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Renal Recovery

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136 papers 100 to 500 followers
By Isabel Acosta-Ochoa Nephrology senior staff. Valladolid. Spain
https://www.readbyqxmd.com/read/29142963/understanding-electronic-aki-alerts-characterization-by-definitional-rules
#1
Jennifer Holmes, Gethin Roberts, Soma Meran, John D Williams, Aled O Phillips
Introduction: Automated acute kidney injury (AKI) electronic alerts are based on comparing creatinine with historic results. Methods: We report the significance of AKI defined by 3 "rules" differing in the time period from which the baseline creatinine is obtained, and AKI with creatinine within the normal range. Results: A total of 47,090 incident episodes of AKI occurred between November 2013 and April 2016. Rule 1 (>26 μmol/l increase in creatinine within 48 hours) accounted for 9...
May 2017: KI Reports
https://www.readbyqxmd.com/read/29131132/points-of-concern-in-post-acute-kidney-injury-management
#2
Jill Vanmassenhove, Raymond Vanholder, Norbert Lameire
The incidence of acute kidney injury (AKI) will in the future remain high, partly due to an increase in comorbidities and other AKI favoring factors such as the rise in high-risk diagnostic and therapeutic interventions. AKI has emerged as a major public health concern with high human and financial costs. It has recently been demonstrated that patients surviving an AKI episode show increased all-cause mortality, chronic kidney disease (CKD), ESRD, cardiovascular events, and reduced quality of life. Although it is important to acknowledge that, after an AKI episode, the risk of dying by far exceeds the risk of developing incident or progressive CKD and/or entering a maintenance renal replacement therapy (RRT) program, currently only a minority of patients are referred for renal follow-up, even after AKI-requiring RRT...
November 2, 2017: Nephron
https://www.readbyqxmd.com/read/29132132/care-of-the-acute-kidney-injury-survivor
#3
Ron Wald, Abhijat Kitchlu, Ziv Harel, Samuel A Silver
While the short-term implications of acute kidney injury (AKI) have been known for many years, far less attention has been paid to the health of AKI survivors. This was perhaps fueled by a prevailing wisdom that if a patient was fortunate enough to survive the primary illness associated with AKI, the prognosis for future health was auspicious. More recently, this dogma was challenged by data suggesting that after an episode of AKI, patients remain at risk of experiencing multiple adverse health outcomes. Greater recognition and appreciation of the risks faced by AKI survivors have led to the development of quality improvement initiatives that are supposed to enrich this vulnerable population...
November 13, 2017: Nephron
https://www.readbyqxmd.com/read/29088005/renal-replacement-therapy-modality-in-the-icu-and-renal-recovery-at-hospital-discharge
#4
Martin Bonnassieux, Antoine Duclos, Antoine G Schneider, Aurélie Schmidt, Stève Bénard, Charlotte Cancalon, Olivier Joannes-Boyau, Carole Ichai, Jean-Michel Constantin, Jean-Yves Lefrant, John A Kellum, Thomas Rimmelé
OBJECTIVES: Acute kidney injury requiring renal replacement therapy is a major concern in ICUs. Initial renal replacement therapy modality, continuous renal replacement therapy or intermittent hemodialysis, may impact renal recovery. The aim of this study was to assess the influence of initial renal replacement therapy modality on renal recovery at hospital discharge. DESIGN: Retrospective cohort study of all ICU stays from January 1, 2010, to December 31, 2013, with a "renal replacement therapy for acute kidney injury" code using the French hospital discharge database...
October 28, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/29051004/assessing-time-of-full-renal-recovery-following-minimally-invasive-partial-nephrectomy
#5
Mark T Dawidek, Ernest Chan, Shawna L Boyle, Alp Sener, Patrick P Luke
OBJECTIVE: To assess renal function in the operated kidney at different time points post partial nephrectomy (PN) and establish the time in which optimal recovery occurs. Recovery of renal function post-PN has received significant attention. However, the optimal time to determine full recovery has not been clearly established. METHODS: Renal function following minimally invasive (laparoscopic and robotic) PNs performed between 2002 and 2015 was reviewed. Patients included in this study had renal function assessed pre-operatively as well as 3 days, 6-12 weeks, and 1 year post-PN, using a combination of estimated glomerular filtration rate (eGFR) from serum creatinine and relative renal uptake (RRU) from Tc99m-MAG3 renal scintigraphy...
October 16, 2017: Urology
https://www.readbyqxmd.com/read/29044306/biomarkers-of-renal-recovery-after-acute-kidney-injury
#6
Sérgio Mina Gaião, José Artur Osório de Carvalho Paiva
Novel biomarkers can be suitable for early acute kidney injury diagnosis and the prediction of the need for dialysis. It remains unclear whether such biomarkers may also play a role in the prediction of recovery after established acute kidney injury or in aiding the decision of when to stop renal support therapy. PubMed, Web of Science and Google Scholar were searched for studies that reported on the epidemiology of renal recovery after acute kidney injury, the risk factors of recovery versus non-recovery after acute kidney injury, and potential biomarkers of acute kidney injury recovery...
July 2017: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/29025786/disparity-between-nephrologists-opinions-and-contemporary-practices-for-community-follow-up-after-aki-hospitalization
#7
Divya J Karsanji, Neesh Pannu, Braden J Manns, Brenda R Hemmelgarn, Zhi Tan, Kailash Jindal, Nairne Scott-Douglas, Matthew T James
BACKGROUND AND OBJECTIVES: Recent guidelines suggest that patients should be evaluated after AKI for resolution versus progression of CKD. There is uncertainty as to the role of nephrologists in this process. The objective of this study was to compare the follow-up recommendations from nephrologists with contemporary processes of care for varying scenarios of patients hospitalized with AKI. DESIGN, SETTING PARTICIPANTS, & MEASUREMENTS: We surveyed Canadian nephrologists using a series of clinical vignettes of patients hospitalized with severe AKI and asked them to rank their likelihood of recommending follow-up for each patient after hospital discharge...
November 7, 2017: Clinical Journal of the American Society of Nephrology: CJASN
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
#8
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/28884349/functional-and-morphological-recovery-of-solitary-kidneys-after-drainage-double-j-stent-placement-vs-emergency-ureteroscopy-which-one-is-reasonable
#9
Kemal Sarica, Fatih Tarhan, Kutluhan Erdem, Ahmet Halil Sevinc, Rasim Guzel, Bilal Eryildirim
The purpose of the study was to evaluate the functional and morphological recovery of solitary kidneys following the relief of obstruction by two different approaches. Data of 65 adult patients with acute renal failure in obstructed solitary kidney were evaluated. Depending on the type of emergent decompression procedure while 34 patients were treated with a double J stent placement only 31 patients underwent ureteroscopic lithotripsy with double J stent placement. Following these procedures, in addition to the amount of excreted urine during the first 24 h, changes in the serum creatinine levels and the degree of hydronephrosis were noted and evaluated during the first week of follow-up after intervention...
September 7, 2017: Urolithiasis
https://www.readbyqxmd.com/read/28875354/-life-after-acute-kidney-injury-long-term-consequences-%C3%AF-and-implications-for-clinical-practice
#10
REVIEW
S J Klein, A K Brandtner, M Peball, M Joannidis
Acute kidney injury (AKI) is a common complication in critically ill patients and is accompanied by significantly increased mortality and morbidity. Those complications are not limited to the acute phase of the illness, but may also affect a patient's risk profile long after AKI. Recovery of renal function is observed in the majority of patients although this rate significantly deteriorates with increasing severity of the AKI. After an AKI episode, the long-term risk for the development of chronic kidney disease (CKD) is considerably increased, as well as the risk for cardiovascular and neurological complications...
October 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/28869251/cardiac-surgery-associated-acute-kidney-injury-risk-factors-pathophysiology-and-treatment
#11
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/28858859/independent-risk-factors-and-2-year-outcomes-of-acute-kidney-injury-after-surgery-for-congenital-heart-disease
#12
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/28753855/ischemia-and-functional-recovery-from-partial-nephrectomy-refined-perspectives
#13
Wen Dong, Jitao Wu, Chalairat Suk-Ouichai, Elvis Caraballo Antonio, Erick M Remer, Jianbo Li, Joseph Zabell, Sudhir Isharwal, Steven C Campbell
BACKGROUND: Nephron mass preservation is a key determinant of functional outcomes after partial nephrectomy (PN), while ischemia plays a secondary role. Analyses focused specifically on recovery of the operated kidney appear to be most informative, yet have only included limited numbers of patients. OBJECTIVE: To evaluate the relative impact of parenchymal preservation and ischemia on functional recovery after PN using a more robust cohort allowing for more refined perspectives about ischemia...
March 3, 2017: European Urology Focus
https://www.readbyqxmd.com/read/28826934/inotropes-and-cardiorenal-syndrome-in-acute-heart-failure-a-retrospective-comparative-analysis
#14
Marta Madeira, Francisca Caetano, Inês Almeida, Andreia Fernandes, Liliana Reis, Marco Costa, Lino Gonçalves
INTRODUCTION: Cardiorenal syndrome (CRS) is common in acute heart failure (AHF), and is associated with dire prognosis. Levosimendan, a positive inotrope that also has diuretic effects, may improve patients' renal profile. Published results are conflicting. OBJECTIVES: We aimed to assess the incidence of CRS in AHF patients according to the inotrope used and to determine its predictors in order to identify patients who could benefit from the most renoprotective inotrope...
September 2017: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
https://www.readbyqxmd.com/read/28814331/circulating-levels-of-soluble-fas-scd95-are-associated-with-risk-for-development-of-a-nonresolving-acute-kidney-injury-subphenotype
#15
Pavan K Bhatraju, Cassianne Robinson-Cohen, Carmen Mikacenic, Susanna Harju-Baker, Victoria Dmyterko, Natalie S J Slivinski, W Conrad Liles, Jonathan Himmelfarb, Susan R Heckbert, Mark M Wurfel
BACKGROUND: Critically ill patients with acute kidney injury (AKI) can be divided into two subphenotypes, resolving or nonresolving, on the basis of the trajectory of serum creatinine. It is unknown if the biology underlying these two AKI recovery patterns is different. METHODS: We measured eight circulating biomarkers in plasma obtained from a cohort of patients admitted to an intensive care unit (ICU) (n = 1241) with systemic inflammatory response syndrome...
August 17, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28721029/the-impact-of-transient-and-persistent-acute-kidney-injury-on-short-term-outcomes-in-very-elderly-patients
#16
Qinglin Li, Meng Zhao, Xiaodan Wang
OBJECTIVES: Acute kidney injury (AKI) is a common complication in elderly patients and is associated with poor outcomes. However, the effect of transient and persistent geriatric AKI on short-term mortality is unclear. We aimed to study the incidence, clinical characteristics, and prognostic impact of transient and persistent AKI in such patients. METHODS: We retrospectively enrolled very elderly patients (≥75 years) from the geriatric department of the Chinese PLA General Hospital between 2007 and 2015...
2017: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/28709597/outcomes-and-renal-function-trajectory-after-acute-kidney-injury-the-narrow-road-to-perdition
#17
Steven G Coca
Analyses of the Grampian Laboratory Outcomes Morbidity and Mortality Study-II cohort support the notion that acute kidney injury (AKI) increases the risk of progression of glomerular filtration rate after recovery from AKI to a new baseline. However, the findings have to be considered in the bigger context of the absolute event rates for de novo progression versus nonrecovery and the competing risk of death after AKI. Examination of the data raises important implications for the design and implementation of clinical trials with interventions that target the AKI-to-chronic kidney disease transition...
August 2017: Kidney International
https://www.readbyqxmd.com/read/28673900/inhibition-of-i%C3%AE%C2%BAb-kinase-at-24%C3%A2-hours-after-acute-kidney-injury-improves-recovery-of-renal-function-and-attenuates-fibrosis
#18
Florence L Johnson, Nimesh S A Patel, Gareth S D Purvis, Fausto Chiazza, Jianmin Chen, Regina Sordi, Guillaume Hache, Viktoria V Merezhko, Massimo Collino, Muhammed M Yaqoob, Christoph Thiemermann
BACKGROUND: Acute kidney injury (AKI) is a major risk factor for the development of chronic kidney disease. Nuclear factor-κB is a nuclear transcription factor activated post-ischemia, responsible for the transcription of proinflammatory proteins. The role of nuclear factor-κB in the renal fibrosis post-AKI is unknown. METHODS AND RESULTS: We used a rat model of AKI caused by unilateral nephrectomy plus contralateral ischemia (30 minutes) and reperfusion injury (up to 28 days) to show impairment of renal function (peak: 24 hours), activation of nuclear factor-κB (peak: 48 hours), and fibrosis (28 days)...
July 3, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28542272/factors-associated-with-poor-outcomes-of-continuous-renal-replacement-therapy
#19
Chih-Chin Kao, Ju-Yeh Yang, Likwang Chen, Chia-Ter Chao, Yu-Sen Peng, Chih-Kang Chiang, Jenq-Wen Huang, Kuan-Yu Hung
Continuous renal replacement therapy (CRRT) is one of the dialysis modalities for critically ill patients. Despite intensive dialysis care, a high mortality rate is found in these patients. Our objective was to investigate the factors associated with poor outcomes in these patients. We conducted a retrospective cohort study using the National Health Insurance Research Database. Records of critically ill patients who received CRRT between 2007 and 2011 were retrieved, and the patients were categorized into two groups: those with acute kidney injury (AKI) and those with history of end-stage renal disease (ESRD)...
2017: PloS One
https://www.readbyqxmd.com/read/28615146/novel-insights-into-acute-kidney-injury-chronic-kidney-disease-continuum-and-the-role-of-renin-angiotensin-system
#20
REVIEW
Yu-Hsiang Chou, Tao-Min Huang, Tzong-Shinn Chu
Acute kidney injury (AKI) is an independent risk factor for chronic kidney disease (CKD). If injury is mild, a repair process can be adaptive and lead to complete renal recovery. However, severe injury will be accompanied by a maladaptive repair which usually leads to nephron loss, fibrosis, vascular rarefaction, and chronic inflammation. Although various mechanisms underlying AKI-CKD transition have been explored, no intervention has been proved effective to block the transition until very recently. A lack of consensus for monitoring renal function and defining renal recovery after AKI should be the reasons for the slow advance in the discovery of a timely pharmacologic treatment to block AKI-CKD transition...
September 2017: Journal of the Formosan Medical Association, Taiwan Yi Zhi
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