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epidemiology acute kidney injury

Richard R Kew, Tahmineh Tabrizian, James A Vosswinkel, James E Davis, Randeep S Jawa
BACKGROUND: Severe acute muscle injury results in massive cell damage, causing the release of actin into extracellular fluids where it complexes with the vitamin D binding protein (DBP). We hypothesized that a systemic Vitamin D deficiency would result in a less pro-inflammatory phenotype. METHODS: C57BL/6 wild-type and DBP deficient (DBP-/-) mice received intramuscular injections of either 50% glycerol or phosphate-buffered saline into thigh muscles. Muscle injury was assessed by histology...
March 16, 2018: Journal of Trauma and Acute Care Surgery
Simin Dashti-Khavidaki, Hossein Khalili, Mohsen Nasiri-Toosi
There was no report of nephrotoxicity during clinical trials assessed sofosbuvir for treatment of hepatitis C (HCV) infection. This may be due to excluding patients with severe kidney dysfunction, as a main population at risk for drug-induced nephrotoxicity from these studies. There are some reports of acute kidney injury (AKI) possibly related to sofosbuvir-containing treatments from real-life experiences. Areas covered: Available data on epidemiology, type, and possible risk factors for nephrotoxicity of sofosbuvir-containing treatment are reviewed...
March 14, 2018: Expert Review of Clinical Pharmacology
Richard J Johnson, George L Bakris, Claudio Borghi, Michel B Chonchol, David Feldman, Miguel A Lanaspa, Tony R Merriman, Orson W Moe, David B Mount, Laura Gabriella Sanchez Lozada, Eli Stahl, Daniel E Weiner, Glenn M Chertow
Urate is a cause of gout, kidney stones, and acute kidney injury from tumor lysis syndrome, but its relationship to kidney disease, cardiovascular disease, and diabetes remains controversial. A scientific workshop organized by the National Kidney Foundation was held in September 2016 to review current evidence. Cell culture studies and animal models suggest that elevated serum urate concentrations can contribute to kidney disease, hypertension, and metabolic syndrome. Epidemiologic evidence also supports elevated serum urate concentrations as a risk factor for the development of kidney disease, hypertension, and diabetes, but differences in methodologies and inpacts on serum urate concentrations by even subtle changes in kidney function render conclusions uncertain...
February 26, 2018: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Yu Zhang, Li Jiang, Baomin Wang, Xiuming Xi
BACKGROUND: Although there were studies to investigate the risk factors for acute kidney injury (AKI) after surgery, most of them focused on one specific type of surgeries. The risk factors for postoperative AKI in patients undergoing all surgeries in intensive care units (ICU) have not been reported. METHODS: Data from 1731 patients undergoing surgery in 30 ICUs of 28 tertiary hospitals in Beijing from March to August 2012 were prospectively collected. AKI was defined and staged by the KDIGO criteria...
February 26, 2018: International Urology and Nephrology
Stefanie Kennon-McGill, Mitchell R McGill
Research on acetaminophen (APAP) toxicity over the last several decades has focused on the pathophysiology of liver injury, but increasing attention is being paid to other known and possible adverse effects. It has been known for decades that APAP causes acute kidney injury, but confusion exists regarding prevalence, and the mechanisms have not been well investigated. More recently, a number of experimental, clinical and epidemiological studies have reported evidence for pulmonary, endocrine, neurological and neurodevelopmental toxicity, but the quality of evidence from those studies varies...
January 15, 2018: Journal of Clinical and Translational Research
Dana Y Fuhrman, Sandra Kane-Gill, Stuart L Goldstein, Priyanka Priyanka, John A Kellum
BACKGROUND: Most studies of acute kidney injury (AKI) have focused on older adults, and little is known about AKI in young adults (16-25 years) that are cared for in an adult intensive care unit (ICU). We analyzed data from a large single-center ICU database and defined AKI using the Kidney Disease Improving Global Outcomes criteria. We stratified patients 16-55 years of age into four age groups for comparison and used multivariable logistic regression to identify associations of potential susceptibilities and exposures with AKI and mortality...
February 14, 2018: Annals of Intensive Care
Lynn Redahan, Patrick T Murray
There is an expanding body of literature regarding the utility of novel biomarkers in drug-induced kidney injury (DIKI) and other forms of acute kidney injury (AKI). The authors could not thoroughly review this topic without referring to and acknowledging this work. Included is a list of additional articles (see Supplementary Reading List) that have been referenced, but not cited within the body of the text. These references have provided data used within this article and have allowed the authors to discuss the epidemiology of DIKI, its classification, the utility of specific biomarkers, and the impact that comorbid illness and medications can have on their levels...
March 2018: Clinical Pharmacology and Therapeutics
William R Cooke, Ulla K Hemmilä, Alison L Craik, Chimwemwe J Mandula, Priscilla Mvula, Ausbert Msusa, Gavin Dreyer, Rhys Evans
BACKGROUND: Obstetric-related acute kidney injury (AKI) is thought to be a key contributor to the overall burden of AKI in low resource settings, causing significant and preventable morbidity and mortality. However, epidemiological data to corroborate these hypotheses is sparse. This prospective observational study aims to determine the incidence, aetiology and maternal-fetal outcomes of obstetric-related AKI in Malawi. METHODS: Women greater than 20 weeks gestation or less than 6 weeks postpartum admitted to obstetric wards at a tertiary hospital in Blantyre, Malawi, and at high-risk of AKI were recruited between 21st September and 11th December 2015...
February 2, 2018: BMC Nephrology
Wuhua Jiang, Jiarui Xu, Bo Shen, Yimei Wang, Jie Teng, Xiaoqiang Ding
Acute kidney injury (AKI) is a common global health challenge, affecting patient morbidity adversely and resulting in an estimated 1.4 million deaths per year. Since the International Society of Nephrology proposed a goal of eliminating preventable deaths from AKI by 2025, implementation of this program remains far from optimistic not only because of the lack of resources but also because of the scarce data addressing the epidemiology and causes of AKI, especially in developing countries, the relative insufficient health care resources to diagnose and treat AKI, and the delayed awareness of the impact of AKI on patient outcomes...
2018: Contributions to Nephrology
Zaccaria Ricci, Stefano Romagnoli
BACKGROUND: The acute reduction of kidney function in critically and noncritically ill patients (regardless of their age) is one of the deadliest clinical conditions ever reported in modern medicine. Acute kidney injury (AKI) symptoms are sneaky and potentially difficult to be identified at the right time at the bedside. One of the greatest efforts of the recent history of critical care nephrology has been to find a common classification for AKI definition and staging with the purpose of allowing a timely diagnosis and push forward epidemiologic research...
2018: Contributions to Nephrology
Jiarui Xu, Wuhua Jiang, Bo Shen, Yi Fang, Jie Teng, Yimei Wang, Xiaoqiang Ding
Patients who have undergone cardiac surgery are at high risk of acute kidney injury (AKI) and often associated with poor short- and long-term outcomes. It is considered that the burden of AKI can be reduced and the quality of care can be improved by raising the appropriate awareness and using the right tools for early prevention and better management, by (1) improving awareness by understanding the epidemiology and pathophysiology; (2) using tools for risk assessment for early prevention; (3) increasing the use of electronic screening for early diagnosis; and (4) developing right clinical strategies for better treatment...
2018: Contributions to Nephrology
Marlies Ostermann, Jorge Cerdá
BACKGROUND: Acute kidney injury (AKI) is one of the most common complications in acutely ill patients. The epidemiology, clinical presentation, and outcome vary between patients and countries. SUMMARY: Patients with AKI often exhibit multiple organ dysfunction that is caused, in part, by marked cross-talk between the kidney and other organs and tissues. These deleterious interactions arise, at least in part, from systemic inflammatory changes, an increased cytokine load, increases in leukocyte trafficking and activation of neurohormonal processes...
2018: Contributions to Nephrology
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
Supakanya Wongrakpanich, Christos Kallis, Prithiv Prasad, Janani Rangaswami, Andrew Rosenzweig
Rhabdomyolysis is a syndrome caused by injury to skeletal muscle. There is limited data of rhabdomyolysis in the elderly. The objective of this study is to investigate demographic data, etiologies, laboratory values, prognostic factors, and mortality of rhabdomyolysis in the geriatric population. A 4-years retrospective chart review study was conducted. Our inclusion criteria were age above 65 years and creatinine kinase level excess five times of normal upper limit. Among 167 patients, 47.3% were male. The median age at diagnosis was 80...
February 2018: Aging and Disease
Vaka K Sigurjonsdottir, Swasti Chaturvedi, Cherry Mammen, Scott M Sutherland
Acute kidney injury (AKI) is characterized clinically as an abrupt decline in renal function marked by reduced excretion of waste products, disordered electrolytes, and disrupted fluid homeostasis. The recent development of a standardized AKI definition has transformed our understanding of AKI epidemiology and outcomes. We now know that in the short term, children with AKI experience greater morbidity and mortality; additionally, observational studies have established that chronic renal sequelae are far more common after AKI events than previously realized...
January 26, 2018: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
Ramon Alfonso Exeni, Romina Jimena Fernandez-Brando, Adriana Patricia Santiago, Gabriela Alejandra Fiorentino, Andrea Mariana Exeni, Maria Victoria Ramos, Marina Sandra Palermo
Hemolytic uremic syndrome (HUS) is defined as a triad of noninmune microangiopathic hemolytic anemia, thrombocytopenia, and acute kidney injury. The most frequent presentation is secondary to Shiga toxin (Stx)-producing Escherichia coli (STEC) infections, which is termed postdiarrheal, epidemiologic or Stx-HUS, considering that Stx is the necessary etiological factor. After ingestion, STEC colonize the intestine and produce Stx, which translocates across the intestinal epithelium. Once Stx enters the bloodstream, it interacts with renal endothelial and epithelial cells, and leukocytes...
January 25, 2018: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
Richard Sinert
The authors of "Emergency Department Patients with Acute Kidney Injury: Appropriately Discharged but Inadequately Followed-Up?" in this month's AEM reviewed two recent studies (Scheuermeyer et al and Acedillo et al) from the Nephrology literature describing the epidemiology and outcomes of discharged Emergency Department (ED) patients with Acute Kidney Injury (AKI). This review concludes that even mild AKI in discharged ED patients is associated with increased risks of End Stage Renal Disease (ESRD) and mortality...
January 23, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Nareg H Roubinian, Jeanne E Hendrickson, Darrell J Triulzi, Jerome L Gottschall, Michael Michalkiewicz, Dhuly Chowdhury, Daryl J Kor, Mark R Looney, Michael A Matthay, Steven H Kleinman, Donald Brambilla, Edward L Murphy
OBJECTIVES: Transfusion-associated circulatory overload is characterized by hydrostatic pulmonary edema following blood transfusion. Restrictive transfusion practice may affect the occurrence and severity of transfusion-associated circulatory overload in critically ill patients. We sought to examine contemporary risk factors and outcomes for transfusion-associated circulatory overload. DESIGN: Case-control study. SETTING: Four tertiary care hospitals...
January 3, 2018: Critical Care Medicine
Liezl Du Plessis, Shahrad Rod Rassekh, Cherry Mammen
BACKGROUND/OBJECTIVES: Childhood acute myeloid leukemia (AML) is a rare and heterogeneous disease. Pediatric data on the epidemiology of acute kidney injury (AKI) in AML are limited. We report on the incidence of AKI in childhood AML and the risk factors associated with AKI episodes. METHODS: A retrospective cohort of 53 patients (≤18 years), with de novo AML, receiving chemotherapy over a 10-year period. All serum creatinine (SCr) levels during therapy-related hospitalizations were assessed to stage AKI episodes as per Kidney Disease: Improving Global Outcomes criteria...
December 29, 2017: Pediatric Blood & Cancer
Wojciech Wołyniec, Wojciech Ratkowski, Katarzyna Kasprowicz, Zbigniew Jastrzębski, Sylwia Małgorzewicz, Konrad Witek, Tomasz Grzywacz, Piotr Żmijewski, Marcin Renke
THE MAIN PROBLEM: Acute kidney injury (AKI) is reported as a common complication of marathon and ultramarathon running. In previous studies AKI was diagnosed on the basis of the creatinine level in serum and estimated glomerular filtration rate (eGFR). In the present study we calculated eGFR and also measured creatinine clearance after every 25 km of a 100 km run. METHODS: 20 healthy, amateur runners (males, mean age 40.75 ± 7.15 years, mean weight 76.87 ± 8.39 kg) took part in a 100 km run on a track...
December 27, 2017: Journal of Strength and Conditioning Research
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