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https://www.readbyqxmd.com/read/28629397/optimal-timing-of-renal-replacement-therapy-initiation-in-acute-kidney-injury-the-elephant-felt-by-the-blindmen
#1
Chih-Chung Shiao, Tao-Min Huang, Herbert D Spapen, Patrick M Honore, Vin-Cent Wu
Renal replacement therapy (RRT) is a key component in the management of severe acute kidney injury (AKI) in critically ill patients. Many cohort studies, meta-analyses, and two recent large randomized prospective trials which evaluated the relationship between the timing of RRT initiation and patient outcome remain inconclusive due to substantial differences in study design, patient population, AKI definition, and RRT indication. A cause-specific diagnosis of AKI based on current staging criteria plus a sensitive biomarker (panel) that allows creating a homogeneous study population is definitely needed to assess the impact of early versus late initiation of RRT on patient outcome...
June 20, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28620570/perforated-bladder-as-a-cause-of-abdominal-ascites-in-a-patient-presenting-with-acute-onset-abdominal-pain
#2
Raj Shah, Madhuri Ramakrishnan, Beenish Ahmed, Khalil Abuamr, Osama Yousef
Bladder perforation, especially when atraumatic, is a rare cause of ascites and is often difficult to differentiate from other causes of abdominal pain and ascites in the acute setting.  A 43-year-old Caucasian woman with a history of multiple sclerosis presented with acute abdominal pain. A computed tomography (CT) scan of her abdomen and pelvis without contrast revealed ascites, acute kidney injury (AKI) was noted on laboratory workup, and very little urine was drained by Foley catheter. Over the next several days, the patient's clinical condition deteriorated with no definitive diagnosis...
May 11, 2017: Curēus
https://www.readbyqxmd.com/read/28619541/can-renal-resistive-index-predict-acute-kidney-injury-after-acute-type-a-aortic-dissection-repair
#3
Hai-Bo Wu, Huai Qin, Wei-Guo Ma, Hong-Lei Zhao, Jun Zheng, Jian-Rong Li, Li-Zhong Sun
BACKGROUND: This study sought to determine whether assessment of the renal resistive index (RRI) can predict the short-term reversibility of acute kidney injury (AKI) after repair of acute type A aortic dissection (TAAD). METHODS: This prospective study included 62 patients undergoing repair of acute TAAD. Doppler-based RRIs were obtained preoperatively, immediately after the surgical procedure, and 6, 24, and 48 hours postoperatively. The occurrence of AKI was evaluated daily according to Acute Kidney Injury Network criteria...
June 13, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28616213/postoperative-goal-directed-therapy-and-development-of-acute-kidney-injury-following-major-elective-noncardiac-surgery-post-hoc-analysis-of-pom-o-randomized-controlled-trial
#4
Amour Patel, John R Prowle, Gareth L Ackland
Background: The role of goal-directed therapy (GDT) in preventing creatinine rise following noncardiac surgery is unclear. We performed a post-hoc analysis of a randomized controlled trial to assess the relationship between postoperative optimization of oxygen delivery and development of acute kidney injury (AKI)/creatinine rise following noncardiac surgery. Methods: Patients were randomly assigned immediately postoperatively to receive either fluid and/or dobutamine therapy to maintain/restore their preoperative oxygen delivery, or protocolized standard care (oxygen delivery only recorded)...
June 2017: Clinical Kidney Journal
https://www.readbyqxmd.com/read/28616210/acute-kidney-injury-an-overview-of-diagnostic-methods-and-clinical-management
#5
Daniel Hertzberg, Linda Rydén, John W Pickering, Ulrik Sartipy, Martin J Holzmann
Acute kidney injury (AKI) is a common condition in multiple clinical settings. Patients with AKI are at an increased risk of death, over both the short and long term, and of accelerated renal impairment. As the condition has become more recognized and definitions more unified, there has been a rapid increase in studies examining AKI across many different clinical settings. This review focuses on the classification, diagnostic methods and clinical management that are available, or promising, for patients with AKI...
June 2017: Clinical Kidney Journal
https://www.readbyqxmd.com/read/28598051/prevention-and-management-of-acute-kidney-injury-what-a-physician-should-know
#6
Danish Kathuria, N P Singh
The incidence of acute kidney injury (AKI) has been increasing worldwide. The increase is attributable not only to ageing population with multiple comorbidities, polypharmacy, increasing use of contrast for diagnostic and therapeutic procedures but also to the fact that now it is being recognized more often. The 'Zero by 25' initiative by International Society of Nephrology aims at preventing all avoidable deaths from AKI worldwide by the year 2025. It calls for greater awareness about management of AKI among primary care physicians...
May 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/28588162/role-of-prifle-criteria-in-early-diagnosis-of-severity-staging-of-neonatal-aki-and-its-impact-on-management
#7
S Afroz, T Ferdaus, M Hanif, A H Mollah, M Banerjee, T H Khan
Mortality is high among sick neonates who have concomitant acute kidney injury (AKI). This observational study was done at Special Care Baby Unit (SCABU) of Dhaka Medical College Hospital (DMCH), Bangladesh from October 2013 to March 2014 to find out the role of pRIFLE criteria in prediction of severity stages of AKI in neonate and early intervention to see the immediate outcome. A total of 44 neonates with AKI were included, all were treated conservatively and with intermittent peritoneal dialysis (IPD) as needed...
April 2017: Mymensingh Medical Journal: MMJ
https://www.readbyqxmd.com/read/28586767/quantification-and-dosing-of-renal-replacement-therapy-in-acute-kidney-injury-a-reappraisal
#8
William R Clark, Martine Leblanc, Zaccaria Ricci, Claudio Ronco
BACKGROUND/AIMS: Delivered dialysis therapy is routinely measured in the management of patients with end-stage renal disease; yet, the quantification of renal replacement prescription and delivery in acute kidney injury (AKI) is less established. While continuous renal replacement therapy (CRRT) is widely understood to have greater solute clearance capabilities relative to intermittent therapies, neither urea nor any other solute is specifically employed for CRRT dose assessments in clinical practice at present...
2017: Blood Purification
https://www.readbyqxmd.com/read/28586115/early-detection-of-postoperative-acute-kidney-injury-in-acute-stanford-type-a-aortic-dissection-with-doppler-renal-resistive-index
#9
Huai Qin, Haibo Wu, Yi Chen, Nan Zhang, Zhanming Fan
OBJECTIVES: This study aimed to evaluate the early efficiency of Doppler renal resistive index (DRRI) in prediction of acute kidney injury (AKI) after surgery in acute Stanford Type A aortic dissection (AAAD) patients. METHODS: Sixty-one AAAD patients who planned to receive Sun's surgical management were prospectively enrolled. The DRRI was measured by ultrasonography Doppler on the day before surgery (DRRIpre ), on admission to the intensive care unit (DRRIT0 ), 6 hours after surgery (DRRIT6 ), 24 hours after surgery (DRRIT24 ), and 48 hours after surgery (DRRIT48 )...
June 6, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/28584266/novel-rapid-immunohistochemistry-using-an-alternating-current-electric-field-for-intraoperative-diagnosis-of-sentinel-lymph-nodes-in-breast-cancer
#10
Kaori Terata, Hajime Saito, Hiroshi Nanjo, Yuko Hiroshima, Satoru Ito, Kasumi Narita, Yoichi Akagami, Ryuta Nakamura, Hayato Konno, Aki Ito, Satoru Motoyama, Yoshihiro Minamiya
Axillary lymph node status and pathological diagnosis of sentinel lymph nodes (SLNs) is a prognostic factor that influences management of postoperative therapy. Recent reports indicate that one-step nucleic acid amplification and hematoxylin and eosin (HE)-stained frozen sections are effective for intraoperative diagnosis of SLNs. In the present study, we report a rapid-immunohistochemical staining (R-IHC) method that enables intraoperative detection of SLN metastases within 16 min using an anti-cytokeratin antibody...
June 5, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28580076/postoperative-acute-kidney-injury
#11
REVIEW
Jung Tak Park
Acute kidney injury (AKI) after cardiac surgery is a common and serious complication. Several definitions of AKI have been proposed recently, and include both increases in serum creatinine levels and decreases in urine output as diagnostic criteria. The pathophysiology of postoperative AKI is complex and involves both ischemic injury and systemic inflammation. Identifying risk factors, such as old age, underlying diabetes, heart failure, and obesity, may aid in the application of preventative methods for postoperative AKI...
June 2017: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/28579710/assessment-of-knowledge-of-acute-kidney-injury-among-non-nephrology-doctors-in-two-government-hospitals-in-ondo-city-southwest-nigeria
#12
Oluseyi Adejumo, Ayodeji Akinbodewa, Oladimeji Alli, Pirisola Olufemi, Abolarin Olatunji
BACKGROUND: Adequate knowledge of acute kidney injury (AKI) among doctors is essential for its prevention, early diagnosis and management. Assessing knowledge of AKI among doctors is necessary to identify areas of deficiencies and key areas to be emphasized when organizing educational programs aimed at improving AKI care. This study determined the knowledge of AKI among non-nephrology doctors in Ondo City, Southwest Nigeria. MATERIALS AND METHODS: This was a cross-sectional descriptive study carried out in two government hospitals in Ondo City using a self-administered pretested questionnaire that assessed knowledge of AKI among non-nephrology doctors...
March 2017: Ethiopian Journal of Health Sciences
https://www.readbyqxmd.com/read/28578840/acute-kidney-injury-after-first-stage-joint-revision-for-infection-risk-factors-and-the-impact-of-antibiotic-dosing
#13
Jeffrey A Geller, Gregory Cunn, Thomas Herschmiller, Taylor Murtaugh, Antonia Chen
BACKGROUND: Scarce literature exists regarding risk factors associated with postoperative acute kidney injury (AKI) after first-stage revision procedures. The purpose of this study was to determine risk factors for AKI and the efficacy of intra-articular antibiotics in infection eradication. METHODS: We retrospectively identified 247 patients who underwent a 2-stage revision procedure for the treatment of hip or knee periprosthetic joint infection. We applied previously published diagnostic criteria for AKI to determine its incidence and risk factors for its development...
May 4, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28570592/a-prospective-study-of-the-demographics-management-and-outcome-of-patients-with-acute-kidney-injury-in-cape-town-south-africa
#14
Thandiwe A L Dlamini, Peter J Heering, Tawanda Chivese, Brian Rayner
AIM: To study the demographics and outcome of acute kidney injury (AKI) at Groote Schuur Hospital, Cape Town, South Africa. METHODS AND FINDINGS: A prospective observational study of AKI fulfilling the Kidney Disease: Improving Global Outcomes definition, from 8 July 2012 to 8 July 2013. Ethics approval was granted by the University of Cape Town Human Research Ethics Committee. Consent was waived because patient data was de-identified and patient management was not adversely affected by the study...
2017: PloS One
https://www.readbyqxmd.com/read/28569136/molecular-differences-in-susceptibility-of-the-kidney-to-sepsis-induced-kidney-injury
#15
Martin Matejovic, Lenka Valesova, Jan Benes, Roman Sykora, Roman Hrstka, Jiri Chvojka
BACKGROUND: Septic acute kidney injury affects 40-50% of all septic patients. Molecular differences between septic patients with and without acute kidney injury (AKI) are only poorly understood. Here, we investigated gene expression changes that differentiated the subjects who developed septic AKI from those who did not and coupled this approach with traditional parameters of renal physiology. METHODS: In 15 anesthetized, mechanically ventilated and instrumented pigs, progressive sepsis was induced either by peritonitis or by continuous intravenous infusion of Pseudomonas aeruginosa...
May 31, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28564734/-diagnostics-and-non-dialytic-management-of-aki-update
#16
Daniel Patschan, Gerhard A Müller
No abstract text is available yet for this article.
June 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28564127/impact-of-terlipressin-infusion-during-and-after-live-donor-liver-transplantation-on-incidence-of-acute-kidney-injury-and-neutrophil-gelatinase-associated-lipocalin-serum-levels-a-randomized-controlled-trial
#17
Mohamed Abdelrauf Kandil, Khalid Mousa Abouelenain, Ayman Alsebaey, Hanaa Said Rashed, Mohamed Helmi Afifi, Mohamed Abdelmoneem Mahmoud, Khaled Ahmed Yassen
Acute kidney injury (AKI) with liver transplantation is not uncommon. Impact of Terlipressin infusion on AKI, haemodynamics and plasma concentration of Neutrophil Gelatinase Associated Lipocalin (NGAL) was studied METHODS: Patients (n=50) were randomized (NCT02059460, USA) into 2 equal groups; Terlipressin vs Controls. Terlipressin (1-4 μg/kg/h) was administrated for 5 days. Intraoperative Transoesophageal Doppler for haemodynamic management. Renal functions, peak portal vein blood flow velocity (PPV) and hepatic artery resistive index (HARI) were recorded...
May 31, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28561005/management-of-patients-at-risk-of-acute-kidney-injury
#18
REVIEW
Jill Vanmassenhove, Jan Kielstein, Achim Jörres, Wim Van Biesen
Acute kidney injury (AKI) is a multifaceted syndrome that occurs in different settings. The course of AKI can be variable, from single hit and complete recovery, to multiple hits resulting in end-stage renal disease. No interventions to improve outcomes of established AKI have yet been developed, so prevention and early diagnosis are key. Awareness campaigns and education for health-care professionals on diagnosis and management of AKI-with attention to avoidance of volume depletion, hypotension, and nephrotoxic interventions-coupled with electronic early warning systems where available can improve outcomes...
May 27, 2017: Lancet
https://www.readbyqxmd.com/read/28553036/postpartum-acute-kidney-injury-experience-of-a-tertiary-care-center
#19
M M Mir, M S Najar, A M Chaudary, H Azad, A R Reshi, K A Banday, M A Bhat, I A Wani, M M Wani, M Ursilla
Pregnancy-related-acute kidney injury (PR-AKI) had decreased from 40% to 20% in 1960 to <10% in recent series, mostly due to meticulous antenatal management. Postpartum-AKI (PP-AKI) resulting from late obstetric complications has become more apparent after improvement in antenatal care and legalization of medical termination of pregnancy. Women with renal injury in peripartum period admitted to our hospital over a period of 2 years (April 2013 to May 2015) were studied. Of 713 patients of AKI admitted, 61 had PR-AKI with an incidence of 4...
May 2017: Indian Journal of Nephrology
https://www.readbyqxmd.com/read/28548696/the-roles-of-continuous-renal-replacement-therapy-in-septic-acute-kidney-injury
#20
Takuya Ueno
Despite hundreds of clinical and basic studies that have led to a better mechanistic understanding of sepsis, the number of cases with sepsis in the United States is still rising. Sepsis is a common cause of acute kidney injury (AKI) and may explain long-term complications and mortality. In the current article, a new therapeutic concept using continuous renal replacement therapy to prevent and manage long-term sequelae in septic AKI is described.
May 26, 2017: Artificial Organs
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