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By Isabel Acosta-Ochoa Nephrology senior staff. Valladolid. Spain
Agata Bielecka-Dabrowa, Breno Godoy, Joerg C Schefold, Michael Koziolek, Maciej Banach, Stephan von Haehling
PURPOSE OF REVIEW: Acute decompensated heart failure (ADHF) is one of the biggest challenges in the management of chronic heart failure. Despite several advances in medical and device therapy, high readmission and mortality rates continue to be a burden on healthcare systems worldwide. The aim of the current review is to provide an overview on current as well as future approaches in cardiorenal interactions in patients with ADHF. RECENT FINDINGS: One of the strongest predictors of adverse outcomes in ADHF is renal dysfunction, referred to as cardiorenal syndromes (CRS) or cardiorenal interactions...
July 10, 2018: Current Heart Failure Reports
Abduzhappar Gaipov, Miklos Z Molnar, Praveen K Potukuchi, Keiichi Sumida, Zoltan Szabo, Oguz Akbilgic, Elani Streja, Connie M Rhee, Santhosh K G Koshy, Robert B Canada, Kamyar Kalantar-Zadeh, Csaba P Kovesdy
Background: Previous studies reported that compared with percutaneous coronary interventions (PCIs), coronary artery bypass grafting (CABG) is associated with a reduced risk of mortality and repeat revascularization in patients with mild to moderate chronic kidney disease (CKD) and end-stage renal disease (ESRD). Information about outcomes associated with CABG versus PCI in patients with advanced stages of CKD is limited. We evaluated the incidence and relative risk of acute kidney injury (AKI) associated with CABG versus PCI in patients with advanced CKD...
July 9, 2018: Nephrology, Dialysis, Transplantation
Christina Bradshaw, Yuanchao Zheng, Samuel A Silver, Glenn M Chertow, Jin Long, Shuchi Anand
BACKGROUND: Diarrheal illness is a major reason for hospitalization, but data on consequent acute kidney injury (AKI) are sparse. OBJECTIVE: To determine the incidence of AKI in infectious and non-infectious diarrheal illness requiring hospitalization and to identify correlates and outcomes of diarrhea-associated AKI. DESIGN: Using data from the 2012 National Inpatient Sample (NIS), we created a cohort of patients with a primary diagnosis of diarrheal illness...
June 18, 2018: Journal of General Internal Medicine
Daniela Ponce, Dayana Bitencourt Dias, Ginivaldo Ribeiro Nascimento, Liciana Vaz de Arruda Silveira, André Luís Balbi
AIM: This study aimed to evaluate the long-term outcome of patients after a severe episode of acute kidney injury (AKI) on survival and progression to chronic kidney disease (CKD) and to identify risk factors associated with these outcomes. METHODS: We performed a prospective study that evaluated the long-term outcome of 509 AKI stage 3 patients who were followed by nephrologists in a Brazilian University Hospital from 2004 to 2013. RESULTS: Age was 60...
April 2016: Nephrology
Xin Xu, Sheng Nie, Zhangsuo Liu, Chunbo Chen, Gang Xu, Yan Zha, Jing Qian, Bicheng Liu, Shuai Han, Anping Xu, Xing Xu, Fan Fan Hou
BACKGROUND AND OBJECTIVES: Comprehensive epidemiologic data on AKI are particularly lacking in Asian countries. This study sought to assess the epidemiology and clinical correlates of AKI among hospitalized adults in China. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: This was a multicenter retrospective cohort study of 659,945 hospitalized adults from a wide range of clinical settings in nine regional central hospitals across China in 2013. AKI was defined and staged according to Kidney Disease Improving Global Outcomes criteria...
September 4, 2015: Clinical Journal of the American Society of Nephrology: CJASN
Nicola Panocchia, Luigi Tazza, Enrico Di Stasio, Massimo Liberatori, Carlo Vulpio, Stefania Giungi, Giovanna Lucani, Manuela Antocicco, Maurizio Bossola
AIM: Data on the outcome of chronic kidney disease (CKD) patients who are hospitalized and start unplanned urgent haemodialysis (HD) are lacking. This prospective, longitudinal, observational study aimed to define the hospital mortality rate and associated factors in CKD patients who start unplanned urgent HD. METHODS: Between January 2003 and December 2009, all patients with CKD who were hospitalized, diagnosed with ESRD and started unplanned urgent haemodialysis at Haemodialysis Service of the Catholic University of Rome, Italy were recruited...
January 2016: Nephrology
M Schetz, J Gunst, G De Vlieger, G Van den Berghe
PURPOSE: Studies on recovery from acute kidney injury (AKI) in ICU patients yield variable results. We assessed the impact of different recovery definitions, of different exclusion criteria, and of imputing missing baseline creatinine on AKI recovery in a heterogeneous ICU population. METHODS: Secondary analysis of the EPaNIC database. Recovery of kidney function in patients who developed AKI in ICU was assessed at hospital discharge. We studied recovery rates of different AKI stages with different definitions of recovery after inclusion or exclusion of non-survivors and in patients with or without chronic kidney disease (CKD)...
September 2015: Intensive Care Medicine
Pradeep Arora, Sina Davari-Farid, Leili Pourafkari, Anu Gupta, Hasan H Dosluoglu, Nader D Nader
OBJECTIVE: This study examined the effect of perioperative acute kidney injury (AKI) on long-term kidney dysfunction and death after lower extremity revascularization. Perioperative AKI is commonly seen in the form of mild rises of serum creatinine after major cardiovascular surgeries. Its effect on long-term survival and development of chronic kidney disease (CKD) is well established in cardiac surgery patients. However, there are no data on the effect of AKI on long-term outcomes after revascularization for lower limb ischemia...
March 2015: Journal of Vascular Surgery
Sandra L Kane-Gill, Florentina E Sileanu, Raghavan Murugan, Gregory S Trietley, Steven M Handler, John A Kellum
BACKGROUND: Risk for acute kidney injury (AKI) in older adults has not been evaluated systematically. We sought to delineate the determinants of risk for AKI in older compared with younger adults. STUDY DESIGN: Retrospective analysis of patients hospitalized in July 2000 to September 2008. SETTING & PARTICIPANTS: We identified all adult patients admitted to an intensive care unit (n=45,655) in a large tertiary-care university hospital system...
June 2015: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Austin G Stack, Liam F Casserly, Cornelius J Cronin, Tetyana Chernenko, Walter Cullen, Ailish Hannigan, Rajiv Saran, Howard Johnson, Gemma Browne, John P Ferguson
BACKGROUND: Chronic Kidney Disease (CKD) is a major non-communicable chronic disease that is associated with adverse clinical and economic outcomes. Passive surveillance systems are likely to improve efforts for prevention of chronic kidney disease (CKD) and inform national service planning. This study was conducted to determine the overall prevalence of CKD in the Irish health system, assess period trends and explore patterns of variation as part of a novel surveillance initiative. METHODS: We identified 207, 336 adult patients, age 18 and over, with serum creatinine measurements recorded from a provincial database between 2005-2011 in the Northwest of Ireland...
2014: BMC Nephrology
Florentina E Sileanu, Raghavan Murugan, Nicole Lucko, Gilles Clermont, Sandra L Kane-Gill, Steven M Handler, John A Kellum
BACKGROUND AND OBJECTIVES: AKI in critically ill patients is usually part of multiorgan failure. However, nonrenal organ failure may not always precede AKI and patients without evidence of these organ failures may not be at low risk for AKI. This study examined the risk and outcomes associated with AKI in critically ill patients with and without cardiovascular or respiratory organ failures at presentation to the intensive care unit (ICU). DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: A large, academic medical center database, with records from July 2000 through October 2008, was used and the authors identified a low-risk cohort as patients without cardiovascular and respiratory organ failures defined as not receiving vasopressor support or mechanical ventilation within the first 24 hours of ICU admission...
February 6, 2015: Clinical Journal of the American Society of Nephrology: CJASN
Mario Meola, Federico Nalesso, Ilaria Petrucci, Sara Samoni, Claudio Ronco
Approximately 70% of community-acquired cases of acute kidney injury are attributed to pre-renal causes. In most of these cases, the underlying kidney function may be normal, but decreased renal perfusion associated with low intravascular volume or decreased arterial pressure can determine a reduced glomerular filtration rate (GFR). Autoregulatory mechanisms can partially compensate renal perfusion reduction in order to maintain GFR. In patients with pre-existing chronic kidney disease, however, these mechanisms are impaired, and the susceptibility to develop acute-on-chronic renal failure is higher...
2016: Contributions to Nephrology
Lluís Llauger, Javier Jacob, Òscar Miró
The interaction between acute heart failure (AHF) and renal dysfunction is complex. Several studies have evaluated the prognostic value of this syndrome. The aim of this systematic review, which includes non-selected samples, was to investigate the impact of different renal function variables on the AHF prognosis. The categories included in the studies reviewed included: creatinine, blood urea nitrogen (BUN), the BUN/creatinine quotient, chronic kidney disease, the formula to estimate the glomerular filtration rate, criteria of acute renal injury and new biomarkers of renal damage such as neutrophil gelatinase-associated lipocalin (NGAL and cystatin c)...
June 5, 2018: Medicina Clínica
Joanne L Carter, Christopher T Parker, Paul E Stevens, Gillian Eaglestone, Sarah Knight, Christopher K T Farmer, Edmund J Lamb
BACKGROUND: Identification of acute kidney injury (AKI) is predominantly based on changes in plasma creatinine concentration, an insensitive marker. Alternative biomarkers have been proposed. The reference change value (RCV), the point at which biomarker change can be inferred to have occurred with statistical certainty, provides an objective assessment of change in serial tests results in an individual. METHODS: In 80 patients with chronic kidney disease, weekly measurements of blood and urinary biomarker concentrations were undertaken over 6 weeks...
June 2016: Clinical Chemistry
Scott Sanoff, Mark D Okusa
Acute kidney injury (AKI) is a devastating clinical problem that affects a growing number of patients, especially elderly ones, and is associated with high morbidity and mortality. It was previously thought that patients who survive an episode of AKI recover renal function without further sequelae; however, recent population- based studies suggest that this may not be the case. New clinical studies suggest that a strikingly large percentage of patients who have AKI do not fully recover renal function or require permanent renal replacement therapy, and that this population has an important impact on the epidemiology of chronic kidney disease (CKD) and end-stage renal disease...
2011: Contributions to Nephrology
Nitin Khosla, Sharon B Soroko, Glenn M Chertow, Jonathan Himmelfarb, T Alp Ikizler, Emil Paganini, Ravindra L Mehta
BACKGROUND AND OBJECTIVES: Acute kidney injury (AKI) is associated with adverse outcomes in critically ill patients. The influence of preexisting chronic kidney disease (CKD) on AKI outcomes is unclear. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We analyzed data from a prospective observational cohort study of AKI in critically ill patients who received nephrology consultation: the Program to Improve Care in Acute Renal Disease. In-hospital mortality rate, length of stay, and dialysis dependence were compared in patients with and without a prior history of CKD, defined by an elevated serum creatinine, proteinuria, and/or abnormal renal ultrasound within a year before hospitalization...
December 2009: Clinical Journal of the American Society of Nephrology: CJASN
Po-Hung Lee, Vin-Cent Wu, Fu-Chang Hu, Chun-Fu Lai, Yung-Ming Chen, Tun-Jun Tsai, Kwan-Dun Wu
BACKGROUND: Information is limited regarding the outcomes of patients with preexisting chronic kidney disease (CKD) who develop dialysis-requiring acute kidney injury. METHODS: 131 adult patients with advanced CKD who received emergent hemodialysis from January to June in 2002 were recruited and monitored for all-cause mortality and end-stage renal disease until the end of 2007. RESULTS: Among patients investigated, 21 (16%) were successfully withdrawn from acute hemodialysis after an average of 8 sessions of dialysis therapy (range: 1-44)...
2011: American Journal of Nephrology
Natacha Riffaut, Olivier Moranne, Alexandre Hertig, Thierry Hannedouche, Cécile Couchoud
Background: Acute kidney injury (AKI) is a common condition that is associated with poor short- and long-term outcomes. The aim of this nationwide cohort study was to profile the long-term outcome of patients admitted for AKI in France. Methods: Based on the comprehensive French hospital discharge database, all hospitalizations for an AKI episode were categorized in four groups according to the presence of at least one dialysis session [renal replacement therapy (RRT)] and according to the coding of AKI as the principal or associated diagnosis (PRINC_DIAG or ASS_DIAG)...
May 26, 2018: Nephrology, Dialysis, Transplantation
Yin-Chou Hsu, Chih-Wei Hsu
BACKGROUND: Acute kidney injury (AKI) is a common complication in septic patients, imposing a heavy burden of illness in terms of morbidity and mortality. Serum lactate is a widely used marker predicting the severity of sepsis. A paucity of research has investigated septic AKI in emergency departments (EDs) and its correlation with initial serum lactate level. This study aimed at identifying risk factors for septic AKI and clarifying the link between initial serum lactate level and septic AKI in ED patients...
May 15, 2018: American Journal of Emergency Medicine
Linda Shavit, Ofer Merin, Tal Grenader, Ehud Jacobson, Chani Waldenberg, Daniel Bitran, Daniel Fink, Shuli Silberman
BACKGROUND: Preoperative hyponatremia adversely impacts outcomes of cardiothoracic surgery. However, in patients with chronic kidney disease, the association of sodium levels on postoperative events has never been evaluated. We investigated the impact of preoperative hyponatremia on outcomes after cardiac surgery in patients with non-dialysis-dependent chronic kidney disease. Primary endpoints were operative mortality and acute kidney injury requiring dialysis. Secondary endpoints were major infection and long-term survival...
May 8, 2018: Annals of Thoracic Surgery
2018-05-14 06:01:51
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