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Renal Replacement Therapy in AKI

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https://www.readbyqxmd.com/read/29206655/pathophysiology-clinical-presentation-and-treatment-of-coma-and-acute-kidney-injury-complicating-falciparum-malaria
#1
Katherine Plewes, Gareth D H Turner, Arjen M Dondorp
PURPOSE OF REVIEW: Cerebral impairment and acute kidney injury (AKI) are independent predictors of mortality in both adults and children with severe falciparum malaria. In this review, we present recent advances in understanding the pathophysiology, clinical features, and management of these complications of severe malaria, and discuss future areas of research. RECENT FINDINGS: Cerebral malaria and AKI are serious and well recognized complications of severe malaria...
December 4, 2017: Current Opinion in Infectious Diseases
https://www.readbyqxmd.com/read/29202871/mesenchymal-stem-cell-derived-extracellular-vesicles-for-kidney-repair-current-status-and-looming-challenges
#2
REVIEW
Arash Aghajani Nargesi, Lilach O Lerman, Alfonso Eirin
Novel therapies are urgently needed to address the rising incidence and prevalence of acute kidney injury (AKI) and chronic kidney disease (CKD). Mesenchymal stem/stromal cells (MSCs) have shown promising results in experimental AKI and CKD, and have been used in the clinic for more than a decade with an excellent safety profile. The regenerative effects of MSCs do not rely on their differentiation and ability to replace damaged tissues, but are primarily mediated by the paracrine release of factors, including extracellular vesicles (EVs), composed of microvesicles and exosomes...
December 4, 2017: Stem Cell Research & Therapy
https://www.readbyqxmd.com/read/29202728/non-tunneled-versus-tunneled-dialysis-catheters-for-acute-kidney-injury-requiring-renal-replacement-therapy-a-prospective-cohort-study
#3
Mallika L Mendu, Megan F May, Arnaud D Kaze, Dionne A Graham, Salena Cui, Margaret E Chen, Naomi Shin, Ayal A Aizer, Sushrut S Waikar
BACKGROUND: Acute kidney injury requiring renal replacement therapy (AKI-RRT) is associated with high morbidity, mortality and resource utilization. The type of vascular access placed for AKI-RRT is an important decision, for which there is a lack of evidence-based guidelines. METHODS: We conducted a prospective cohort study over a 16-month period with 154 patients initiated on AKI-RRT via either a non-tunneled dialysis catheter (NTDC) or a tunneled dialysis catheter (TDC) at an academic hospital...
December 4, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/29202260/interobserver-agreement-for-post-mortem-renal-histopathology-and-diagnosis-of-acute-tubular-necrosis-in-critically-ill-patients
#4
Neil J Glassford, Alison Skene, Maria B Guardiola, Matthew J Chan, Sean M Bagshaw, Rinaldo Bellomo, Kim Solez
BACKGROUND: The renal histopathology of critically ill patients dying with acute kidney injury (AKI) in intensive care units of high income countries remains uncertain. METHODS: Retrospective observational assessment of interobserver agreement in the reporting of renal post mortem histopathology, and the ability of pathologists blinded to the clinical context to independently identify the presence of pre-mortem AKI from digital images of histological sections from 34 critically ill patients dying in teaching hospitals in Australia and Canada...
December 2017: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/29199769/peritoneal-dialysis-for-acute-kidney-injury
#5
REVIEW
Linfeng Liu, Ling Zhang, Guan J Liu, Ping Fu
BACKGROUND: Peritoneal dialysis (PD) has been suggested as an effective and safe dialysis modality in patients with acute kidney injury (AKI). However, whether PD is superior to extracorporeal therapy (e.g. haemodialysis) in terms of improving survival, recovery of kidney function, metabolic and clinical outcomes is still inconclusive. OBJECTIVES: The aim of this review was to evaluate the benefits and harms of PD for patients with AKI compared with extracorporeal therapy or different PD modalities...
December 4, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29199512/long-term-renal-and-overall-survival-of-critically-ill-patients-with-acute-renal-injury-who-received-continuous-renal-replacement-therapy
#6
Lingping Wu, Ping Zhang, Yi Yang, Hua Jiang, Yongchun He, Chunping Xu, Huijuan Yan, Qi Guo, Qun Luo, Jianghua Chen
BACKGROUND: Acute kidney injury (AKI) is associated with the increased short-term mortality of critically ill patients on continuous renal replacement therapy (CRRT). The aim of this research was to evaluate the association of kidney function at discharge with the long-term renal and overall survival of critically ill patients with AKI who were on CRRT in an intensive care unit (ICU). METHODS: We retrospectively collected data for critically ill patients with AKI who were admitted to ICU on CRRT at a tertiary metropolitan hospital in China between 2008 and 2013...
November 2017: Renal Failure
https://www.readbyqxmd.com/read/29197350/effect-of-hyperchloremia-on-acute-kidney-injury-in-critically-ill-septic-patients-a-retrospective-cohort-study
#7
Lenar Yessayan, Javier A Neyra, Fabrizio Canepa-Escaro, George Vasquez-Rios, Michael Heung, Jerry Yee
BACKGROUND: Hyperchloremia is common in critically ill septic patients. The impact of hyperchloremia on the incidence of acute kidney injury (AKI) is not well studied. We investigated the association between hyperchloremia and AKI within the first 72 h of intensive care unit (ICU) admission. METHODS: 6490 ICU adult patients admitted with severe sepsis or septic shock were screened for eligibility. Exclusion criteria included: AKI on admission, baseline estimated glomerular filtration rate (eGFR) <15 ml/min/1...
December 2, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/29196074/acute-kidney-injury-in-pediatric-patients-receiving-allogeneic-hematopoietic-cell-transplantation-incidence-risk-factors-and-outcomes
#8
Kyung-Nam Koh, Anusha Sunkara, Guolian Kang, Amanda Sooter, Daniel A Mulrooney, Brandon Triplett, Ali Mirza Onder, John Bissler, Lea C Cunningham
Acute kidney injury (AKI) is a common adverse event following hematopoietic cell transplantation (HCT). AKI is associated with early death or chronic kidney disease among transplant survivors. However, large-scale pediatric studies based on standardized criteria are lacking. We performed a retrospective analysis of 1057 pediatric patients who received allogeneic HCT to evaluate the incidence and risk factors of AKI according to AKI Network criteria within the first 100 days of HCT. We also determined the effect of AKI on patient survival...
November 28, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/29190861/-outcome-of-acute-kidney-injury-in-critically-ill-patients-treated-with-intermittent-hemodialysis-versus-crrt
#9
Mariana Ávalos-López, María Juana Pérez-López, Carolina Aguilar-Martínez, Ana María Del Carmen Díaz-Franco, Alejandro Esquivel-Chávez, José Angel Baltazar-Torres
BACKGROUND: Acute kidney injury (AKI) is common in critically ill patients and it is associated with poor outcome. Some patients require renal replacement therapy (RRT), and the most frequently used are intermittent hemodialysis (IHD) and continuous renal replacement therapies (CRRT). Current evidence is insufficient to conclude which modality is most appropriate to treat critically ill patients with AKI. METHODS: We reviewed the clinical records of critically ill patients with stage 3 AKI treated with RRT...
November 2017: Revista Médica del Instituto Mexicano del Seguro Social
https://www.readbyqxmd.com/read/29190735/subgroup-analysis-of-continuous-renal-replacement-therapy-in-severely-burned-patients
#10
Jaechul Yoon, Youngmin Kim, Dohern Kym, Jun Hur, Haejun Yim, Yong-Suk Cho, Wook Chun
Continuous renal replacement therapy (CRRT) is administered to critically ill patients with renal injuries as renal replacement or renal support. We aimed to identify predictors of mortality among burn patients receiving CRRT, and to investigate clinical differences according to acute kidney injury (AKI) status. This retrospective observational study evaluated 216 Korean burn patients who received CRRT at a burn intensive care unit. Patients were categorized by AKI status. Data were collected regarding arterial pH, laboratory results, ratio of arterial oxygen partial pressure to fractional inspired oxygen (PF ratio), and urine production...
2017: PloS One
https://www.readbyqxmd.com/read/29186517/renal-replacement-therapy-intensity-for-acute-kidney-injury-and-recovery-to-dialysis-independence-a-systematic-review-and-individual-patient-data-meta-analysis
#11
Ying Wang, Martin Gallagher, Qiang Li, Serigne Lo, Alan Cass, Simon Finfer, John Myburgh, Catherine Bouman, Robert Faulhaber-Walter, John A Kellum, Paul M Palevsky, Claudio Ronco, Patrick Saudan, Ashita Tolwani, Rinaldo Bellomo
Background: There is no consensus whether higher intensity dose renal replacement therapy (RRT) compared with standard intensity RRT has survival benefit and achieves better renal recovery in acute kidney injury (AKI). Methods: In an individual patient data meta-analysis, we merged individual patient data from randomized controlled trials (RCTs) comparing high with standard intensity RRT in intensive care unit patients with severe AKI. The primary outcome was all-cause mortality...
November 23, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/29184415/reversible-preoperative-renal-dysfunction-does-not-add-to-the-risk-of-postoperative-acute-kidney-injury-after-cardiac-valve-surgery
#12
Jia-Rui Xu, Ya-Min Zhuang, Lan Liu, Bo Shen, Yi-Mei Wang, Zhe Luo, Jie Teng, Chun-Sheng Wang, Xiao-Qiang Ding
Objective: To evaluate the impact of the renal dysfunction (RD) type and change of postoperative cardiac function on the risk of developing acute kidney injury (AKI) in patients who underwent cardiac valve surgery. Method: Reversible renal dysfunction (RRD) was defined as preoperative RD in patients who had not been initially diagnosed with chronic kidney disease (CKD). Cardiac function improvement (CFI) was defined as postoperative left ventricular ejection function - preoperative left ventricular ejection function (ΔEF) >0%, and cardiac function not improved (CFNI) as ΔEF ≤0%...
2017: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/29178943/high-volume-hemofiltration-in-adult-burn-patients-with-septic-shock-and-acute-kidney-injury-a-multicenter-randomized-controlled-trial
#13
Kevin K Chung, Elsa C Coates, David J Smith, Rachel A Karlnoski, William L Hickerson, Angela L Arnold-Ross, Michael J Mosier, Marcia Halerz, Amy M Sprague, Robert F Mullins, Daniel M Caruso, Marlene Albrecht, Brett D Arnoldo, Agnes M Burris, Sandra L Taylor, Steven E Wolf
BACKGROUND: Sepsis and septic shock occur commonly in severe burns. Acute kidney injury (AKI) is also common and often results as a consequence of sepsis. Mortality is unacceptably high in burn patients who develop AKI requiring renal replacement therapy and is presumed to be even higher when combined with septic shock. We hypothesized that high-volume hemofiltration (HVHF) as a blood purification technique would be beneficial in this population. METHODS: We conducted a multicenter, prospective, randomized, controlled clinical trial to evaluate the impact of HVHF on the hemodynamic profile of burn patients with septic shock and AKI involving seven burn centers in the United States...
November 25, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29178124/high-cut-off-membranes-in-acute-kidney-injury-and-continuous-renal-replacement-therapy
#14
Zaccaria Ricci, Stefano Romagnoli, Claudio Ronco
Innovation in continuous renal replacement therapies (CRRT) utilized to treat acute kidney injury (AKI) and sepsis, has brought new machines and techniques. Part of these new advances are due to the availability of innovative biomaterials and the construction of membranes with larger pores and wide distribution of pore sizes. This includes the creation of a new generation of high cut-off membranes whose utilization in clinical practice is promising for the wide spectrum of solutes that are removed during extracorporeal therapies...
November 24, 2017: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/29169177/acute-kidney-injury-in-elderly-population-a-prospective-observational-study
#15
Cássia Gomes da Silveira Santos, Rafael Fernandes Romani, Ricardo Benvenutti, João Otávio Ribas Zahdi, Miguel Carlos Riella, Marcelo Mazza do Nascimento
BACKGROUND/AIMS: Acute kidney injury (AKI) has been reported as a recognized condition among the elderly population; however, its clinical epidemiology is still poorly evaluated. We propose to evaluate the epidemiological profile of AKI in hospitalized elderly patients and the variables associated with renal replacement therapy (RRT) dependency at discharge after an episode of AKI. METHODS: This prospective observational study enrolled 286 elderly patients (aged ≥60 years), who had a diagnosis of AKI and were admitted to a tertiary care hospital...
November 23, 2017: Nephron
https://www.readbyqxmd.com/read/29162023/pentobarbital-removal-during-continuous-venovenous-hemofiltration-case-report-and-review-of-the-literature
#16
David M Hensler, Deepika P McConnell, Kimberly E Levasseur-Franklin, Kasey M Greathouse
BACKGROUND: Renal replacement therapy may enhance the elimination of barbiturates. Pentobarbital clearance during continuous venovenous hemofiltration (CVVH) has not been described previously. We report a patient case involving the measurement of serial pentobarbital levels during CVVH and review relevant literature characterizing extracorporeal pentobarbital elimination. METHODS: The following is a retrospective report of a previously healthy 26-year-old woman who sustained a severe traumatic brain injury (TBI) and required administration of pentobarbital on hospital day 0 for intracranial pressure (ICP) control...
January 1, 2017: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/29149864/kinetic-estimated-glomerular-filtration-rate-in-critically-ill-patients-beyond-the-acute-kidney-injury-severity-classification-system
#17
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
#18
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/29145723/statin-initiation-and-renal-outcomes-following-isolated-coronary-artery-bypass-grafting-a-meta-analysis
#19
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/29137024/effect-of-different-surgical-type-of-coronary-artery-bypass-grafting-on-kidney-injury-a-propensity-score-analysis
#20
Ming-Jen Chan, Cheng-Chia Lee, Shao-Wei Chen, Feng-Chun Tsai, Pyng-Jing Lin, Pei-Chun Fan, Hsiang-Hao Hsu, Ming-Yang Chang, Yung-Chang Chen, Chih-Hsiang Chang
Acute kidney injury (AKI) after coronary artery bypass grafting (CABG) is associated with a less favorable outcome. Off-pump surgery results in lower kidney dysfunction than conventional on-pump arrest surgery. On-pump arrest surgery results in a lower revascularization rate compared with off-pump surgery. On-pump beating heart (OPBH) CABG combines the advantages of beating heart surgery and cardiopulmonary bypass. This study compared the renal outcomes of 3 cardiac surgical methods. From January 2010 to December 2012, 373 patients who underwent on-pump CABG were enrolled...
November 2017: Medicine (Baltimore)
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