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AKI and renal replacement

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https://www.readbyqxmd.com/read/29452878/combining-novel-renal-injury-markers-with-delta-serum-creatinine-early-after-cardiac-surgery-and-risk-stratification-for-serious-adverse-outcomes-an-exploratory-analysis
#1
David R McIlroy, David Farkas, Kun Pan, John W Pickering, H Thomas Lee
OBJECTIVE: To evaluate the prognostic utility of multiple novel urinary biomarkers of renal injury when used alone, in pair-wise combination with an early delta serum creatinine (ΔS Cr ) term, and combined as a broad biomarker panel for the prediction of serious adverse outcomes that may reflect AKI in patients undergoing cardiac surgery. DESIGN: Post-hoc analysis of prospective observational study. SETTING: Academic medical center. PARTICIPANTS: 603 adults undergoing cardiac surgery...
December 30, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29451341/validation-of-acute-kidney-injury-according-to-the-modified-kdigo-criteria-in-infants-after-cardiac-surgery-for-congenital-heart-disease
#2
Kentaro Ueno, Shunji Seki, Naohiro Shiokawa, Tomoyuki Matsuba, Akinori Miyazono, Daisuke Hazeki, Yutaka Imoto, Yoshifumi Kawano
AIM: We aimed to validate the incidence of, risk factors for, and postoperative outcomes of acute kidney injury (AKI) according to the modified Kidney Disease Improving Global Outcomes (m-KDIGO) criteria and compare this criteria with both the pediatric Risk, Injury, Failure, Loss, End-stage disease (pRIFLE) and Acute Kidney Injury Network (AKIN) criteria in infants after cardiac surgery. METHODS: We retrospectively enrolled 145 consecutive infants who underwent open-heart surgery at Kagoshima University Hospital...
February 16, 2018: Nephrology
https://www.readbyqxmd.com/read/29433841/relationship-between-acute-kidney-injury-and-serum-procalcitonin-pct-concentration-in-critically-ill-patients-with-influenza-infection
#3
A Rodríguez, L F Reyes, J Monclou, B Suberviola, M Bodí, G Sirgo, J Solé-Violán, J Guardiola, D Barahona, E Díaz, I Martín-Loeches, M I Restrepo
INTRODUCTION: Serum procalcitonin (PCT) concentration could be increased in patients with renal dysfunction in the absence of bacterial infection. OBJECTIVE: To determine the interactions among serum renal biomarkers of acute kidney injury (AKI) and serum PCT concentration, in patients admitted to the intensive care unit (ICU) due to lung influenza infection. DESIGN: Secondary analysis of a prospective multicentre observational study. SETTING: 148 Spanish ICUs...
February 9, 2018: Medicina Intensiva
https://www.readbyqxmd.com/read/29426053/-renal-replacement-therapy-in-acute-kidney-injury-indication-and-implementation
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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/29377300/effects-of-6-tetrastarch-and-lactated-ringer-s-solution-on-extravascular-lung-water-and-markers-of-acute-renal-injury-in-hemorrhaged-isoflurane-anesthetized-healthy-dogs
#15
M S Diniz, F J Teixeira-Neto, N Celeita-Rodríguez, C H Girotto, M W Fonseca, A C Oliveira-Garcia, B López-Castañeda
BACKGROUND: Tetrastarch can cause acute kidney injury (AKI) in humans with sepsis, but less likely to result in tissue edema than lactated Ringer's solution (LRS). OBJECTIVES: Compare effects of volume replacement (VR) with LRS and 6% tetrastarch solution (TS) on extravascular lung water (EVLW) and markers of AKI in hemorrhaged dogs. ANIMALS: Six healthy English Pointer dogs (19.7-35.3 kg). METHODS: Prospective crossover study...
January 28, 2018: Journal of Veterinary Internal Medicine
https://www.readbyqxmd.com/read/29366580/urinary-biomarkers-may-provide-prognostic-information-for-subclinical-acute-kidney-injury-after-cardiac-surgery
#16
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
#17
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
#18
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
#19
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
#20
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
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