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AKI and renal replacement

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https://www.readbyqxmd.com/read/29023314/renal-dysfunction-and-cirrhosis
#1
François Durand, Jody C Olson, Mitra K Nadim
PURPOSE OF REVIEW: Hepatorenal syndrome (HRS) does not represent the predominant phenotype of acute kidney injury (AKI) in cirrhosis. Early recognition of HRS helps initiate appropriate therapy. The aims of this review are to present redefinition of AKI, to list new biomarkers, to report recent data on vasopressors in HRS and to propose criteria for simultaneous liver and kidney transplantation (SLKT). RECENT FINDINGS: Urine output, which was not part of the definition of AKI might be reconsidered as it has an independent prognostic value...
October 11, 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/29022223/acute-kidney-injury-in-pregnancy-and-the-role-of-underlying-ckd-a-point-of-view-from-m%C3%A3-xico
#2
REVIEW
Margarita Ibarra-Hernández, Oralia Alejandra Orozco-Guillén, María Luz de la Alcantar-Vallín, Ruben Garrido-Roldan, María Patricia Jiménez-Alvarado, Kenia Benitez Castro, Francisco Villa-Villagrana, Mario Borbolla, Juan Manuel Gallardo-Gaona, Guillermo García-García, Norberto Reyes-Paredes, Giorgina Barbara Piccoli
The incidence of acute kidney injury in pregnancy (P-AKI) in developed countries is significantly lower than in developing ones, where it is estimated to range between 4 and 26%. Mortality in cases of P-AKI requiring dialysis is high, varying from 20 to 80%. In developing countries, clinical decisions are often based on the availability of services and not on needs. Prenatal surveillance in Mexico does not include serum creatinine, limiting the potential for early diagnosis of AKI and CKD and their differential diagnosis...
October 11, 2017: Journal of Nephrology
https://www.readbyqxmd.com/read/28982674/haptoglobin-2-2-phenotype-is-associated-with-increased-acute-kidney-injury-after-elective-cardiac-surgery-in-patients-with-diabetes-mellitus
#3
Chenzhuo Feng, Bhiken I Naik, Wenjun Xin, Jennie Z Ma, David C Scalzo, Swapna Thammishetti, Robert H Thiele, Zhiyi Zuo, Jacob Raphael
BACKGROUND: Recent studies reported an association between the 2-2 phenotype of haptoglobin (Hp 2-2) and increased cardiorenal morbidity in nonsurgical diabetic patients. Our goal was to determine whether the Hp 2-2 phenotype was associated with acute kidney injury (AKI) after elective cardiac surgery in patients with diabetes mellitus. METHODS AND RESULTS: We prospectively enrolled 99 diabetic patients requiring elective cardiac surgery with cardiopulmonary bypass...
October 5, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28982602/the-assessment-of-acute-kidney-injury-in-critically-ill-patients
#4
Sebastjan Bevc, Robert Ekart, Radovan Hojs
Acute kidney injury (AKI) is common in critically ill patients and is associated with high morbidity and mortality. The availability of several biomarkers of kidney injury offers new tools for its early recognition and management. The early identification of high-risk patients provides an opportunity to develop strategies for the prevention, early diagnosis and treatment of AKI. Despite progress in critical care medicine over the past decade, the treatment strategies for AKI in critically ill patients, such as when to start renal replacement therapy, remain controversial...
October 2, 2017: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/28982378/efficacy-and-safety-of-a-balanced-salt-solution-versus-a-0-9-saline-infusion-for-the-prevention-of-contrast-induced-acute-kidney-injury-basic-trial-a-study-protocol-for-a-randomized-controlled-trial
#5
Hyung Ah Jo, Sehoon Park, Chan-Duck Kim, Hee-Yeon Jung, Jang-Hee Cho, Ran-Hui Cha, Ea Wha Kang, Tae Ik Chang, Sejoong Kim, Hyung-Jong Kim, Byung Ha Chung, Jung Pyo Lee, Jung Tak Park, Seung Hyeok Han, Tae-Hyun Yoo, Dong-Ryeol Ryu, Sung Jin Moon, Jae Hyun Chang, Dong Ki Kim, Kwon Wook Joo
BACKGROUND: Contrast-induced acute kidney injury (CI-AKI) is one of the most common causes of iatrogenic kidney injury and, therefore, its prevention is an important issue. However, whether the administration of 0.9% saline is the optimal prophylaxis method remains uncertain due to its supra-physiologic chloride component. In particular, recent studies suggest that chloride-restricted solutions showed superiority over 0.9% saline in several clinical settings. METHODS/DESIGN: The investigators designed a multicenter randomized controlled trial to compare the efficacy of a balanced salt solution and 0...
October 5, 2017: Trials
https://www.readbyqxmd.com/read/28978157/the-optimal-time-of-initiation-of-renal-replacement-therapy-in-acute-kidney-injury-a-meta-analysis
#6
Kaiping Luo, Shufang Fu, Weidong Fang, Gaosi Xu
BACKGROUND: The impact on the timing of renal replacement therapy (RRT) initiation on clinical outcomes for patients with acute kidney injury (AKI) remains controversial. MATERIALS AND METHODS: We searched the Cochrane Library, EMBASE, Global Health, MEDLINE, PubMed, the International Clinical Trials Registry Platform, and Web of Science. RESULTS: We included 49 studies involving 9698 patients. Pooled analysis of 5408 critically ill patients with AKI showed that early RRT was significantly associated with reduced mortality compared to late RRT [odds ratio (OR), 0...
September 15, 2017: Oncotarget
https://www.readbyqxmd.com/read/28957333/association-between-mortality-and-replacement-solution-bicarbonate-concentration-in-continuous-renal-replacement-therapy-a-propensity-matched-cohort-study
#7
Kianoush Kashani, Charat Thongprayoon, Wisit Cheungpasitporn, Gina M Iacovella, Abbasali Akhoundi, Robert C Albright
BACKGROUND: Given the known deleterious effects seen with bicarbonate supplementation for acidemia, we hypothesized that utilizing high bicarbonate concentration replacement solution in continuous venovenous hemofiltration (CVVH) would be independently associated with higher mortality. METHODS: In a propensity score-matched historical cohort study conducted at a single tertiary care center from December 9, 2006, through December 31, 2009, a total of 287consecutive adult critically ill patients with Stage III acute kidney injury (AKI) requiring CVVH were enrolled...
2017: PloS One
https://www.readbyqxmd.com/read/28953045/perioperative-acute-kidney-injury-an-under-recognized-problem
#8
Melanie Meersch, Christoph Schmidt, Alexander Zarbock
The incidence of perioperative acute kidney injury (AKI) is more common than previously recognized, especially in high-risk patients undergoing higher risk procedures. The growing number of patients who develop perioperative AKI is related, in part, to the aging population and increase in the number of individuals with chronic comorbidities, particularly those with premorbid chronic kidney disease. Despite the acceptance of standardization in the definition of AKI, clinicians routinely underdiagnose it and fail to appreciate that it is associated with considerable morbidity and mortality...
August 4, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28952138/can-sglt2-inhibitors-cause-acute-renal-failure-plausible-role-for-altered-glomerular-hemodynamics-and-medullary-hypoxia
#9
REVIEW
Auryan Szalat, Amichai Perlman, Mordechai Muszkat, Mogher Khamaisi, Zaid Abassi, Samuel N Heyman
Sodium-glucose co-transporter-2 inhibitors (SGLT2i) provide outstanding long-term cardiovascular and renal protection in high-risk patients with type 2 diabetes mellitus. Yet, despite encouraging renal safety outcomes reported in the EMPA-REG study, scattered reports suggest that there might be a risk for acute kidney injury (AKI), which may occasionally be fatal or might require renal replacement therapy. Reduced trans-glomerular pressure with a modest decline in kidney function, an inherent characteristic of SGLT2i therapy, conceivably forms the basis for the long-term renal protection, resembling agents that block the renin-angiotensin-aldosterone (RAAS) axis...
September 26, 2017: Drug Safety: An International Journal of Medical Toxicology and Drug Experience
https://www.readbyqxmd.com/read/28898482/impact-of-renal-replacement-therapy-on-survival-in-patients-with-kdigo-stage-3-acute-kidney-injury-a-propensity-score-matched-analysis
#10
Hoi-Ping Shum, King-Chung Chan, Catherine Wing-Yan Tam, Wing-Wa Yan, Tak Mao Chan
PURPOSE: To investigate the impact of renal replacement therapy (RRT) on 90-day mortality in critically ill patients suffering from KDIGO stage 3 acute kidney injury (AKI) with or without life-threatening complications using propensity score matching analysis. MATERIAL AND METHODS: We conducted a retrospective analysis of critically ill adult patients with KDIGO Stage 3 AKI with or without RRT during ICU stay between 1/1/2011-31/12/2013. Cox regression analysis and propensity score matching methods were used to determine predictors for 90-day mortality...
September 12, 2017: Nephrology
https://www.readbyqxmd.com/read/28893780/pharmacokinetic-toxicodynamic-analysis-of-colistin-associated-acute-kidney-injury-in-critically-ill-patients
#11
Alan Forrest, Samira M Garonzik, Visanu Thamlikitkul, Evangelos J Giamarellos-Bourboulis, David L Paterson, Jian Li, Fernanda P Silveira, Roger L Nation
Acute kidney injury (AKI) occurs in a substantial proportion of critically ill patients receiving intravenous colistin. In the pharmacokinetic/toxicodynamic analysis reported here the relationship of occurrence of AKI with exposure to colistin and a number of potential patient factors was explored in 153 critically ill patients, none of whom were receiving renal replacement therapy. Tree-based modelling revealed that rates of AKI were substantially higher when average steady-state plasma colistin concentration was greater than ∼2mg/L...
September 11, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28884304/cell-cycle-arrest-biomarkers-in-urine-to-predict-acute-kidney-injury-in-septic-and-non-septic-critically-ill-patients
#12
M Cuartero, J Ballús, J Sabater, X Pérez, N Nin, J Ordonez-Llanos, A J Betbesé
PURPOSE: To analyse the usefulness of the composite index of the tissue inhibitor of metalloproteinases-2 (TIMP-2) and insulin-like growth factor-binding protein 7 (IGFBP7) as urinary biomarkers for the early prediction of AKI in septic and non-septic patients. METHODS: This is a prospective, observational study including patients admitted to ICU from acute care departments and hospital length of stay <48 h. The main exclusion criteria were pre-existing eGFR <30 mL/min/1...
September 7, 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28878224/mild-intracellular-acidification-by-dexamethasone-attenuates-mitochondrial-dysfunction-in-a-human-inflammatory-proximal-tubule-epithelial-cell-model
#13
T J J Schirris, J Jansen, M Mihajlovic, L P van den Heuvel, R Masereeuw, F G M Russel
Septic acute kidney injury (AKI) associates with poor survival rates and often requires renal replacement therapy. Glucocorticoids may pose renal protective effects in sepsis via stimulation of mitochondrial function. Therefore, we studied the mitochondrial effects of dexamethasone in an experimental inflammatory proximal tubule epithelial cell model. Treatment of human proximal tubule epithelial cells with lipopolysaccharide (LPS) closely resembles pathophysiological processes during endotoxaemia, and led to increased cytokine excretion rates and cellular reactive oxygen species levels, combined with a reduced mitochondrial membrane potential and respiratory capacity...
September 6, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28869251/cardiac-surgery-associated-acute-kidney-injury-risk-factors-pathophysiology-and-treatment
#14
REVIEW
Ying Wang, Rinaldo Bellomo
Cardiac surgery-associated acute kidney injury (CSA-AKI) is the most common clinically important complication in adult patients undergoing open heart surgery, and is associated with increased mortality and morbidity. In patients in intensive care units, CSA-AKI is the second most common type of AKI after septic AKI. In this Review, we explore the definition of CSA-AKI, discuss its epidemiology and identify its risk factors. We discuss current theories of the pathophysiology of CSA-AKI and describe its clinical course...
November 2017: Nature Reviews. Nephrology
https://www.readbyqxmd.com/read/28868069/urinary-neutrophil-gelatinase-associated-lipocalin-as-a-predictor-of-acute-kidney-injury-severe-kidney-injury-and-the-need-for-renal-replacement-therapy-in-the-intensive-care-unit
#15
Fatma I Albeladi, Haifa M Algethamy
BACKGROUND: Recent attempts were made to identify early indicators of acute kidney injury (AKI) in order to accelerate treatment and hopefully improve outcomes. This study aims to assess the value of urinary neutrophil gelatinase-associated lipocalin (uNGAL) as a predictor of AKI, severe AKI, and the need for renal replacement therapy (RRT). METHODS: We conducted a prospective study and included adults admitted to our intensive care unit (ICU) at King Abdulaziz University Hospital (KAUH), between May 2012 and June 2013, who had at least 1 major risk factor for AKI...
May 2017: Nephron Extra
https://www.readbyqxmd.com/read/28861420/balanced-versus-isotonic-saline-resuscitation-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials-in-operation-rooms-and-intensive-care-units
#16
Ary Serpa Neto, Ignacio Martin Loeches, Robert B Klanderman, Raphael Freitas Silva, Marcelo Gama de Abreu, Paolo Pelosi, Marcus J Schultz
BACKGROUND: Fluid resuscitation is the cornerstone in treatment of shock, and intravenous fluid administration is the most frequent intervention in operation rooms and intensive care units (ICUs). The composition of fluids used for fluid resuscitation gained interest over the past decade, with recent focus on whether balanced solutions should be preferred over isotonic saline. METHODS: Systematic review and meta-analysis of randomized controlled trials (RCTs) comparing fluid resuscitation with a balanced solution versus isotonic saline in adult patients in operation room or ICUs...
August 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28858859/independent-risk-factors-and-2-year-outcomes-of-acute-kidney-injury-after-surgery-for-congenital-heart-disease
#17
Daishi Hirano, Akira Ito, Akifumi Yamada, Daisuke Kakegawa, Saori Miwa, Chisato Umeda, Kosuke Chiba, Yoichi Takemasa, Ai Tokunaga, Hiroyuki Ida
BACKGROUND: Data are limited regarding risk factors for acute kidney injury (AKI) following cardiac surgery in children with congenital heart disease (CHD). This observational study was performed to examine temporal trends in AKI incidence according to the Pediatric Risk, Injury, Failure, Loss, End-Stage Renal Disease (pRIFLE) criteria, identify independent risk factors for AKI after cardiac surgery, and examine associations between AKI and long-term mortality. METHODS: We retrospectively evaluated 418 patients (259 males, 159 females; median age, 5 months) who underwent cardiac surgery for CHD between April 2007 and August 2013...
2017: American Journal of Nephrology
https://www.readbyqxmd.com/read/28857811/biomarker-guided-intervention-to-prevent-acute-kidney-injury-after-major-surgery-the-prospective-randomized-bigpak-study
#18
Ivan Göcze, Dominik Jauch, Markus Götz, Pascal Kennedy, Bettina Jung, Florian Zeman, Carsten Gnewuch, Bernhard M Graf, Wolfgang Gnann, Bernhard Banas, Thomas Bein, Hans J Schlitt, Tobias Bergler
OBJECTIVE: To determine the impact of renal biomarker-guided implementation of the Kidney Disease Improving Global Outcomes (KDIGO) care bundle on the incidence of acute kidney injury (AKI) after major noncardiac surgery in a single-center unblinded randomized clinical trial. BACKGROUND: Early optimization of volume status and discontinuation of nephrotoxic medication before the occurrence of AKI may be the crucial step to reduce preventable AKI. METHODS: The urinary biomarker-triggered KDIGO care bundle (early optimization of fluid status, maintenance of perfusion pressure, discontinuation of nephrotoxic agents) was compared to standard intensive care unit (ICU) care in 121 patients with an increased AKI risk after major abdominal surgery that was determined by urinary biomarker (inhibitor of metalloproteinase-2 × insulin-like growth factor-binding protein 7) >0...
August 29, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28857121/assessment-of-plasma-endostatin-to-predict-acute-kidney-injury-in-critically-ill-patients
#19
J Mårtensson, S T Vaara, V Pettilä, T Ala-Kokko, S Karlsson, O Inkinen, A Uusaro, A Larsson, M Bell
BACKGROUND: We evaluated whether plasma endostatin predicts acute kidney injury (AKI), need for renal replacement therapy (RRT), or death. METHODS: Prospective, observational, multicenter study from 1 September 2011 to 1 February 2012 with data from 17 intensive care units (ICUs) in Finland. RESULTS: A total of 1112 patients were analyzed. We measured plasma endostatin within 2 h of ICU admission. Early AKI (KDIGO stage within 12 h of ICU admission) was found in 20% of the cohort, and 18% developed late AKI (KDIGO criteria > 12 h from ICU admission)...
August 31, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28843662/the-effect-of-early-renal-replacement-therapy-guided-by-plasma-neutrophil-gelatinase-associated-lipocalin-on-outcome-of-acute-kidney-injury-a-feasibility-study
#20
Nattachai Srisawat, Passisd Laoveeravat, Ploynapas Limphunudom, Nuttha Lumlertgul, Sadudee Peerapornratana, Khajohn Tiranathanagul, Paweena Susantitaphong, Kearkiat Praditpornsilpa, Kriang Tungsanga, Somchai Eiam-Ong
PURPOSE: The optimal time and the parameter utilized for decision to initiate renal replacement therapy (RRT) in acute kidney injury (AKI) are still controversial. Recently, high levels of plasma NGAL (pNGAL) has been strongly correlated with poor AKI outcome. This is a feasibility study conducted to test whether early RRT initiation guided by pNGAL could improve AKI outcome. MATERIAL AND METHODS: The study comprised of triage trial and interventional trial running subsequently...
August 18, 2017: Journal of Critical Care
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