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Renal Recovery

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88 papers 100 to 500 followers
By Isabel Acosta-Ochoa Nephrology senior staff. Valladolid. Spain
Jessica Sheehan Tangren, Camille E Powe, Elizabeth Ankers, Jeffrey Ecker, Kate Bramham, Michelle A Hladunewich, S Ananth Karumanchi, Ravi Thadhani
The effect of clinically recovered AKI (r-AKI) on future pregnancy outcomes is unknown. We retrospectively studied all women who delivered infants between 1998 and 2007 at Massachusetts General Hospital to assess whether a previous episode of r-AKI associated with subsequent adverse maternal and fetal outcomes, including preeclampsia. AKI was defined as rise in serum creatinine concentration to 1.5-fold above baseline. We compared pregnancy outcomes in women with r-AKI without history of CKD (eGFR>90 ml/min per 1...
December 22, 2016: Journal of the American Society of Nephrology: JASN
Carlos E Palant, Richard L Amdur, Lakhmir S Chawla
PURPOSE OF REVIEW: Recent studies indicate that acute kidney injury (AKI) and chronic kidney disease (CKD) are interconnected syndromes. Although the majority of patients who suffer an episode of AKI will recover laboratory indices suggesting complete or near complete recovery of renal function, a significant portion of post-AKI survivors will develop major kidney events, including development of late-stage CKD, need for renal replacement therapies, and death. RECENT FINDINGS: Our review highlights epidemiology of adverse post-AKI events, association of AKI with late development of nonrenal adverse outcomes, use of bedside equations that facilitate prognostication of adverse renal outcomes of AKI, and how variability in serum creatinine values in individual patients, even among those with normal baseline renal function may indicate risk for the development of CKD...
February 2017: Current Opinion in Anaesthesiology
Mario Meola, Federico Nalesso, Ilaria Petrucci, Sara Samoni, Claudio Ronco
Acute kidney injury (AKI), also known in the past as acute renal failure, is a syndrome characterized by the rapid loss of kidney excretory function. It is usually diagnosed by the accumulation of end products of nitrogen metabolism (urea and creatinine) or decreased urine output or both. AKI is the clinical consequence of several disorders that acutely affect the kidney, causing electrolytes and acid-base imbalance, hyperhydration and loss of depurative function. AKI is common in critical care patients in whom it is often secondary to extrarenal events...
2016: Contributions to Nephrology
Muthukrishna P Rajadoss, Chandrasingh Jeyachandra Berry, Grace J Rebekah, Vinu Moses, Shyamkumar N Keshava, Kuruthukulangara S Jacob, Santosh Kumar, Nitin Kekre, Antony Devasia
OBJECTIVES: To identify factors predicting renal recovery in patients presenting with renal failure secondary to bilateral obstructing urolithiasis. PATIENTS AND METHODS: Data from electronic records of consecutive adult patients presenting with bilateral obstructing urolithiasis between January 2007 and April 2011 were retrieved. Ultrasonography of the abdomen, and kidney, ureter, bladder (KUB study) X-ray or abdominal non-contrast computed tomography confirmed the diagnosis...
December 2016: Arab Journal of Urology
John A Kellum, Florentina E Sileanu, Azra Bihorac, Eric A J Hoste, Lakhmir S Chawla
RATIONALE: Little is known about how acute kidney injury (AKI) resolves and whether patterns of reversal of renal dysfunction differ among patients with respect to ultimate recovery. OBJECTIVES: We sought to examine different patterns for AKI reversal that are found in patients and assess how they relate to post-discharge outcomes. METHODS: We studied 16,968 critically ill patients with Kidney Disease Improving Global Outcomes stage 2-3 AKI using an electronic database...
September 16, 2016: American Journal of Respiratory and Critical Care Medicine
Jung Nam An, Jin Ho Hwang, Dong Ki Kim, Hajeong Lee, Shin Young Ahn, Sejoong Kim, Jung Tak Park, Shin-Wook Kang, Yun Kyu Oh, Yon Su Kim, Chun Soo Lim, Hyung Jung Oh, Jung Pyo Lee
OBJECTIVES: Severe acute kidney injury requiring continuous renal replacement therapy is associated with a high risk of early mortality. Our objectives were to identify a cohort of early survivors and to follow their renal progress and long-term mortality. DESIGN: Multicenter, observational, retrospective cohort study. SETTING: ICUs in tertiary academic hospitals in Korea. PATIENTS: From 2009 to 2013, we identified 1,764 severe acute kidney injury patients who were started on continuous renal replacement therapy at four hospitals...
January 2017: Critical Care Medicine
Simon Sawhney, Angharad Marks, Nick Fluck, Adeera Levin, Gordon Prescott, Corri Black
BACKGROUND: The long-term prognosis after acute kidney injury (AKI) is variable. It is unclear how the prognosis of AKI and its relationship to prognostic factors (baseline kidney function, AKI severity, prior AKI episodes, and recovery of kidney function) change as follow-up progresses. STUDY DESIGN: Observational cohort study. SETTING & PARTICIPANTS: The Grampian Laboratory Outcomes Morbidity and Mortality Study II (GLOMMS-II) is a large regional population cohort with complete serial biochemistry and outcome data capture through data linkage...
January 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Punit Yadav, Mark Cook, Paul Cockwell
BACKGROUND: Renal impairment (RI) is a common complication of multiple myeloma (MM). Around 50% of patients with MM have RI at presentation, and up to 5% require dialysis treatment. Severe acute kidney injury (AKI) as a cause of RI is a particular challenge as historically the survival of patients who sustain this complication and require dialysis is very poor. However, in this current period, survival is improving and the focus is on optimum use of novel chemotherapies and the evaluation of extra-corporeal therapies for removal of serum immunoglobulin light chains...
March 2016: Kidney Diseases
Caixia Wang, Lin-Sheng Lv, Hui Huang, Jianqiang Guan, Zengchun Ye, Shaomin Li, Yanni Wang, Tanqi Lou, Xun Liu
The early initiation of renal replacement therapy has been recommended for patients with acute renal failure by some studies, but its effects on mortality and renal recovery are unknown. We conducted an updated meta-analysis to provide quantitative evaluations of the association between the early initiation of renal replacement therapy and mortality for patients with acute kidney injury. After applying inclusion/exclusion criteria, 51 studies, including 10 randomized controlled trials, with a total of 8179 patients were analyzed...
January 2017: Nephrology
Puneeta Tandon, Matthew T James, Juan G Abraldes, Constantine J Karvellas, Feng Ye, Neesh Pannu
BACKGROUND: The implementation of new serum creatinine (SCr)-based criteria for acute kidney injury (AKI) has brought to light several areas of uncertainty in patients with cirrhosis. STUDY DESIGN: Population-based cohort study. SETTING & PARTICIPANTS: Adults with cirrhosis hospitalized between 2002-2012. PREDICTOR: We aimed to address the prognostic implications of the new AKI criteria in cirrhosis. OUTCOMES: Baseline kidney function was defined from all outpatient SCr within 3 months before hospitalization...
2016: PloS One
Wouter De Corte, Annemieke Dhondt, Raymond Vanholder, Jan De Waele, Johan Decruyenaere, Veerle Sergoyne, Joke Vanhalst, Stefaan Claus, Eric A J Hoste
BACKGROUND: In intensive care unit (ICU) patients, acute kidney injury treated with renal replacement therapy (AKI-RRT) is associated with adverse outcomes. The aim of this study was to evaluate variables associated with long-term survival and kidney outcome and to assess the composite endpoint major adverse kidney events (MAKE; defined as death, incomplete kidney recovery, or development of end-stage renal disease treated with RRT) in a cohort of ICU patients with AKI-RRT. METHODS: We conducted a single-center, prospective observational study in a 50-bed ICU tertiary care hospital...
August 12, 2016: Critical Care: the Official Journal of the Critical Care Forum
David G Warnock, T Clark Powell, Edward D Siew, John P Donnelly, Henry E Wang, Ravindra L Mehta
BACKGROUND: Patterns of acute kidney injury (AKI) can be distinguished by the rate of changes in the serum creation concentrations during hospitalizations. We hypothesized that the timing and values of minimum and maximum serum creatinine (sCr) could be used to distinguish between transient hospital-associated AKI (THA-AKI) and hospital-acquired AKI (HA-AKI). MATERIALS AND METHODS: We evaluated adults admitted to 2 regionally distinct academic medical centers. Peak sCr during the hospitalization was used to define AKI, using absolute changes and timing from the minimum sCr...
July 26, 2016: Nephron
S Katayama, S Uchino, M Uji, T Ohnuma, Y Namba, H Kawarazaki, N Toki, K Takeda, H Yasuda, J Izawa, N Tokuhira, I Nagata
This multicentre, retrospective observational study was conducted from January 2010 to December 2010 to determine the optimal time for discontinuing continuous renal replacement therapy (CRRT) by evaluating factors predictive of successful discontinuation in patients with acute kidney injury. Analysis was performed for patients after CRRT was discontinued because of renal function recovery. Patients were divided into two groups according to the success or failure of CRRT discontinuation. In multivariate logistic regression analysis, urine output at discontinuation, creatinine level and CRRT duration were found to be significant variables (area under the receiver operating characteristic curve for urine output, 0...
July 2016: Anaesthesia and Intensive Care
Xiao-Mei Yang, Guo-Wei Tu, Jian Gao, Chun-Sheng Wang, Du-Ming Zhu, Bo Shen, Lan Liu, Zhe Luo
BACKGROUND: The optimal timing of renal replacement therapy (RRT) initiation in patients undergoing cardiac surgery remains controversial. This study aimed to determine whether preemptive RRT or standard RRT was associated with hospital mortality in cardiac surgical patients with acute kidney injury (AKI). METHODS: Data were retrospectively collected from patients who underwent cardiac surgery and experienced postoperative AKI requiring RRT at Zhongshan Hospital of Fudan University from September 1, 2006 to December 31, 2013...
July 2016: Journal of Surgical Research
Nicolas Viallet, Vincent Brunot, Nils Kuster, Delphine Daubin, Noémie Besnard, Laura Platon, Aurèle Buzançais, Romaric Larcher, Olivier Jonquet, Kada Klouche
BACKGROUND: In acute kidney injury (AKI), useless continuation of renal replacement therapy (RRT) may delay renal recovery and impair patient's outcome. In this study, we aimed to identify predictive parameters that may help to a successful RRT weaning for AKI patients. METHODS: We studied 54 surviving AKI patients in which a weaning of RRT was attempted. On the day of weaning (D0) and the following 2 days (D1 and D2), SAPS II and SOFA scores, 24-h diuresis, 24-h urinary creatinine and urea (UCr and UUr), creatinine and urea generation rates (CrGR and UrGR) and clearances (CrCl and UrCl) were collected...
December 2016: Annals of Intensive Care
Yanhong Yuan, Chunlin Wang, Xinghua Shao, Qin Wang, Xiajing Che, Minfang Zhang, Yuanyuan Xie, Lei Tian, Zhaohui Ni, Shan Mou
BACKGROUND: Acute-on-chronic renal injury was commonly seen in clinical practice. Reversibility of acute-on-chronic renal injury had not yet been carefully explored. This study tested whether urinary biomarkers could be used as a noninvasive prognostic marker in patients with acute-on-chronic renal injury. METHODS: 108 adult patients with pre-existing chronic kidney disease presenting with acute-on-chronic renal injury were included. Urinary retinol-binding protein (uRBP), N-Acetyl-b-D-Glucosaminidase (uNAG) and albumin (uALB) was quantified...
July 7, 2016: Journal of Nephrology
James F Doyle, Lui G Forni
Acute kidney injury (AKI) is the most common cause of organ dysfunction in critically ill adults, with a single episode of AKI, regardless of stage, carrying a significant morbidity and mortality risk. Since the consensus on AKI nomenclature has been reached, data reflecting outcomes have become more apparent allowing investigation of both short- and long-term outcomes.Classically the short-term effects of AKI can be thought of as those reflecting an acute deterioration in renal function per se. However, the effects of AKI, especially with regard to distant organ function ("organ cross-talk"), are being elucidated as is the increased susceptibility to other conditions...
July 4, 2016: Critical Care: the Official Journal of the Critical Care Forum
David G Warnock, T Clark Powell, John P Donnelly, Henry E Wang
UNLABELLED: Hospital-associated acute kidney injury (HA-AKI) is associated with increased inpatient mortality. Our objective was to categorize HA-AKI based on the timing of minimum and peak inpatient serum creatinine (sCr) and describe the association with inpatient mortality. MATERIALS AND METHODS: This study is a retrospective analysis of an administrative data set for adults admitted to a single medical center for over 4 years. Changes and timing of the minimum and peak sCr were used to define HA-AKI categories...
2015: Nephron
Heather L Laskey, Nathan Schomaker, Kenneth W Hung, Sumeet K Asrani, Linda Jennings, Trevor L Nydam, Jane Gralla, Alex Wiseman, Hugo R Rosen, Scott W Biggins
Identifying which liver transplantation (LT) candidates with severe kidney injury will have a full recovery of renal function after liver transplantation alone (LTA) is difficult. Avoiding unnecessary simultaneous liver-kidney transplantation (SLKT) can optimize the use of scarce kidney grafts. Incorrect predictions of spontaneous renal recovery after LTA can lead to increased morbidity and mortality. We retrospectively analyzed all LTA patients at our institution from February 2002 to February 2013 (n = 583) and identified a cohort with severe subacute renal injury (n = 40; creatinine <2 mg/dL in the 14-89 days prior to LTA and not on renal replacement therapy [RRT] yet, ≥2 mg/dL within 14 days of LTA and/or on RRT)...
August 2016: Liver Transplantation
Volker Vallon
The clinical diagnosis and recovery of acute kidney injury (AKI) are mainly based on the rapid decline of glomerular filtration rate (GFR) and its subsequent recovery. The factors that determine kidney recovery and reduce the risk of subsequent progression to chronic kidney disease (CKD), however, are poorly understood. Thus, there is a need to better define the magnitude and time pattern of changes in kidney function during AKI and its recovery that go beyond GFR. Tubular transport regulates body homeostasis and the associated transport work is a primary determinant of the kidneys' energy needs...
2016: Nephron
2016-06-01 09:53:47
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