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AKI and renal replacement

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https://www.readbyqxmd.com/read/29694446/clinical-biochemical-and-genetic-risk-factors-for-30-day-and-5-year-mortality-in-518-adult-patients-subjected-to-cardiopulmonary-bypass-during-cardiac-surgery-the-inflacor-study
#1
Maciej Michał Kowalik, Romuald Lango, Piotr Siondalski, Magdalena Chmara, Maciej Brzeziński, Krzysztof Lewandowski, Dariusz Jagielak, Andrzej Klapkowski, Jan Rogowski
There is increasing evidence that genetic variability influences patients' early morbidity after cardiac surgery performed using cardiopulmonary bypass (CPB). The use of mortality as an outcome measure in cardiac surgical genetic association studies is rare. We publish the 30-day and 5-year survival analyses with focus on pre-, intra-, postoperative variables, biochemical parameters, and genetic variants in the INFLACOR (INFLAmmation in Cardiac OpeRations) cohort. In a prospectively recruited cohort of 518 adult Polish Caucasians, who underwent cardiac surgery in which CPB was used, the clinical data, biochemical parameters, IL-6, soluble ICAM-1, TNFα, soluble E-selectin, and 10 single nucleotide polymorphisms were evaluated for their association with 30-day and 5-year mortality...
April 25, 2018: Acta Biochimica Polonica
https://www.readbyqxmd.com/read/29693303/sofa-coagulation-score-and-changes-in-platelet-counts-in-severe-acute-kidney-injury-analysis-from-the-randomised-evaluation-of-normal-versus-augmented-level-renal-study
#2
Jin Lin, Martin Gallagher, Rinaldo Bellomo, Meili Duan, Konlawi Trongtrakul, Amanda Ying Wang
AIM: To evaluate the prognostic value of baseline SOFA coagulation score (SOFA-CS) and change in platelet counts in patients with severe acute kidney injury (AKI) requiring continuous renal replacement therapy (CRRT). METHODS: We performed a secondary analysis from the Randomised Evaluation of Normal versus Augmented Level of RRT (RENAL) study. The primary endpoint was all-cause mortality at 90 days after randomisation. The association between baseline SOFA-CS, changes in platelet counts, process of care, and clinical outcomes were analysed using multivariate Cox model adjusted for baseline variables...
April 24, 2018: Nephrology
https://www.readbyqxmd.com/read/29689116/intermittent-furosemide-administration-in-patients-with-or-at-risk-for-acute-kidney-injury-meta-analysis-of-randomized-trials
#3
Tiziana Bove, Alessandro Belletti, Alessandro Putzu, Simone Pappacena, Giuseppe Denaro, Giovanni Landoni, Sean M Bagshaw, Alberto Zangrillo
BACKGROUND: Furosemide is the most common loop diuretic used worldwide. The off-label administration of furosemide bolus(es) for the prevention or to reverse acute kidney injury (AKI) is widespread but not supported by available evidence. We conducted a meta-analysis of randomized trials (RCTs) to investigate whether bolus furosemide to prevent or treat AKI is detrimental on patients' survival. METHODS: Electronic databases were searched through October 2017 for RCTs comparing bolus furosemide administration versus any comparator in patients with or at risk for AKI...
2018: PloS One
https://www.readbyqxmd.com/read/29686717/preoperative-blood-morphology-and-incidence-of-acute-kidney-injury-after-on-pump-coronary-artery-bypass-grafting-a-single-center-preliminary-report
#4
Bartłomiej Perek, Dawid Maison, Szymon Budnick, Kinga Gębala, Veronica Casadei, Daniela Dadej, Artur Chmielewski, Marcin Ligowski, Piotr Buczkowski, Anna Perek, Marek Jemielity
Introduction: Acute kidney injury (AKI) after coronary artery bypass grafting (CABG) performed in cardiopulmonary bypass (CPB) may complicate the postoperative course and has a negative impact on outcome. In some cases, postoperative AKI develops in spite of normal baseline creatinine concentration and estimated glomerular filtration rate (eGFR). Aim: To examine whether there is any association between the preoperative blood morphology and incidence of post-operative AKI...
March 2018: Kardiochirurgia i Torakochirurgia Polska, Polish Journal of Cardio-Thoracic Surgery
https://www.readbyqxmd.com/read/29684655/effect-of-fluid-challenge-on-renal-resistive-index-after-major-orthopaedic-surgery-a-prospective-observational-study-using-doppler-ultrasonography
#5
Fabrice Ferré, Philippe Marty, Cédric Folcher, Matt Kurrek, Vincent Minville
BACKGROUND: A postoperative renal resistive index (RRI) > 0.70 has the best threshold to early predict acute kidney injury (AKI). The response of RRI to a postoperative fluid challenge (FC) is unknown. The aim of our study was to assess the impact of a FC on RRI in suspected hypovolaemia patients after orthopaedic surgery. DESIGN: In this single-centre observational study, we prospectively screened 156 patients in the recovery room after having undergone a hip or knee replacement...
April 20, 2018: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/29673370/early-versus-standard-initiation-of-renal-replacement-therapy-in-furosemide-stress-test-non-responsive-acute-kidney-injury-patients-the-fst-trial
#6
Nuttha Lumlertgul, Sadudee Peerapornratana, Thananda Trakarnvanich, Wanjak Pongsittisak, Kajbundit Surasit, Anan Chuasuwan, Pleumjit Tankee, Khajohn Tiranathanagul, Kearkiat Praditpornsilpa, Kriang Tungsanga, Somchai Eiam-Ong, John A Kellum, Nattachai Srisawat
BACKGROUND: The timing of initiation of renal replacement therapy (RRT) in severe acute kidney injury (AKI) remains controversial, with early initiation resulting in unnecessary therapy for some patients while expectant therapy may delay RRT for other patients. The furosemide stress test (FST) has been shown to predict the need for RRT and therefore could be used to exclude low-risk patients from enrollment in trials of RRT timing. We conducted this multicenter pilot study to determine whether FST could be used to screen patients at high risk for RRT and to determine the feasibility of incorporating FST into a trial of early initiation of RRT...
April 19, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29672307/extended-sessions-of-polymyxin-b-immobilized-fiber-column-hemoperfusion-ameliorate-renal-outcome-and-mortality-in-septic-shock-with-acute-kidney-injury
#7
Hiroshi Maekawa, Kousuke Negishi
BACKGROUND/AIMS: Polymyxin-B (PMX) treatment has been reported to decrease mortality in patients with septic shock and acute kidney injury (AKI). In this study, we aimed to evaluate whether extended sessions of PMX (Ext-PMX) immobilized fiber column hemoperfusion ameliorate clinical outcomes in patients complicated with septic shock and AKI without surgical control. METHODS: Twenty-two patients with nonsurgical septic shock and AKI who received PMX were included...
April 19, 2018: Blood Purification
https://www.readbyqxmd.com/read/29671040/preoperative-right-heart-hemodynamics-predict-postoperative-acute-kidney-injury-after-heart-transplantation
#8
Goksel Guven, Milos Brankovic, Alina A Constantinescu, Jasper J Brugts, Dennis A Hesselink, Sakir Akin, Ard Struijs, Ozcan Birim, Can Ince, Olivier C Manintveld, Kadir Caliskan
PURPOSE: Acute kidney injury (AKI) frequently occurs after heart transplantation (HTx), but its relation to preoperative right heart hemodynamic (RHH) parameters remains unknown. Therefore, we aimed to determine their predictive properties for postoperative AKI severity within 30 days after HTx. METHODS: From 1984 to 2016, all consecutive HTx recipients (n = 595) in our tertiary referral center were included and analyzed for the occurrence of postoperative AKI staged by the kidney disease improving global outcome criteria...
April 18, 2018: Intensive Care Medicine
https://www.readbyqxmd.com/read/29669237/current-practice-of-diagnosis-and-management-of-acute-kidney-injury-in-intensive-care-unit-in-resource-limited-settings
#9
Nattachai Srisawat, Nattaya Sintawichai, Win Kulvichit, Nuttha Lumlertgul, Patita Sitticharoenchai, Nicha Thamrongsat, Sadudee Peerapornratana
PURPOSE: In a resource limited settings, there is sparse information about the management of acute kidney injury (AKI) based on systemic data collection. This survey aimed to described the current management of AKI in intensive care units (ICUs) across Thailand. MATERIALS AND METHODS: Questionnaires were distributed to 160 physicians involved in the intensive care between January and December 2014 across Thailand. Distribution was done through an online survey platform or telephone interview...
April 11, 2018: Journal of Critical Care
https://www.readbyqxmd.com/read/29651499/aki-biomarkers-are-poor-discriminants-for-subsequent-need-for-renal-replacement-therapy-but-do-not-disqualify-them-yet
#10
EDITORIAL
Harm-Jan de Grooth, Jean-Jacques Parienti, Miet Schetz
No abstract text is available yet for this article.
April 12, 2018: Intensive Care Medicine
https://www.readbyqxmd.com/read/29643888/spectrum-of-complications-of-severe-dka-in-children-in-pediatric-intensive-care-unit
#11
Qalab Abbas, Saba Arbab, Anwar Ul Haque, Khadija Nuzhat Humayun
Objectives: To describe the spectrum of complications of Diabetic Ketoacidosis (DKA) observed in children admitted with severe DKA. Methods: Retrospective review of the medical records of all children admitted with the diagnosis of severe DKA in Pediatric Intensive Care Unit (PICU) of the Aga Khan University Hospital, from January 2010 to December 2015 was done. Data was collected on a structured proforma and descriptive statistics were applied. Results: Total 37 children were admitted with complicated DKA (1...
January 2018: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/29628970/acute-kidney-injury-in-pediatric-patients-with-rhabdomyolysis
#12
Young Shin Lim, Heeyeon Cho, Sang Taek Lee, Yeonhee Lee
Purpose: This study aimed to evaluate the clinical findings in pediatric rhabdomyolysis and the predictive factors for acute kidney injury (AKI) in Korean children. Methods: Medical records of 39 Korean children, who were newly diagnosed with rhabdomyolysis from January 2008 to December 2015, were retrospectively analyzed. The diagnosis was made from the medical history, elevated serum creatinine kinase level >1,000 IU/L, and plasma myoglobin level >150 ng/mL...
March 2018: Korean Journal of Pediatrics
https://www.readbyqxmd.com/read/29627837/combination-of-mean-platelet-volume-platelet-count-ratio-and-the-apache-ii-score-better-predicts-the-short-term-outcome-in-patients-with-acute-kidney-injury-receiving-continuous-renal-replacement-therapy
#13
Junhui Li, Yingchuan Li, Xiaohua Sheng, Feng Wang, Dongsheng Cheng, Guihua Jian, Yongguang Li, Liang Feng, Niansong Wang
BACKGROUND/AIMS: Both the Acute physiology and Chronic Health Evaluation (APACHE II) score and mean platelet volume/platelet count Ratio (MPR) can independently predict adverse outcomes in critically ill patients. This study was aimed to investigate whether the combination of them could have a better performance in predicting prognosis of patients with acute kidney injury (AKI) who received continuous renal replacement therapy (CRRT). METHODS: Two hundred twenty-three patients with AKI who underwent CRRT between January 2009 and December 2014 in a Chinese university hospital were enrolled...
March 29, 2018: Kidney & Blood Pressure Research
https://www.readbyqxmd.com/read/29627229/the-use-of-cell-cycle-arrest-biomarkers-in-the-early-detection-of-acute-kidney-injury-is-this-the-new-renal-troponin
#14
Luis M Ortega, Michael Hueng
Acute kidney injury (AKI) has a high prevalence in critical care patients. Early detection might prevent patients from developing chronic kidney disease and requirement for renal replacement therapy. If we compare AKI with acute coronary syndrome, in which an increase in cardiac troponin may trigger early diagnosis and therapeutic intervention, we could extrapolate a similar technique in patients with early AKI without changes in urinary frequency or serum creatinine. The objective is to identify biomarker-positive, creatinine-negative patients that would allow therapeutic interventions to be initiated before finding changes in serum creatinine, preventing kidney damage...
April 4, 2018: Nefrología: Publicación Oficial de la Sociedad Española Nefrologia
https://www.readbyqxmd.com/read/29615192/acute-kidney-injury-predicts-mortality-in-emergency-general-surgery-patients
#15
Alexandra Briggs, Joaquim M Havens, Ali Salim, Kenneth B Christopher
BACKGROUND: Patients undergoing Emergency General Surgery (EGS) have increased risk of complications and death. The risk of AKI in patients undergoing EGS, along with associated outcomes, is unknown. METHODS: This two-institution observational study included adults admitted to intensive care units between 1997 and 2012. EGS was defined by 7 procedures occurring within 48 hours of ICU admission. The main outcome studied was AKI within 5 days, along with 90-day mortality...
March 14, 2018: American Journal of Surgery
https://www.readbyqxmd.com/read/29597218/membranes-and-sorbents
#16
William R Clark, Dayong Gao, Anna Lorenzin, Claudio Ronco
For continuous renal replacement therapy (CRRT), the extracorporeal filter provides solute depuration, fluid removal, and control of electrolyte and acid-base balance in critically ill patients with acute kidney injury (AKI). The membranes comprising CRRT filters are almost exclusively based on hollow fiber designs and, while adapted from the chronic hemodialysis field, have features that are specific to the requirements of CRRT nevertheless. In addition, these devices have evolved through the 40 years of CRRT in response to changes in clinical practice and the desire to extend the solute removal spectrum...
2018: Contributions to Nephrology
https://www.readbyqxmd.com/read/29597216/indications-and-timing-of-continuous-renal-replacement-therapy-application
#17
Sean M Bagshaw, Ron Wald
Renal replacement therapy (RRT) is increasingly utilized to support critically ill patients with severe acute kidney injury (AKI). The clinical dilemma of when to ideally start RRT in these patients has been a longstanding issue that is in need of higher quality evidence to guide clinical practice. When clinicians are confronted with patients with life-threatening complications of AKI, the decision to start RRT is straightforward. However, in the absence of clear indications, the ideal circumstances and timing that balance the perceived benefits and risks of early versus delayed RRT remain uncertain...
2018: Contributions to Nephrology
https://www.readbyqxmd.com/read/29579262/acute-kidney-injury-in-critically-ill-patients-with-solid-tumours
#18
Delphine Kemlin, Lucie Biard, Lionel Kerhuel, Lara Zafrani, Marion Venot, Luis Teixeira, Benoit Schlemmer, Elie Azoulay, Emmanuel Canet
Background: Patients with solid tumours are at risk for acute kidney injury (AKI), however, epidemiological data are limited. Methods: We conducted a study that included patients with solid tumours admitted to a single-centre intensive care unit (ICU) from January 2011 to December 2015. We analysed factors associated with the occurence of AKI, ICU and Day-90 mortality. Results: Two-hundred and four patients were included. The incidence of AKI was 59%, chiefly related to sepsis (80%), hypovolaemia (40%) and outflow tract obstruction (17%)...
March 22, 2018: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/29575788/acute-kidney-injury-in-critically-ill-patients-a-prospective-randomized-study-of-tidal-peritoneal-dialysis-versus-continuous-renal-replacement-therapy
#19
Abdullah Al-Hwiesh, Ibrahiem Abdul-Rahman, Fredric Finkelstein, Jose Divino-Filho, Hatem Qutub, Nadia Al-Audah, Abdalla Abdelrahman, Nazeeh El-Fakhrany, Mohammed Nasr El-Din, Tamer El-Salamony, Abdulsalam Noor, Mohammed Al-Shahrani, Khalid Al-Otaibi
Few studies have discussed the role of peritoneal dialysis (PD) in managing acute kidney injury (AKI) in critically ill patients. The present study compares the outcome of AKI in intensive care unit (ICU) patients randomized to treatment with tidal PD (TPD) or continuous venovenous hemodiafiltration (CVVHDF). One hundred and twenty-five ICU patients with AKI were randomly allotted to CVVHDF, (Group A, N = 62) or TPD, (group B, N = 63). Cause and severity of renal injury were assessed at the time of initiating dialysis...
March 25, 2018: Therapeutic Apheresis and Dialysis
https://www.readbyqxmd.com/read/29562937/cerebral-microembolism-in-the-critically-ill-with-acute-kidney-injury-comet-aki-trial-study-protocol-for-a-randomized-controlled-clinical-trial
#20
Gabor Erdoes, Dominik E Uehlinger, Beatrice Kobel, Monika P Stucki, Roland Wiest, Frank Stueber, Niklaus Fankhauser, Stephan M Jakob, Joerg C Schefold
BACKGROUND: Microembolism is a frequent pathological event during extracorporeal renal replacement therapy (RRT). Some previous data indicate that microemboli are generated in patients who are undergoing RRT and that these may contribute to increased cerebrovascular and neurocognitive morbidity in patients with end-stage renal disease. The current trial aims to quantify the microembolic load and respective qualitative composition that effectively reaches the intracerebral circulation in critically ill patients treated with different RRT modalities for acute kidney injury (AKI)...
March 21, 2018: Trials
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