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AKI and renal replacement

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https://www.readbyqxmd.com/read/28097012/pharmacokinetics-and-pharmacodynamics-of-antibiotics-in-critically-ill-acute-kidney-injury-patients
#1
REVIEW
Welder Zamoner, Fernanda M de Freitas, Durval S S Garms, Mariele Gobo de Oliveira, André L Balbi, Daniela Ponce
Sepsis is the most common cause of death in critically ill patients and is associated with multiorgan failure, including acute kidney injury (AKI). This situation can require acute renal support and increase mortality. Therefore, it is essential to administer antimicrobials in doses that achieve adequate serum levels, avoiding both overdosing and drug toxicity as well as underdosing and the risk of antibiotic resistance and higher mortality. Currently, there are no validated guidelines on antibiotic dose adjustments in septic patients with AKI...
December 2016: Pharmacology Research & Perspectives
https://www.readbyqxmd.com/read/28091757/-renal-protection-in-intensive-care-myths-and-facts
#2
S John
BACKGROUND: Acute kidney injury (AKI) is a common and severe complication in patients on the intensive care unit with a significant impact on patient mortality, morbidity and costs of care; therefore, renal protective therapy is most important in these severely ill patients. AIM OF THE REVIEW: Many renal protective strategies have been postulated during the last decades, which are sometimes still in place as a kind of "myth" but which are not always proven by evidence-based "facts"...
January 13, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28089458/impact-of-interaction-of-diabetes-mellitus-and-impaired-renal-function-on-prognosis-and-the-incidence-of-acute-kidney-injury-in-patients-undergoing-transcatheter-aortic-valve-replacement-tavr
#3
Dimitry Schewel, Milad Zavareh, Jury Schewel, Thomas Thielsen, Tobias Schmidt, Ulrich Schäfer, Karl-Heinz Kuck, Christian Frerker
BACKGROUND: In high-risk patients with severe aortic stenosis undergoing transcatheter aortic valve replacement (TAVR) diabetes mellitus (DM) is a common comorbidity. It is known to increase the risk of arteriosclerosis and adversely affect morbidity, mortality for all types of cardiovascular disease, and post-procedural outcome after percutaneous and surgical procedures. Moreover, DM is known to facilitate the genesis of renal failure (RF). Pre-existing RF seems to increase the rate of acute kidney injury (AKI), which is a powerful short- and midterm predictor of mortality in patients undergoing TAVR...
January 7, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28088774/association-between-e-alert-implementation-for-detection-of-acute-kidney-injury-and-outcomes-a-systematic-review
#4
Philippe Lachance, Pierre-Marc Villeneuve, Oleksa G Rewa, Francis P Wilson, Nicholas M Selby, Robin M Featherstone, Sean M Bagshaw
BACKGROUND: Electronic alerts (e-alerts) for acute kidney injury (AKI) in hospitalized patients are increasingly being implemented; however, their impact on outcomes remains uncertain. METHODS: We performed a systematic review. Electronic databases and grey literature were searched for original studies published between 1990 and 2016. Randomized, quasi-randomized, observational and before-and-after studies that included hospitalized patients, implemented e-alerts for AKI and described their impact on one of care processes, patient-centred outcomes or resource utilization measures were included...
January 14, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28078828/biomarkers-upon-discontinuation-of-renal-replacement-therapy-predict-60-day-survival-and-renal-recovery-in-critically-ill-patients-with-acute-kidney-injury
#5
Tingting Yang, Si Sun, Yuliang Zhao, Qiang Liu, Mei Han, Liping Lin, Baihai Su, Songmin Huang, Lichuan Yang
Introduction There is no consensus on the specific indications for weaning critically ill patients with acute kidney injury (AKI) off renal replacement therapy (RRT). This study aimed to explore the prognostic value of several biomarkers measured upon discontinuation of RRT for their value in predicting 60-day survival and renal recovery in an effort to add knowledge to the decision-making process regarding RRT withdrawal. Methods We prospectively enrolled 102 patients with AKI who required RRT from the intensive care unit...
January 11, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28076311/biomarkers-of-acute-kidney-injury-the-pathway-from-discovery-to-clinical-adoption
#6
Kianoush Kashani, Wisit Cheungpasitporn, Claudio Ronco
Acute kidney injury (AKI) is a common complication of critical illnesses and has a significant impact on outcomes, including mortality and morbidities. Unfortunately, apart from prophylactic measures, no effective treatment for this syndrome is known. Therefore, early recognition of AKI not only can provide better opportunities for preventive interventions, but also opens many gates for research and development of effective therapeutic options. Over the last few years, several new AKI biomarkers have been discovered and validated to improve early detection, differential diagnosis, and differentiation of patients into risk groups for progressive renal failure, need for renal replacement therapy (RRT), or death...
January 11, 2017: Clinical Chemistry and Laboratory Medicine: CCLM
https://www.readbyqxmd.com/read/28060212/urinary-mitochondrial-dna-levels-identify-acute-kidney-injury-in-surgical-critical-illness-patients
#7
Qiongyuan Hu, Jianan Ren, Jie Wu, Guanwei Li, Xiuwen Wu, Song Liu, Gefei Wang, Guosheng Gu, Huajian Ren, Zhiwu Hong, Jieshou Li
BACKGROUND: Recent studies showed that mitochondrial injury and mitochondrial DNA (mtDNA) damage are associated with the initiation and progression of acute kidney injury (AKI). However, practical limitations of existing assays of mitochondrial function have limited our ability to study the link between mitochondrial dysfunction and renal injury. Therefore, we evaluated urinary mtDNA (UmtDNA) as a biomarker of AKI in critical illness patients. METHODS: DNA was isolated from urine samples in surgical intensive care unit (SICU) patients and quantified by quantitative polymerase chain reaction (PCR)...
January 4, 2017: Shock
https://www.readbyqxmd.com/read/28011057/the-ischemic-nephrotoxic-acute-kidney-injury-and-the-use-of-renal-biomarkers-in-clinical-practice
#8
REVIEW
Michele Andreucci, Teresa Faga, Antonio Pisani, Maria Perticone, Ashour Michael
The term Acute Renal Failure (ARF) has been replaced by the term Acute Kidney Injury (AKI). AKI indicates an abrupt (within 24-48h) decrease in Glomerular Filtraton Rate, due to renal damage, that causes fluid and metabolic waste retention and alteration of electrolyte and acid-base balance. The renal biomarkers of AKI are substances or processes that are indicators of normal or impaired function of the kidney. The most used renal biomarker is still serum creatinine that is inadequate for several reasons, one of which is its inability to differentiate between hemodynamic changes of renal function ("prerenal azotemia") from intrinsic renal failure or obstructive nephropathy...
December 21, 2016: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/28002877/the-drugs-that-mostly-frequently-induce-acute-kidney-injury-a-case%C3%A2-%C3%A2-non-case-study-of-a-pharmacovigilance-database
#9
Marion Pierson-Marchandise, Valérie Gras, Julien Moragny, Joelle Micallef, Louise Gaboriau, Sylvie Picard, Gabriel Choukroun, Kamel Masmoudi, Sophie Liabeuf
AIMS: Acute kidney injury (AKI) is associated with a high hospitalization rate, accelerated long-term decline in kidney function and a high mortality rate. Adverse drug reactions (ADRs) constitute one of the most important modifiable factors in the context of AKI. Most studies of drug-induced AKI have focused on a sole drug class. The objective of the present study was to establish a comprehensive overview of drug-induced AKI on the basis of spontaneously reported ADRs in the French national pharmacovigilance database (FPVD)...
December 21, 2016: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/27997877/effects-of-low-dose-atrial-natriuretic-peptide-infusion-on-cardiac-surgery-associated-acute-kidney-injury-a-multicenter-randomized-controlled-trial
#10
Chieko Mitaka, Tetsu Ohnuma, Takanori Murayama, Fumio Kunimoto, Michio Nagashima, Tetsuhiro Takei, Naoya Iguchi, Makoto Tomita
PURPOSE: To evaluate the effects of atrial natriuretic peptide (ANP) on renal function and medical costs in patients with acute kidney injury (AKI) associated with cardiac surgery. MATERIALS AND METHODS: The Japanese trial for AKI in Post-cardiovascular surgery patients by ANP (JAPAN) was a prospective, multicenter, randomized, double-blind, placebo-controlled study conducted in 11 hospitals in Japan. Acute kidney injury was defined as an increase in serum creatinine of at least 0...
December 11, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/27993157/early-phase-cumulative-hypotension-duration-and-severe-stage-progression-in-oliguric-acute-kidney-injury-with-and-without-sepsis-an-observational-study
#11
Junichi Izawa, Tetsuhisa Kitamura, Taku Iwami, Shigehiko Uchino, Masanori Takinami, John A Kellum, Takashi Kawamura
BACKGROUND: Managing blood pressure in patients with acute kidney injury (AKI) could effectively prevent severe-stage progression. However, the effect of hypotension duration in the early phase of AKI remains poorly understood. This study investigated the association between early-phase cumulative duration of hypotension below threshold mean arterial pressure (MAP) and severe-stage progression of oliguric AKI in critically ill patients, and assessed the difference in association with presence of sepsis...
December 19, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27986669/risk-of-acute-kidney-injury-in-patients-on-concomitant-vancomycin-and-piperacillin-tazobactam-compared-to-those-on-vancomycin-and-cefepime
#12
Bhagyashri Navalkele, Jason M Pogue, Shigehiko Karino, Bakht Nishan, Madiha Salim, Shantanu Solanki, Amina Pervaiz, Nader Tashtoush, Hamadullah Shaikh, Sunitha Koppula, Jonathan Koons, Tanveer Hussain, William Perry, Richard Evans, Emily T Martin, Ryan P Mynatt, Kyle P Murray, Michael J Rybak, Keith S Kaye
BACKGROUND: Recent evidence suggests that among patients receiving vancomycin, receipt of concomitant piperacillin-tazobactam increases the risk of nephrotoxicity. Well-controlled, adequately powered studies comparing rates of acute kidney injury (AKI) among patients receiving vancomycin + piperacillin-tazobactam (VPT) compared to similar patients receiving vancomycin + cefepime (VC) are lacking. In this study we compared the incidence of AKI among patients receiving combination therapy with VPT to a matched group receiving VC...
October 20, 2016: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/27977430/long-term-consequences-of-acute-kidney-injury-in-the-perioperative-setting
#13
Carlos E Palant, Richard L Amdur, Lakhmir S Chawla
PURPOSE OF REVIEW: Recent studies indicate that acute kidney injury (AKI) and chronic kidney disease (CKD) are interconnected syndromes. Although the majority of patients who suffer an episode of AKI will recover laboratory indices suggesting complete or near complete recovery of renal function, a significant portion of post-AKI survivors will develop major kidney events, including development of late-stage CKD, need for renal replacement therapies, and death. RECENT FINDINGS: Our review highlights epidemiology of adverse post-AKI events, association of AKI with late development of nonrenal adverse outcomes, use of bedside equations that facilitate prognostication of adverse renal outcomes of AKI, and how variability in serum creatinine values in individual patients, even among those with normal baseline renal function may indicate risk for the development of CKD...
February 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/27965312/hyponatraemia-induced-rhabdomyolysis-complicated-by-anuric-acute-kidney-injury-a-renal-replacement-conundrum
#14
Paul Secombe, Chris Milne
Hyponatraemia-induced rhabdomyolysis is a rare, but reported phenomenon, particularly in patients with chronic schizophrenia on depot antipsychotics prone to psychogenic polydipsia. To the best of our knowledge, there are no reported cases of hyponatraemia-induced rhabdomyolysis complicated by oligo-anuric acute kidney injury (AKI) requiring continuous renal replacement therapy (CRRT). The initiation of CRRT is complicated in severe hyponatraemia, predominantly due to the need to avoid rapid changes in tonicity associated with rapid changes in sodium...
December 13, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27957417/comparison-of-clinical-characteristics-of-patients-with-acute-kidney-injury-after-intravenous-versus-inhaled-colistin-therapy
#15
A Young Cho, Hyun Ju Yoon, Jung Cheol Lee, Jin Young Kwak, Kwang Young Lee, In O Sun
BACKGROUND: The aim of this study was to investigate the incidence and clinical characteristics of intravenous (IV) or inhaled (IH) colistin-associated acute kidney injury (AKI) using the Risk, Injury, Failure, Loss, End-stage Renal Disease criteria. METHODS: From 2010 to 2014, 160 patients were treated with IV or IH colistin. Of these, we included 126 patients who received colistin for > 72 hours for the treatment of pneumonia and compared the incidence and clinical characteristics of patients in the IV (n = 107) and IH (n = 19) groups...
December 2016: Kidney Research and Clinical Practice
https://www.readbyqxmd.com/read/27942175/snakebite-mediated-acute-kidney-injury-prognostic-predictors-oxidative-and-carbonyl-stress-a-prospective-study
#16
P Mukhopadhyay, R Mishra, D Mukherjee, R Mishra, M Kar
Snake bite is an occupational hazard in India and important preventable cause of acute kidney injury (AKI). This study was done to estimate the magnitude of snakebite-induced AKI (SAKI) who required renal replacement therapy, prognostic predictors, and final outcome, and to measure the oxidative and carbonyl stress (CS) level in SAKI patient who underwent hemodialysis (HD). All SAKI patients dialyzed between April 2010 and July 2011 in NRS Medical College were included. Demographical, clinical, and biochemical data were analyzed, and patients are followed to discharge or death...
November 2016: Indian Journal of Nephrology
https://www.readbyqxmd.com/read/27930561/meta-analysis-for-outcomes-of-acute-kidney-injury-after-cardiac-surgery
#17
Qiankun Shi, Liang Hong, Xinwei Mu, Cui Zhang, Xin Chen
This study aimed to investigate the outcomes of acute kidney injury (AKI) after cardiac surgery by the meta-analysis.Electronic databases PubMed and Embase were searched for relative studies from December 2008 to June 2015. For eligible studies, the R software was conducted to meta-analyze outcomes of AKI patients (AKI group) and none-AKI patients after cardiac surgery (NO AKI group). The chi-square-based Q test and I statistic were used for heterogeneity analysis. P < 0.1 or I > 50% revealed significant heterogeneity among studies, and then a random effects model was used; otherwise a fixed effect model was performed...
December 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27923227/optimal-role-of-the-nephrologist-in-the-intensive-care-unit
#18
D J Askenazi, Michael Heung, Michael J Connor, Rajit K Basu, Jorge Cerdá, Kent Doi, Jay L Koyner, Azra Bihorac, Ladan Golestaneh, Anitha Vijayan, Mark D Okusa, Sarah Faubel
As advances in Critical Care Medicine continue, critically ill patients are surviving despite the severity of their illness. The incidence of acute kidney injury (AKI) has increased, and its impact on clinical outcomes as well as medical expenditures has been established. The role, indications and technological advancements of renal replacement therapy (RRT) have evolved, allowing more effective therapies with less complications. With these changes, Critical Care Nephrology has become an established specialty, and ongoing collaborations between critical care physicians and nephrologist have improved education of multi-disciplinary team members and patient care in the ICU...
December 3, 2016: Blood Purification
https://www.readbyqxmd.com/read/27921036/acute-kidney-injury-in-asia
#19
REVIEW
Li Yang
BACKGROUND: Acute kidney injury (AKI) is a common disorder and is associated with a high morbidity and mortality worldwide. The diversity of the climate and of the socioeconomic and developmental status in Asia has a great influence on the etiology and presentation of AKI in different regions. In view of the International Society of Nephrology's 0by25 initiative, more and more attention has been paid to AKI in Asian countries. SUMMARY: In this review, we summarize the recent achievements with regard to the prevalence and clinical patterns of AKI in Asian countries...
October 2016: Kidney Diseases
https://www.readbyqxmd.com/read/27915348/delayed-nephrology-consultation-and-high-mortality-on-acute-kidney-injury-a-meta-analysis
#20
Débora M Soares, José F Pessanha, Aashish Sharma, Alessandra Brocca, Claudio Ronco
BACKGROUND: Acute kidney injury (AKI) is a complex syndrome associated with substantial morbidity, mortality and costs. Despite advancements in diagnosis and care practice, AKI remains a disorder usually under/late-recognized with high mortality. One of the hidden reasons for poor outcome might be delayed nephrology consultation, with the involvement of the specialist only in severe stages of AKI when renal replacement therapy (RRT) is required. METHODS: We searched PubMed, EMBASE and Cochrane central register for related work on the subject...
December 3, 2016: Blood Purification
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