www.readbyqxmd.com/read/29092921/contrast-induced-acute-kidney-injury-and-mortality-in-st-elevation-myocardial-infarction-treated-with-primary-percutaneous-coronary-intervention
#16
Johanne Silvain, Lee S Nguyen, Vincent Spagnoli, Mathieu Kerneis, Paul Guedeney, Nicolas Vignolles, Kristel Cosker, Olivier Barthelemy, Claude Le Feuvre, Gérard Helft, Jean-Philippe Collet, Gilles Montalescot
OBJECTIVES: Contrast-induced acute kidney injury (CI-AKI) is a common and potentially severe complication in patients with ST elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (pPCI). There is no consensus on the best definition of CI-AKI to identify patients at risk of haemodialysis or death. The objective of this study was to assess the association of CI-AKI, using four definitions, on inhospital mortality, mortality or haemodialysis requirement over 1-year follow-up, in patients with STEMI treated with pPCI...
November 1, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/29089137/ambient-temperature-and-hospital-admissions-for-acute-kidney-injury-a-time-series-analysis
#17
Youn-Hee Lim, Rina So, Choongho Lee, Yun-Chul Hong, Minseon Park, Logyoung Kim, Hyung-Jin Yoon
Some studies have suggested that high ambient temperatures are a risk factor for kidney-related diseases. However, none have examined the association between ambient temperature and acute kidney injury (AKI). This study aimed to examine the association between daily mean temperature and AKI and identify high-risk subgroups in this association. We obtained health insurance claim data from the Health Insurance Review and Assessment Service (HIRA) for 24,800 admitted cases of AKI during the period 2007-2014 in Seoul, Korea...
October 28, 2017: Science of the Total Environment
https://www.readbyqxmd.com/read/29074166/association-between-high-environmental-heat-and-risk-of-acute-kidney-injury-among-older-adults-in-a-northern-climate-a-matched-case-control-study
#18
Rebecca K McTavish, Lucie Richard, Eric McArthur, Salimah Z Shariff, Rey Acedillo, Chirag R Parikh, Ron Wald, Piotr Wilk, Amit X Garg
BACKGROUND: An association between high heat and acute kidney injury (AKI) has been reported in warm climates. However, whether this association generalizes to a northern climate, with more variable temperatures, is unknown. STUDY DESIGN: Matched case-control study. SETTING & PARTICIPANTS: Our study focused on older adults (mean age, 80 years) in the northern climate of Ontario, Canada. 52,913 case patients who had a hospital encounter with AKI in April through September 2005 to 2012 were matched with 174,222 controls for exact date, age, sex, rural residence, income, and history of chronic kidney disease...
October 23, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/29071091/the-use-of-the-renalguard-system-in-cardiac-surgery-with-cardiopulmonary-bypass-a-first-in-man-prospective-observational-feasibility-pilot-study
#19
Heyman Luckraz, Ramesh Giri, Benmjamin Wrigley, Anne-Marie Hennessy, Johann Nicholas, Alan Nevill
OBJECTIVES: As proof of concept, this prospective, observational study assessed the feasibility and early clinical outcomes of performing on-pump cardiac surgery with the RenalGuard system. BACKGROUND: Acute kidney injury (AKI) is reported in up to 30% of patients undergoing cardiac surgery and is a recognised independent predictor of both morbidity and mortality. Forced diuresis with the RenalGuard system reduces the incidence of AKI during percutaneous coronary intervention procedures but its use in cardiac surgery has not been explored...
2017: Open Heart
https://www.readbyqxmd.com/read/29069239/factors-associated-with-mortality-in-a-population-with-acute-kidney-injury-undergoing-hemodialysis-in-peru
#20
Percy Herrera-Añazco, Alvaro Taype-Rondan, Josmel Pacheco-Mendoza, J Jaime Miranda
INTRODUCTION: Patients with acute kidney injury (AKI) in developing countries are described in a profile of young age, with less comorbidities, with unifactorial, and with a lower mortality compared to patients in developed countries. OBJECTIVE: To assess mortality in patients with acute kidney injury undergoing hemodialysis (HD) and its associated factors in a developing country setting. METHODS: Retrospective study. Demographic, clinical, and mortality variables were collected from patients who presented AKI and underwent HD between January 2014 and December 2015 at a national reference hospital in Lima, Peru...
April 2017: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
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