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Renal Replacement Therapy in AKI

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https://www.readbyqxmd.com/read/29426053/-renal-replacement-therapy-in-acute-kidney-injury-indication-and-implementation
#1
Mira Küllmar, Alexander Zarbock
Acute kidney injury (AKI) is a common complication in critically ill patients and is associated with a worse short- and long-term outcome. The KDIGO (Kidney Disease: Improving Global Outcomes) guidelines suggest to implement preventive strategies in high-risk patients. Definition and classification of acute kidney injury according to the KDIGO criteria are based on an increase in serum creatinine and/or a decrease in urinary output. Renal replacement therapy (RRT) is the only supportive measure in patients with severe AKI...
February 2018: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/29423196/renal-recovery-after-severe-acute-kidney-injury-in-critically-ill-myeloma-patients-a-retrospective-study
#2
Adrien Joseph, Stephanie Harel, Marion Venot, Sandrine Valade, Eric Mariotte, Claire Pichereau, Akli Chermak, Lara Zafrani, Elie Azoulay, Emmanuel Canet
Background: Despite substantial improvements in the management of multiple myeloma, renal failure remains an important burden that tremendously impairs prognosis. The purpose of this study was to describe the characteristics and to establish prognostic factors of renal recovery in myeloma patients admitted to the intensive care unit (ICU) for acute kidney injury (AKI) Stage 3 treated with renal replacement therapy (RRT). Methods: A retrospective single-centre cohort study was performed, including consecutive myeloma patients admitted to one medical ICU between 1 January 2007 and 1 September 2015 and treated with RRT...
February 2018: Clinical Kidney Journal
https://www.readbyqxmd.com/read/29417731/super-high-flux-continuous-venovenous-hemodialysis-using-regional-citrate-anticoagulation-long-term-stability-of-middle-molecule-clearance
#3
Martin Siebeck, Thomas Dimski, Timo Brandenburger, Torsten Slowinski, Detlef Kindgen-Milles
Continuous renal replacement therapy is a standard treatment in critically ill patients with acute kidney injury. All CRRT techniques provide a high low-molecular weight clearance but even with hemofiltration, clearance of middle molecules is low. We investigated whether a new super high-flux hemofilter provides effective and sustained middle molecule clearance during citrate-anticoagulated continuous venovenous hemodialysis for up to 72 h. We included 14 critically ill patients with AKI-KDIGO-III in a prospective observational trial...
February 8, 2018: Therapeutic Apheresis and Dialysis
https://www.readbyqxmd.com/read/29415663/the-impact-of-disease-severity-on-paradoxical-association-between-body-mass-index-and-mortality-in-patients-with-acute-kidney-injury-undergoing-continuous-renal-replacement-therapy
#4
Hyoungnae Kim, Hyunwook Kim, Misol Lee, Min-Uk Cha, Ki Heon Nam, Seong Yeong An, Su-Young Jung, Jong Hyun Jhee, Seohyun Park, Hae-Ryong Yun, Youn Kyung Kee, Hyung Jung Oh, Jung Tak Park, Tae Ik Chang, Tae-Hyun Yoo, Shin-Wook Kang, Seung Hyeok Han
BACKGROUND: Association between high body mass index (BMI) and survival benefit is confounded by comorbid conditions such as nutritional status and inflammation. Patients with acute kidney injury (AKI), particularly those receiving continuous renal replacement therapy (CRRT), are highly catabolic and more susceptible to loss of energy. Herein, we evaluated whether disease severity can modify the relationship between BMI and mortality. METHODS: We conducted an observational study in 1144 patients who had undergone CRRT owing to various causes of AKI between 2010 and 2014...
February 7, 2018: BMC Nephrology
https://www.readbyqxmd.com/read/29415048/phosphate-is-a-potential-biomarker-of-disease-severity-and-predicts-adverse-outcomes-in-acute-kidney-injury-patients-undergoing-continuous-renal-replacement-therapy
#5
Su-Young Jung, Jaeyeol Kwon, Seohyun Park, Jong Hyun Jhee, Hae-Ryong Yun, HyoungNae Kim, Youn Kyung Kee, Chang-Yun Yoon, Tae-Ik Chang, Ea Wha Kang, Jung Tak Park, Tae-Hyun Yoo, Shin-Wook Kang, Seung Hyeok Han
Hyperphosphatemia is associated with mortality in patients with chronic kidney disease, and is common in critically ill patients with acute kidney injury (AKI); however, its clinical implication in these patients is unknown. We conducted an observational study in 1144 patients (mean age, 63.2 years; male, 705 [61.6%]) with AKI who received continuous renal replacement therapy (CRRT) between January 2009 and September 2016. Phosphate levels were measured before (0 h) and 24 h after CRRT initiation. We assessed disease severity using various clinical parameters...
2018: PloS One
https://www.readbyqxmd.com/read/29405672/acute-renal-replacement-therapy-in-patients-with-major-extremity-injuries
#6
Silvia DE Rosa, Gianluca Villa, Kenji Inaba, Sara Samoni, Claudio Ronco
INTRODUCTION: This narrative review will describe treatment options for patients in the ICU with major extremity injury requiring extracorporeal myoglobin removal and contemporaneous support for systemic complications, such as sepsis, systemic inflammation and coagulation disorders. EVIDENCE ACQUISITION: Peer-reviewed manuscripts indexed in PubMed. A systematic search for articles describing treatment options for patients in the ICU with major extremity injury were included in the analysis...
February 5, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29393193/technology-in-medicine-moving-towards-precision-management-of-acute-kidney-injury
#7
Jorge Cerdá, Gianluca Villa, Mauro Neri, Claudio Ronco
The integration of modern information communication technology and technologically advanced equipment to routine clinical practice are important technological stepping stones in the management of patients with acute kidney injury (AKI). These tools improve practice and patient outcomes by supporting and individualizing all phases of AKI management. This narrative review describes the most recent bedside technological advances in AKI diagnosis, renal replacement therapy education, prescription, monitoring, delivery, and measurement of outcomes with an emphasis on providing highly personalized patient care...
2018: Contributions to Nephrology
https://www.readbyqxmd.com/read/29393135/acute-kidney-injury-in-the-geriatric-population
#8
Mitchell H Rosner, Gaetano La Manna, Claudio Ronco
The aging kidney is more susceptible to injury. Thus, it is not surprising that acute kidney injury (AKI) is a disorder with a relative high incidence in the elderly population, especially those with critical illness. Given the comorbid conditions common in the geriatric population as well as the increase in exposure to various nephrotoxic insults, it is likely that the incidence of AKI will grow in the coming decades. Thus, it is critical to gain an understanding of the cellular and molecular pathways operative in increasing the susceptibility to AKI with an aim to design therapies that will mitigate the risk of AKI...
2018: Contributions to Nephrology
https://www.readbyqxmd.com/read/29393128/pediatric-acute-kidney-injury
#9
Tiziana Fragasso, Zaccaria Ricci, Stuart L Goldstein
BACKGROUND: Acute kidney injury (AKI) in children is a serious condition with an important impact on morbidity and mortality. Onset can be insidious and it is frequently unrecognized in the early phase when the therapeutic opportunities are theoretically more effective. SUMMARY: The present review focuses on the most recent epidemiology studies and the progress in pediatric AKI (pAKI) research. Standardization of definition (presented in the Kidney Disease: Improving Global Outcomes) and novel biomarkers have been developed to help clinicians recognize kidney injury in a timely manner, both in adult and pediatric populations...
2018: Contributions to Nephrology
https://www.readbyqxmd.com/read/29388370/the-role-of-continuous-renal-replacement-therapy-in-the-management-of-acute-kidney-injury-associated-with-sinusoidal-obstruction-syndrome-following-hematopoietic-cell-transplantation
#10
Rupesh Raina, Ghada A Abusin, Prashant Vijayaraghavan, Jeffery J Auletta, Linda Cabral, Hasan Hashem, Beth A Vogt, Kenneth R Cooke, Rolla F Abu-Arja
Maintaining fluid balance, pre- and post-MA-HCT is essential and usually requires frequent administration of diuretics. Hepatic sinusoidal obstructive syndrome is potentially life-threatening, especially when associated with AKI and MOF. This study describes six patients who developed AKI-associated SOS and diuretic-resistant FO who subsequently underwent CRRT using standardized management guidelines for fluid balance post-HCT. Retrospective chart review was done for HCT patients between September 2011 and October 2013 at a tertiary care children's hospital...
February 1, 2018: Pediatric Transplantation
https://www.readbyqxmd.com/read/29378487/incidence-risk-factors-and-outcome-of-acute-kidney-injury-in-neurocritical-care
#11
Stefan Büttner, Andrea Stadler, Christoph Mayer, Sammy Patyna, Christoph Betz, Christian Senft, Helmut Geiger, Oliver Jung, Fabian Finkelmeier
PURPOSE: Acute kidney injury (AKI) is a severe complication in medical and surgical intensive care units accounting for a high morbidity and mortality. Incidence, risk factors, and prognostic impact of this deleterious condition are well established in this setting. Data concerning the neurocritically ill patients is scarce. Therefore, aim of this study was to determine the incidence of AKI and elucidate risk factors in this special population. METHODS: Patients admitted to a specialized neurocritical care unit between 2005 and 2011 with a length of stay above 48 hours were analyzed retrospectively for incidence, cause, and outcome of AKI (AKI Network-stage ≥2)...
January 1, 2018: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/29366580/urinary-biomarkers-may-provide-prognostic-information-for-subclinical-acute-kidney-injury-after-cardiac-surgery
#12
Christian Albert, Annemarie Albert, Johanna Kube, Rinaldo Bellomo, Nicholas Wettersten, Hermann Kuppe, Sabine Westphal, Michael Haase, Anja Haase-Fielitz
OBJECTIVE: This study aimed to determine the biomarker-specific outcome patterns and short-and long-term prognosis of cardiac surgery-asoociated acute kidney injury (AKI) identified by standard criteria and/or urinary kidney biomarkers. METHODS: Patients enrolled (N = 200), originated a German multicenter study (NCT00672334). Standard risk injury, failure, loss, and end-stage renal disease classification (RIFLE) criteria (including serum creatinine and urine output) and urinary kidney biomarker test result (neutrophil gelatinase-associated lipocalin, midkine, interleukin 6, and proteinuria) were used for diagnosis of postoperative AKI...
December 22, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29360002/does-acute-kidney-injury-affect-survival-in-adults-with-acute-respiratory-distress-syndrome-requiring-extracorporeal-membrane-oxygenation
#13
Richard Devasagayaraj, Nicholas C Cavarocchi, Hitoshi Hirose
INTRODUCTION: Patients who develop severe acute respiratory distress syndrome (ARDS) despite full medical management may require veno-venous extracorporeal membrane oxygenation (VV ECMO) to support respiratory function. Survival outcomes remain unclear in those who develop acute kidney injury (AKI) requiring continuous renal replacement therapy (CRRT) during VV ECMO for isolated severe respiratory failure in adult populations. METHODS: A retrospective chart review (2010-2016) of patients who underwent VV ECMO for ARDS was conducted with university institutional review board (IRB) approval...
January 1, 2018: Perfusion
https://www.readbyqxmd.com/read/29352593/pre-admission-proteinuria-impacts-risk-of-non-recovery-after-dialysis-requiring-acute-kidney%C3%A2-injury
#14
Benjamin J Lee, Alan S Go, Rishi Parikh, Thomas K Leong, Thida C Tan, Sophia Walia, Raymond K Hsu, Kathleen D Liu, Chi-Yuan Hsu
Renal recovery after dialysis-requiring acute kidney injury (AKI-D) is an important clinical and patient-centered outcome. Here we examined whether the pre-admission proteinuria level independently influences risk for non-recovery after AKI-D in a community-based population. All adult members of Kaiser Permanente Northern California who experienced AKI-D between January 1, 2009 and September 30, 2015 were included. Pre-admission proteinuria levels were determined by dipstick up to four years before the AKI-D hospitalization and the outcome was renal recovery (survival and dialysis-independence four weeks and more) at 90 days after initiation of renal replacement therapy...
January 9, 2018: Kidney International
https://www.readbyqxmd.com/read/29344507/definition-management-and-outcomes-of-acute-kidney-injury-an-international-survey-of-nephrologists
#15
Umar Farooq, Aaron Tober, Vernon Chinchilli, W Brian Reeves, Nasrollah Ghahramani
Background: Acute kidney injury (AKI) is a complex disease burdened by uncertainties of definition, management strategies, and prognosis. This study explores the relationship between demographic characteristics of nephrologists and their perceptions about the definition, management, and follow-up of AKI. Methods: We developed a Web-based survey, the International Survey on Acute Kidney Injury (ISAKI), consisting of 29 items in 4 categories: (1) demographic and practice characteristics, (2) definition of AKI, (3) management of renal replacement therapy (RRT) in AKI, and (4) sequelae of AKI...
December 2017: Kidney Diseases
https://www.readbyqxmd.com/read/29344022/role-of-body-mass-index-in-acute-kidney-injury-patients-after-cardiac-surgery
#16
Zhouping Zou, Yamin Zhuang, Lan Liu, Bo Shen, Jiarui Xu, Zhe Luo, Jie Teng, Chunsheng Wang, Xiaoqiang Ding
Background/Aims: To explore the association of body mass index (BMI) with the risk of developing acute kidney injury after cardiac surgery (CS-AKI) and for AKI requiring renal replacement therapy (AKI-RRT) after cardiac surgery. Methods: Clinical data of 8,455 patients undergoing cardiac surgery, including demographic preoperative, intraoperative, and postoperative data were collected. Patients were divided into underweight (BMI <18.5), normal weight (18.5≤ BMI <24), overweight (24≤ BMI <28), and obese (BMI ≥28) groups...
December 2017: Cardiorenal Medicine
https://www.readbyqxmd.com/read/29336390/long-term-quality-of-life-postacute-kidney-injury-in-cardiac-surgery-patients
#17
Pankaj Kumar Mishra, Heyman Luckraz, Jayanta Nandi, Alan Nevill, Ramesh Giri, Andrew Panayiotou, Johann Nicholas
BACKGROUND: Acute renal failure after cardiac surgery is known to be associated with significant short-term morbidity and mortality. There have as yet been no major reports on long-term quality of life (QOL). This study assessed the impact of acute kidney injury (AKI) and renal replacement therapy (RRT) on long-term survival and QOL after cardiac surgery. The need for long-term RRT is also assessed. MATERIALS AND METHODS: Patients who underwent cardiac surgery between 2005 and 2011 (n = 6087) and developed AKI (RIFLE criteria, n = 570) were included...
January 2018: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/29327197/-new-kidney-function-tests-renal-functional-reserve-and-furosemide-stress-test
#18
REVIEW
D Kindgen-Milles, T Slowinski, T Dimski
Acute kidney injury (AKI) occurs in 30-50% of all intensive care patients. Renal replacement therapy (RRT) has to be initiated in 10-15%. The early in-hospital mortality is about 50%. Up to 20% of all survivors develop chronic kidney disease after intensive care discharge and progress to end-stage kidney disease within the next 10 years. For timely initiation of prophylactic or therapeutic interventions, it is crucial to exactly determine the actual kidney function, i. e., glomerular filtration rate (GFR), and to gain insight into the further development of kidney function...
January 11, 2018: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/29289268/rhabdomyolysis-associated-acute-kidney-injury-with-normal-creatine-phosphokinase
#19
Faisal Kamal, Lindsay Snook, Jagannath H Saikumar
Rhabdomyolysis is a syndrome characterized by the breakdown of skeletal muscle and leakage of intracellular myocyte contents, such as creatine phosphokinase (CPK) and myoglobin, into the interstitial space and plasma resulting in acute kidney injury (AKI). Elevated CPK of at least 5 times the upper limit of normal is an important diagnostic marker of Rhabdomyolysis. We present a case of rhabdomyolysis with severe AKI with a normal CPK at presentation. A 32-year-old man presented with acute respiratory failure and AKI after an overdose of recreational drugs...
January 2018: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/29285109/acute-kidney-injury-in-cancer-patients-and-impedance-cardiography-assisted-renal-replacement-therapy-experience-from-the-onconephrology-unit-of-a-chinese-tertiary-hospital
#20
Tao Wang, Yan Zhang, Qingxia Li, Shumin Jia, Changjin Shi, Kai Niu, Bing Liu
Acute kidney injury (AKI) in cancer patients may disrupt anticarcinogenic treatment and greatly increase associated mortality rates. The present study reported on the management of cancer patients with AKI and, from the nephrologic viewpoint, on the significance of fine volume control during the continuous renal replacement therapy (CRRT). The records of 117 cancer patients with AKI treated over three years were reviewed and their data were compared with those of 120 healthy controls. AKI was defined according to the Kidney Disease: Improving Global Outcomes criteria with serum creatinine levels determined on initial admission and for the diagnosis of AKI...
December 2017: Experimental and Therapeutic Medicine
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