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Renal Replacement Therapy in AKI

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https://www.readbyqxmd.com/read/28898482/impact-of-renal-replacement-therapy-on-survival-in-patients-with-kdigo-stage-3-acute-kidney-injury-a-propensity-score-matched-analysis
#1
Hoi-Ping Shum, King-Chung Chan, Catherine Wing-Yan Tam, Wing-Wa Yan, Tak Mao Chan
PURPOSE: To investigate the impact of renal replacement therapy (RRT) on 90-day mortality in critically ill patients suffering from KDIGO stage 3 acute kidney injury (AKI) with or without life-threatening complications using propensity score matching analysis. MATERIAL AND METHODS: We conducted a retrospective analysis of critically ill adult patients with KDIGO Stage 3 AKI with or without RRT during ICU stay between 1/1/2011-31/12/2013. Cox regression analysis and propensity score matching methods were used to determine predictors for 90-day mortality...
September 12, 2017: Nephrology
https://www.readbyqxmd.com/read/28893780/pharmacokinetic-toxicodynamic-analysis-of-colistin-associated-acute-kidney-injury-in-critically-ill-patients
#2
Alan Forrest, Samira M Garonzik, Visanu Thamlikitkul, Evangelos J Giamarellos-Bourboulis, David L Paterson, Jian Li, Fernanda P Silveira, Roger L Nation
Acute kidney injury (AKI) occurs in a substantial proportion of critically ill patients receiving intravenous colistin. In the pharmacokinetic/toxicodynamic analysis reported here the relationship of occurrence of AKI with exposure to colistin and a number of potential patient factors was explored in 153 critically ill patients, none of whom were receiving renal replacement therapy. Tree-based modelling revealed that rates of AKI were substantially higher when average steady-state plasma colistin concentration was greater than ∼2mg/L...
September 11, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28878224/mild-intracellular-acidification-by-dexamethasone-attenuates-mitochondrial-dysfunction-in-a-human-inflammatory-proximal-tubule-epithelial-cell-model
#3
T J J Schirris, J Jansen, M Mihajlovic, L P van den Heuvel, R Masereeuw, F G M Russel
Septic acute kidney injury (AKI) associates with poor survival rates and often requires renal replacement therapy. Glucocorticoids may pose renal protective effects in sepsis via stimulation of mitochondrial function. Therefore, we studied the mitochondrial effects of dexamethasone in an experimental inflammatory proximal tubule epithelial cell model. Treatment of human proximal tubule epithelial cells with lipopolysaccharide (LPS) closely resembles pathophysiological processes during endotoxaemia, and led to increased cytokine excretion rates and cellular reactive oxygen species levels, combined with a reduced mitochondrial membrane potential and respiratory capacity...
September 6, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28869251/cardiac-surgery-associated-acute-kidney-injury-risk-factors-pathophysiology-and-treatment
#4
REVIEW
Ying Wang, Rinaldo Bellomo
Cardiac surgery-associated acute kidney injury (CSA-AKI) is the most common clinically important complication in adult patients undergoing open heart surgery, and is associated with increased mortality and morbidity. In patients in intensive care units, CSA-AKI is the second most common type of AKI after septic AKI. In this Review, we explore the definition of CSA-AKI, discuss its epidemiology and identify its risk factors. We discuss current theories of the pathophysiology of CSA-AKI and describe its clinical course...
September 4, 2017: Nature Reviews. Nephrology
https://www.readbyqxmd.com/read/28868069/urinary-neutrophil-gelatinase-associated-lipocalin-as-a-predictor-of-acute-kidney-injury-severe-kidney-injury-and-the-need-for-renal-replacement-therapy-in-the-intensive-care-unit
#5
Fatma I Albeladi, Haifa M Algethamy
BACKGROUND: Recent attempts were made to identify early indicators of acute kidney injury (AKI) in order to accelerate treatment and hopefully improve outcomes. This study aims to assess the value of urinary neutrophil gelatinase-associated lipocalin (uNGAL) as a predictor of AKI, severe AKI, and the need for renal replacement therapy (RRT). METHODS: We conducted a prospective study and included adults admitted to our intensive care unit (ICU) at King Abdulaziz University Hospital (KAUH), between May 2012 and June 2013, who had at least 1 major risk factor for AKI...
May 2017: Nephron Extra
https://www.readbyqxmd.com/read/28861420/balanced-versus-isotonic-saline-resuscitation-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials-in-operation-rooms-and-intensive-care-units
#6
Ary Serpa Neto, Ignacio Martin Loeches, Robert B Klanderman, Raphael Freitas Silva, Marcelo Gama de Abreu, Paolo Pelosi, Marcus J Schultz
BACKGROUND: Fluid resuscitation is the cornerstone in treatment of shock, and intravenous fluid administration is the most frequent intervention in operation rooms and intensive care units (ICUs). The composition of fluids used for fluid resuscitation gained interest over the past decade, with recent focus on whether balanced solutions should be preferred over isotonic saline. METHODS: Systematic review and meta-analysis of randomized controlled trials (RCTs) comparing fluid resuscitation with a balanced solution versus isotonic saline in adult patients in operation room or ICUs...
August 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28858859/independent-risk-factors-and-2-year-outcomes-of-acute-kidney-injury-after-surgery-for-congenital-heart-disease
#7
Daishi Hirano, Akira Ito, Akifumi Yamada, Daisuke Kakegawa, Saori Miwa, Chisato Umeda, Kosuke Chiba, Yoichi Takemasa, Ai Tokunaga, Hiroyuki Ida
BACKGROUND: Data are limited regarding risk factors for acute kidney injury (AKI) following cardiac surgery in children with congenital heart disease (CHD). This observational study was performed to examine temporal trends in AKI incidence according to the Pediatric Risk, Injury, Failure, Loss, End-Stage Renal Disease (pRIFLE) criteria, identify independent risk factors for AKI after cardiac surgery, and examine associations between AKI and long-term mortality. METHODS: We retrospectively evaluated 418 patients (259 males, 159 females; median age, 5 months) who underwent cardiac surgery for CHD between April 2007 and August 2013...
September 1, 2017: American Journal of Nephrology
https://www.readbyqxmd.com/read/28857811/biomarker-guided-intervention-to-prevent-acute-kidney-injury-after-major-surgery-the-prospective-randomized-bigpak-study
#8
Ivan Göcze, Dominik Jauch, Markus Götz, Pascal Kennedy, Bettina Jung, Florian Zeman, Carsten Gnewuch, Bernhard M Graf, Wolfgang Gnann, Bernhard Banas, Thomas Bein, Hans J Schlitt, Tobias Bergler
OBJECTIVE: To determine the impact of renal biomarker-guided implementation of the Kidney Disease Improving Global Outcomes (KDIGO) care bundle on the incidence of acute kidney injury (AKI) after major noncardiac surgery in a single-center unblinded randomized clinical trial. BACKGROUND: Early optimization of volume status and discontinuation of nephrotoxic medication before the occurrence of AKI may be the crucial step to reduce preventable AKI. METHODS: The urinary biomarker-triggered KDIGO care bundle (early optimization of fluid status, maintenance of perfusion pressure, discontinuation of nephrotoxic agents) was compared to standard intensive care unit (ICU) care in 121 patients with an increased AKI risk after major abdominal surgery that was determined by urinary biomarker (inhibitor of metalloproteinase-2 × insulin-like growth factor-binding protein 7) >0...
August 29, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28857121/assessment-of-plasma-endostatin-to-predict-acute-kidney-injury-in-critically-ill-patients
#9
J Mårtensson, S T Vaara, V Pettilä, T Ala-Kokko, S Karlsson, O Inkinen, A Uusaro, A Larsson, M Bell
BACKGROUND: We evaluated whether plasma endostatin predicts acute kidney injury (AKI), need for renal replacement therapy (RRT), or death. METHODS: Prospective, observational, multicenter study from 1 September 2011 to 1 February 2012 with data from 17 intensive care units (ICUs) in Finland. RESULTS: A total of 1112 patients were analyzed. We measured plasma endostatin within 2 h of ICU admission. Early AKI (KDIGO stage within 12 h of ICU admission) was found in 20% of the cohort, and 18% developed late AKI (KDIGO criteria > 12 h from ICU admission)...
August 31, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28843662/the-effect-of-early-renal-replacement-therapy-guided-by-plasma-neutrophil-gelatinase-associated-lipocalin-on-outcome-of-acute-kidney-injury-a-feasibility-study
#10
Nattachai Srisawat, Passisd Laoveeravat, Ploynapas Limphunudom, Nuttha Lumlertgul, Sadudee Peerapornratana, Khajohn Tiranathanagul, Paweena Susantitaphong, Kearkiat Praditpornsilpa, Kriang Tungsanga, Somchai Eiam-Ong
PURPOSE: The optimal time and the parameter utilized for decision to initiate renal replacement therapy (RRT) in acute kidney injury (AKI) are still controversial. Recently, high levels of plasma NGAL (pNGAL) has been strongly correlated with poor AKI outcome. This is a feasibility study conducted to test whether early RRT initiation guided by pNGAL could improve AKI outcome. MATERIAL AND METHODS: The study comprised of triage trial and interventional trial running subsequently...
August 18, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28817669/the-association-between-renal-recovery-after-acute-kidney-injury-and-long-term-mortality-after-transcatheter-aortic-valve-replacement
#11
Charat Thongprayoon, Wisit Cheungpasitporn, Narat Srivali, Wonngarm Kittanamongkolchai, Ankit Sakhuja, Kevin L Greason, Kianoush B Kashani
BACKGROUND: This study aimed to examine the association between renal recovery status at hospital discharge after acute kidney injury (AKI) and long-term mortality following transcatheter aortic valve replacement (TAVR). METHODS: We screened all adult patients who survived to hospital discharge after TAVR for aortic stenosis at a quaternary referral medical center from January 1, 2008, through June 30, 2014. An AKI was defined as an increase in serum creatinine level of 0...
2017: PloS One
https://www.readbyqxmd.com/read/28813470/comparison-of-macrophage-migration-inhibitory-factor-and-neutrophil-gelatinase-associated-lipocalin-2-to-predict-acute-kidney-injury-after-liver-transplantation-an-observational-pilot-study
#12
Joanna Baron-Stefaniak, Judith Schiefer, Edmund J Miller, Gabriela A Berlakovich, David M Baron, Peter Faybik
INTRODUCTION: Several biomarkers have been suggested as early predictors of acute kidney injury (AKI) after orthotopic liver transplantation (OLT). Neutrophil gelatinase-associated lipocalin-2 (NGAL) appears to be a promising predictor of AKI after OLT, but the clinical benefit remains to be proven. Recently, systemic macrophage migration inhibitory factor (MIF) has been proposed as early indicator for requirement of renal replacement therapy after OLT. The aim of this prospective, observational pilot study was to compare the predictive values of serum and urinary MIF for severe AKI after OLT to those of serum and urinary NGAL...
2017: PloS One
https://www.readbyqxmd.com/read/28803772/perioperative-statins-do-not-prevent-acute-kidney-injury-after-cardiac-surgery-a-meta-analysis-of-randomized-controlled-trials
#13
Bing-Cheng Zhao, Pu Shen, Ke-Xuan Liu
OBJECTIVES: To evaluate whether perioperative statins reduce the risk of acute kidney injury (AKI) after cardiac surgery. DESIGN: Systematic review and meta-analysis of randomized trials. SETTING: Perioperative management in hospitals that perform cardiac surgery. PARTICIPANTS: Adult patients undergoing cardiac surgery. INTERVENTIONS: PubMed, EMBASE, and the Cochrane Library databases were searched for randomized trials...
April 21, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28792165/acute-stylet-peritoneal-dialysis-in-acute-kidney-injury-the-soul-never-dies
#14
Amith Vijay Leon D'Souza, Nishad Raveendran, Rajendra Singh Tanwar, Piyush Kimmatkar, Pankaj Beniwal, Dhananjai Agarwal, Vinay Vinay
BACKGROUND: Acute Kidney Injury (AKI) has a significant mortality rate. In developing countries, mortality due to AKI is high due to lack of access to dialysis facilities and related cost. The main goal of International Society of Nephrology (ISN) 0 by 25 initiative is to eliminate deaths due to AKI. Peritoneal dialysis is an underutilized modality in such a scenario. The aim of this study was to look into effectiveness of starting Acute stylet Peritoneal Dialysis (PD) in a resource constraint settings...
July 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/28768271/long-term-outcomes-and-associated-risk-factors-of-post-hospitalization-dialysis-dependent-acute-kidney-injury-patients
#15
Ajay S Rathore, Tushar Chopra, Jennie Z Ma, Wenjun Xin, Emaad M Abdel-Rahman
BACKGROUND/AIMS: Acute kidney injury requiring dialysis (AKI-D) is associated with poor outcomes. Centers for Medicare and Medicaid Services have reversed their clarification allowing AKI-D patients to be dialyzed at outpatient dialysis units. Data assessing long-term outcomes of AKI-D patients and their predictors is needed to adopt guidelines to ensure adequate management. We assessed long-term outcomes and associated risk factors of AKI-D patients who survived 90 days post-hemodialysis (HD) initiation...
July 29, 2017: Nephron
https://www.readbyqxmd.com/read/28763874/-correlation-between-serum-uric-acid-level-and-acute-renal-injury-after-coronary-artery-bypass-grafting
#16
D Q Xu, J Du, Z Zheng, Y Tang, L Zou, Y H Zhang, H T Zhang
Objective: To evaluate whether early postoperative serum uric acid level can predict postoperative acute renal injury (AKI) among patients undergoing coronary artery bypass grafting (CABG). Methods: The study retrospectively enrolled 1 306 patients undergoing CABG in Fuwai Hospital between September 2012 and December 2013. The patients were divided into 5 groups by the concentrations of serum uric acid measured on the morning of the first postoperative day, and uric acid categories were as follow: less than 195 μmol/L (Q1 group, 262 cases), 195-236 μmol/L (Q2 group, 263 cases), 237-280 μmol/L (Q3 group, 260 cases), 281-336 μmol/L (Q4 group, 261 cases), more than 336 μmol/L (Q5 group, 260 cases)...
July 11, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28762237/aminoglycoside-impregnated-cement-spacer-precipitating-acute-kidney-injury-requiring-hemodialysis
#17
Sohail Abdul Salim, Jessica Everitt, Aaron Schwartz, Mohit Agarwal, Jorge Castenada, Tibor Fülöp, Luis A Juncos
The current standard of care for prosthetic joint infection includes two-stage arthroplasty, with antibiotic-impregnated cement spacers (ACS) utilized between the stages. We report a 75-year-old woman with previously normal renal function, who developed acute kidney injury (AKI) secondary to biopsy-proven acute tubular necrosis and acute interstitial nephritis after ACS placement containing tobramycin and vancomycin. Peak tobramycin level measured 25.3 mcg/mL, the highest value reported in the literature after ACS placement...
July 31, 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/28761770/extended-peritoneal-dialysis-and-renal-recovery-in-hiv-infected-patients-with-prolonged-aki-a-report-of-2-cases
#18
Donlawat Saengpanit, Pongpratch Puapatanakul, Piyaporn Towannang, Talerngsak Kanjanabuch
Peritoneal dialysis (PD) has recently been established as a treatment option for renal replacement therapy (RRT) in patients with acute kidney injury (AKI). Its efficacy in providing fluid and small solute removal has also been demonstrated in clinical trials and is equivalent to hemodialysis (HD). However, effect of RRT modality on renal recovery after AKI remains a controversy. Moreover, the setting of human immunodeficiency virus- (HIV-) infected patients with AKI requiring RRT makes the decision on RRT initiation and modality selection more complicated...
2017: Case Reports in Nephrology
https://www.readbyqxmd.com/read/28743566/mortality-prediction-in-patients-with-acute-kidney-injury-requiring-renal-replacement-therapy-after-cardiac-surgery
#19
Inga Skarupskienė, Dalia Adukauskienė, Jurgita Kuzminskienė, Laima Rimkutė, Vilma Balčiuvienė, Edita Žiginskienė, Vytautas Kuzminskis, Agnė Adukauskaitė, Daiva Pentiokinienė, Inga Arūnė Bumblytė
BACKGROUND AND OBJECTIVE: Acute kidney injury (AKI) is a common and potentially serious postoperative complication after cardiac surgery, and it remains a cause of major morbidity and mortality. The aim of our study was to assess the prognostic illness severity score and to estimate the significant risk factors for poor outcome of patients with AKI requiring renal replacement therapy (RRT) after cardiac surgery. MATERIALS AND METHODS: We retrospectively analyzed data of adult (>18 years) patients (n=111) who underwent open heart surgery and had developed AKI with need for RRT...
July 14, 2017: Medicina
https://www.readbyqxmd.com/read/28742776/venovenous-bypass-is-associated-with-a-lower-incidence-of-acute-kidney-injury-after-liver-transplantation-in-patients-with-compromised-pretransplant-renal-function
#20
Kai Sun, Fu Hong, Yun Wang, Vatche G Agopian, Min Yan, Ronald W Busuttil, Randolph H Steadman, Victor W Xia
BACKGROUND: Although the hemodynamic benefits of venovenous bypass (VVB) during liver transplantation (LT) are well appreciated, the impact of VVB on posttransplant renal function is uncertain. The aim of this study was to determine if VVB was associated with a lower incidence of posttransplant acute kidney injury (AKI). METHODS: Medical records of adult (≥18 years) patients who underwent primary LT between 2004 and 2014 at a tertiary hospital were reviewed. Patients who required pretransplant renal replacement therapy and intraoperative piggyback technique were excluded...
July 21, 2017: Anesthesia and Analgesia
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