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Risk Assessment of Acute Kidney Injury

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https://www.readbyqxmd.com/read/28225801/perioperative-hemoglobin-area-under-the-curve-is-an-independent-predictor-of-renal-failure-after-cardiac-surgery-results-from-a-spanish-multicenter-retrospective-cohort-study
#1
Paula Duque-Sosa, Diego Martínez-Urbistondo, Gemma Echarri, Raquel Callejas, María Josefa Iribarren, Gregorio Rábago, Pablo Monedero
Perioperative anemia is an important risk factor for cardiac surgery-associated acute kidney injury (CSA-AKI). Nonetheless, the severity of the anemia and the time in the perioperative period in which the hemoglobin level should be considered as a risk factor is conflicting. The present study introduces the concept of perioperative hemoglobin area under the curve (pHb-AUC) as a surrogate marker of the evolution of perioperative hemoglobin concentration. Through a retrospective analysis of prospectively collected data, we assessed this new variable as a risk factor for the development of acute kidney injury after cardiac surgery in 966 adult patients who underwent cardiac surgery with cardiopulmonary bypass, at twenty-three academic hospitals in Spain...
2017: PloS One
https://www.readbyqxmd.com/read/28224940/telemedicine-to-promote-patient-safety-use-of-phone-based-interactive-voice-response-system-to-reduce-adverse-safety-events-in-pre-dialysis-ckd
#2
REVIEW
Shoshana Weiner, Jeffery C Fink
CKD patients have several features conferring on them a high risk of adverse safety events, which are defined as incidents with unintended harm related to processes of care or medications. These characteristics include impaired kidney function, polypharmacy, and frequent health system encounters. The consequences of such events in CKD can include new or prolonged hospitalization, accelerated kidney function loss, acute kidney injury, ESRD, and death. Health information technology administered via telemedicine presents opportunities for CKD patients to remotely communicate safety-related findings to providers for the purpose of improving their care...
January 2017: Advances in Chronic Kidney Disease
https://www.readbyqxmd.com/read/28219918/clinical-outcomes-of-remote-ischemic-preconditioning-prior-to-cardiac-surgery-a-meta-analysis-of-randomized-controlled-trials
#3
REVIEW
Brian Pierce, Indra Bole, Vaiibhav Patel, David L Brown
BACKGROUND: Multiple randomized controlled trials of remote ischemic preconditioning (RIPC) prior to cardiac surgery have failed to demonstrate clinical benefit. The aim of this updated meta-analysis was to evaluate the effect of RIPC on outcomes following cardiac surgery. METHODS AND RESULTS: Searches of PubMed, Cochrane, EMBASE, and Web of Science databases were performed for 1970 to December 13, 2015. Randomized controlled trials comparing RIPC with a sham procedure prior to cardiac surgery performed with cardiopulmonary bypass were assessed...
February 20, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28218990/renal-function-at-one-year-after-cardiac-transplantion-rather-than-acute-kidney-injury-is-highly-associated-with-long-term-patient-survival-and-loss-of-renal-function
#4
Gijs Fortrie, Olivier C Manintveld, Alina A Constantinescu, Pieter C van de Woestijne, Michiel G H Betjes
BACKGROUND: The current study aims to assess the association between acute kidney injury (AKI), renal function one year after transplantation and long-term adverse outcomes after cardiac transplantation. METHODS: A retrospective cohort study was performed including 471 adult cardiac transplantation recipients that survived the first postoperative year between 1984 and 2012. Primary outcome variables were long-term overall and renal survival. RESULTS: During the first postoperative week 40% (n=288) of the recipients developed AKI stage I, 22% (n=104) stage II, 13% (n=63) stage III and 4% (n=17) required temporary RRT...
February 20, 2017: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/28218392/acute-kidney-injury-and-mortality-1-year-after-major-non-cardiac-surgery
#5
M E O'Connor, R W Hewson, C J Kirwan, G L Ackland, R M Pearse, J R Prowle
BACKGROUND: Even mild and transient acute kidney injury (AKI), defined by increases in serum creatinine level, has been associated with adverse outcomes after major surgery. However, characteristic decreases in creatinine concentration during major illness could confound accurate assessment of postoperative AKI. METHODS: In a single-hospital, retrospective cohort study of non-cardiac surgery, the association between postoperative AKI, defined using the Kidney Disease: Improving Global Outcomes criteria, and 1-year survival was modelled using a multivariable Cox proportional hazards analysis...
February 20, 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28216344/perioperative-outcome-of-endovascular-repair-for-complex-abdominal-aortic-aneurysms
#6
Klaas H J Ultee, Sara L Zettervall, Peter A Soden, Jeremy Darling, Hence J M Verhagen, Marc L Schermerhorn
BACKGROUND: As endovascular aneurysm repair (EVAR) continues to advance, eligibility of patients with anatomically complex abdominal aortic aneurysms (AAAs) for EVAR is increasing. However, whether complex EVAR is associated with favorable outcome over conventional open repair and how outcomes compare with infrarenal EVAR remains unclear. This study examined perioperative outcomes of patients undergoing complex EVAR, focusing on differences with complex open repair and standard infrarenal EVAR...
February 16, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28208118/validation-of-a-novel-monitoring-system-to-measure-contrast-volume-use-during-invasive-angiography
#7
Anand Prasad, Irma Scholler, Daniel Levin, Gus Banda, Christopher M Mullin, Steven R Bailey
BACKGROUND: Multiple studies have demonstrated the relationship between contrast volume (CV) and the risk of acute kidney injury (AKI). Quantification of total CV is often estimated and therefore may be inaccurate. We describe validation of a novel contrast monitoring system (CMS) (Osprey Medical), which is designed to detect and display injection by injection and total CV use on a monitor system in real time. METHODS: Thirty patients undergoing a coronary or peripheral angiogram were included...
February 15, 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/28202201/acute-kidney-injury-is-an-independent-risk-factor-for-myocardial-injury-after-noncardiac-surgery-in-critical-patients
#8
Xiu-Juan Zhao, Feng-Xue Zhu, Shu Li, Hong-Bin Zhang, You-Zhong An
BACKGROUND: Myocardial injury after noncardiac surgery (MINS) contributes to mortality and morbidity. However, risk factors accelerating its development remain unclear. The aim of this study was to identify the incidence and risk factors of MINS. METHODS: A retrospective and observational cohort study of critical patients (n=1087) after noncardiac surgery was carried out at a large and tertiary university hospital from January 2012 to January 2013. The clinical data including medical history as well as intraoperative and postoperative variables were recorded...
January 26, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28197679/contrast-associated-acute-kidney-injury-in-the-critically-ill-systematic-review-and-bayesian-meta-analysis
#9
Stephan Ehrmann, Andrew Quartin, Brian P Hobbs, Vincent Robert-Edan, Cynthia Cely, Cynthia Bell, Genevieve Lyons, Tai Pham, Roland Schein, Yimin Geng, Karim Lakhal, Chaan S Ng
PURPOSE: Critically ill patients, among whom acute kidney injury is common, are often considered particularly vulnerable to iodinated contrast medium nephrotoxicity. However, the attributable incidence remains uncertain given the paucity of observational studies including a control group. This study assessed acute kidney injury incidence attributable to iodinated contrast media in critically ill patients based on new data accounting for sample and effect size and including a control group...
February 14, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28197046/outcome-of-noncardiac-surgical-patients-admitted-to-a-multidisciplinary-intensive-care-unit
#10
Pradeep Kumar, M K Renuka, M S Kalaiselvan, A S Arunkumar
CONTEXT: Surgical procedures carry significant morbidity and mortality depending on the type of surgery and patients. There is a dearth of evidence from India on the outcome of surgical patients admitted to an Intensive Care Unit (ICU). AIMS: We aimed to describe the incidence and risk factors of postoperative complications and mortality in noncardiac surgical patients admitted to the ICU. SETTINGS AND DESIGN: This was a prospective observational study on all perioperative patients admitted to a multidisciplinary ICU for 18 months...
January 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28193259/acute-kidney-injury-increases-the-risk-of-end-stage-renal-disease-after-cardiac-surgery-in-an-asian-population-a-prospective-cohort-study
#11
Sophia Tsong Huey Chew, Roderica Rui Ge Ng, Weiling Liu, Khuan Yew Chow, Lian Kah Ti
BACKGROUND: Acute kidney injury (AKI) after cardiac surgery is associated with increased morbidity and mortality. The long-term association between AKI and end-stage renal disease (ESRD) in an Asian population is unknown. Given the high prevalence of diabetes and a younger age of presentation for cardiac surgery, it is important to track this progression of kidney disease. Therefore, we studied the long-term risk of ESRD and mortality in our Asian patients who developed AKI after cardiac surgery...
February 13, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28192452/increased-risk-of-dementia-in-patients-hospitalized-with-acute-kidney-injury-a-nationwide-population-based-cohort-study
#12
Hsin-Hsi Tsai, Ruoh-Fang Yen, Cheng-Li Lin, Chia-Hung Kao
PURPOSE: To determine whether acute kidney injury (AKI) is a risk factor for dementia. METHODS: This nationwide population-based cohort study was based on data from the Taiwan National Health Insurance Research Database for 2000-2011. The incidence and relative risk of dementia were assessed in 207788 patients hospitalized for AKI. The comparison control was selected using the propensity score based on age, sex, index year and comorbidities. RESULTS: During the 12-year follow-up, patients with AKI had a significantly higher incidence for developing dementia than did the controls (8...
2017: PloS One
https://www.readbyqxmd.com/read/28182801/acute-kidney-injury-in-patients-treated-with-vancomycin-and-piperacillin-tazobactam-a-retrospective-cohort-analysis
#13
W Cliff Rutter, Donna R Burgess, Jeffery C Talbert, David S Burgess
BACKGROUND: Empiric antimicrobial therapy often consists of the combination of gram-positive coverage with vancomycin (VAN) and gram-negative coverage, specifically an antipseudomonal beta-lactam such as piperacillin-tazobactam (PTZ). Nephrotoxicity is commonly associated with VAN therapy; however, recent reports show higher nephrotoxicity rates among patients treated with the combination of VAN and PTZ. OBJECTIVE: This study evaluated the effect of the VAN/PTZ combination on acute kidney injury (AKI) compared to VAN and PTZ monotherapies...
February 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28181125/different-trajectories-and-significance-of-b-type-natriuretic-peptide-congestion-and-acute-kidney-injury-in-patients-with-heart-failure
#14
Matteo Beltrami, Gaetano Ruocco, Aladino Ibrahim, Barbara Lucani, Beatrice Franci, Ranuccio Nuti, Alberto Palazzuoli
The exact relationship existing among congestion status, brain natriuretic peptide (BNP) changes and acute kidney injury (AKI) has not been elucidated in patients with acute heart failure (AHF). The aims of this study are: to investigate the relation and prognostic role of BNP, AKI and clinical congestion after discharge; to define the exact BNP cut off value or a BNP in-hospital reduction to identify patients with higher risk during vulnerable post-discharge phase. We consecutively enrolled 157 patients with a diagnosis of AHF...
February 8, 2017: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/28178929/latent-variable-modeling-improves-aki-risk-factor-identification-and-aki-prediction-compared-to-traditional-methods
#15
Loren E Smith, Derek K Smith, Jeffrey D Blume, Edward D Siew, Frederic T Billings
BACKGROUND: Acute kidney injury (AKI) is diagnosed based on postoperative serum creatinine change, but AKI models have not consistently performed well, in part due to the omission of clinically important but practically unmeasurable variables that affect creatinine. We hypothesized that a latent variable mixture model of postoperative serum creatinine change would partially account for these unmeasured factors and therefore increase power to identify risk factors of AKI and improve predictive accuracy...
February 8, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28143401/acute-kidney-injury-induces-high-sensitivity-troponin-measurement-changes-after-cardiac-surgery
#16
Amr S Omar, Khaled Mahmoud, Samy Hanoura, Hany Osman, Praveen Sivadasan, Suraj Sudarsanan, Yasser Shouman, Rajvir Singh, Abdulaziz AlKhulaifi
BACKGROUND: The value of cardiac troponin as a risk assessment tool for cardiac disease in the setting of end-stage renal diseases (ESRD) is not equivalent to its value in those with normal renal function. This consideration had not been studied in settings of acute kidney injury (AKI). We aim to explore the diagnostic value of high sensitive troponin T (hsTnT) in the settings of cardiac surgery-induced AKI. METHODS: Single center observational retrospective study...
January 31, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28142264/annals-express-neutrophil-gelatinase-associated-lipocalin-is-a-better-biomarker-than-cystatin-c-for-predicting-imminent-acute-kidney-injury-in-critically-ill-patients
#17
Itir Yegenaga, Fatih Kamis, Canan Baydemir, Elizade Erdem, Koray Celebi, Necmi Eren, Nur Baykara
AIMS: The prevention of acute kidney injury (AKI) can be lifesaving for intensive care unit (ICU) patients. However, conventional methods are not sufficient for predicting the risk for approaching AKI. In this study, the promising biomarker NGAL(neutrophil gelatinase-associated lipocalin) was compared to CysC (Cystatin C ) for indicating risk of future AKI. METHODS: One hundred eighty-three adult patients without chronic kidney disease or renal replacement therapy were included in this study...
January 1, 2017: Annals of Clinical Biochemistry
https://www.readbyqxmd.com/read/28142133/perioperative-hemodynamic-instability-and-fluid-overload-are-associated-with-increasing-acute-kidney-injury-severity-and-worse-outcome-after-cardiac-surgery
#18
Anja Haase-Fielitz, Michael Haase, Rinaldo Bellomo, Paolo Calzavacca, Anke Spura, Hassina Baraki, Ingo Kutschka, Christian Albert
PURPOSE: The study aimed to investigate patients' characteristics, fluid and hemodynamic management, and outcomes according to the severity of cardiac surgery-associated acute kidney injury (CSA-AKI). METHODS: In a single-center, prospective cohort study, we enrolled 282 adult cardiac surgical patients. In a secondary analysis, we assessed preoperative patients' characteristics, physiological variables, and medication for intra- and postoperative fluid and hemodynamic management and outcomes according to CSA-AKI stages by the Renal risk, Injury, Failure, Loss, End-stage renal disease (RIFLE) classification...
January 31, 2017: Blood Purification
https://www.readbyqxmd.com/read/28141912/high-volume-haemofiltration-for-sepsis-in-adults
#19
REVIEW
Emma Mj Borthwick, Christopher J Hill, Kannaiyan S Rabindranath, Alexander P Maxwell, Danny F McAuley, Bronagh Blackwood
BACKGROUND: Severe sepsis and septic shock are leading causes of death in the intensive care unit (ICU), despite advances in the treatment of patients with severe sepsis and septic shock, including early recognition, appropriate treatment with antibiotics and support of organs that may have been affected by the illness. High-volume haemofiltration (HVHF) is a blood purification technique that may improve outcomes in severe sepsis or septic shock. The technique of HVHF has evolved from renal replacement therapies used in the ICU to treat critically ill patients with acute kidney injury (AKI)...
January 31, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28138736/the-intensive-care-medicine-agenda-on-acute-kidney-injury
#20
REVIEW
Peter Pickkers, Marlies Ostermann, Michael Joannidis, Alexander Zarbock, Eric Hoste, Rinaldo Bellomo, John Prowle, Michael Darmon, Joseph V Bonventre, Lui Forni, Sean M Bagshaw, Miet Schetz
Acute kidney injury (AKI) is a common complication in the critically ill. Current standard of care mainly relies on identification of patients at risk, haemodynamic optimization, avoidance of nephrotoxicity and the use of renal replacement therapy (RRT) in established AKI. The detection of early biomarkers of renal tissue damage is a recent development that allows amending the late and insensitive diagnosis with current AKI criteria. Increasing evidence suggests that the consequences of an episode of AKI extend long beyond the acute hospitalization...
January 30, 2017: Intensive Care Medicine
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