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AKI

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277 papers 100 to 500 followers
By Isabel Acosta-Ochoa Nephrology senior staff. Valladolid. Spain
https://www.readbyqxmd.com/read/28729384/characteristics-and-outcomes-of-patients-discharged-home-from-an-emergency-department-with-aki
#1
Rey R Acedillo, Ron Wald, Eric McArthur, Danielle Marie Nash, Samuel A Silver, Matthew T James, Michael J Schull, Edward D Siew, Michael E Matheny, Andrew A House, Amit X Garg
BACKGROUND AND OBJECTIVES: Patients discharged home from an emergency department with AKI are not well described. This study describes their characteristics and outcomes and compares these outcomes to two referent groups. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We conducted a population-based retrospective cohort study in Ontario, Canada from 2003 to 2012 of 6346 patients aged ≥40 years who were discharged from the emergency department with AKI (defined using serum creatinine values)...
July 20, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28682569/-nephrologist-and-icu-the-need-of-new-expertise
#2
Filippo Mariano, Marco Pozzato
Episodes of dialytic Acute Kidney Injury (AKI stage III KDIGO) can lead to chronic kidney disease (CKD), even after a long time. Prelimary data indicate that the relationship between AKI and CKD is affected by dialysis technical modalities and factors in part modifiable, such as an early dialysis timing, dose adeguacy, continuous treatment, use of biocompatible membranes and regional citrate anticoagulation. However, in most ICUs involvement of nephrologist consultant is marginal. Of more, nephrological follow-up after discharge, which allows to slow down the progression rate of CKD even just by a correct pharmacological and dietetic approach (sartans, ACEis), is an uncommon practice...
April 2017: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
https://www.readbyqxmd.com/read/28666082/intradialytic-hypotension-in-acute-kidney-injury-requiring-renal-replacement-therapy
#3
Shilpa Sharma, Sushrut S Waikar
The treatment of severe acute kidney injury (AKI) with dialytic support for renal replacement therapy can be life sustaining and permit recovery from critical illness. Like any interventional therapy, however, renal replacement therapy with intermittent hemodialysis or continuous therapy can cause complications. Intradialytic hypotension is a common complication and can cause further ischemic injury to the recovering kidneys, thereby reducing the probability of renal recovery. The optimal dialytic technique-continuous or intermittent-has not been conclusively demonstrated in randomized controlled trials...
June 30, 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/28633144/standardized-renal-endpoints-for-perioperative-clinical-trials-the-standardized-endpoints-in-perioperative-medicine-initiative
#4
David R McIlroy, Andrew D Shaw, Paul S Myles
Perioperative acute kidney injury is a common problem. While clinical trials seek to evaluate the impact of interventions on a variety of primary and secondary endpoints with the aim of implementing this knowledge to improve perioperative outcomes, the use of valid and relevant endpoints within clinical trials is of critical importance to achieving this goal. Suitable endpoints must be validated for the study population and in light of the clinical context under investigation while also considering regulatory requirements that govern the licensing of new therapeutic agents as well as the values of patients whose outcomes we seek to improve...
June 21, 2017: Nephron
https://www.readbyqxmd.com/read/28600756/how-to-improve-the-care-of-patients-with-acute-kidney-injury
#5
EDITORIAL
Rinaldo Bellomo, Suvi T Vaara, John A Kellum
No abstract text is available yet for this article.
June 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28561005/management-of-patients-at-risk-of-acute-kidney-injury
#6
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/28467867/acute-kidney-injury-in-patients-with-cancer
#7
REVIEW
Mitchell H Rosner, Mark A Perazella
New England Journal of Medicine, Volume 376, Issue 18, Page 1770-1781, May 2017.
May 4, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28396736/the-clinical-utility-of-kinetic-glomerular-filtration-rate
#8
Eoin D O'Sullivan, Arthur Doyle
Background: In acutely unwell patients with rapidly changing renal function, estimating glomerular filtration rate (GFR) and predicting adverse renal outcomes are challenging and often inaccurate. Kinetic GFR (kGFR) is an estimate of immediate biomarker clearance derived from two discreet measurements that may better represent acute function. Our objective is to assess the clinical utility of kGFR as a predictive tool and examine the association of kGFR to adverse renal outcomes compared with measurements to traditional estimates...
April 2017: Clinical Kidney Journal
https://www.readbyqxmd.com/read/28392996/body-mass-index-is-inversely-associated-with-mortality-in-patients-with-acute-kidney-injury-undergoing-continuous-renal-replacement-therapy
#9
Hyoungnae Kim, Joohwan Kim, Changhwan Seo, Misol Lee, Min-Uk Cha, Su-Young Jung, Jong Hyun Jhee, Seohyun Park, Hae-Ryong Yun, Youn Kyung Kee, Chang-Yun Yoon, Hyung Jung Oh, Jung Tak Park, Tae Ik Chang, Tae-Hyun Yoo, Shin-Wook Kang, Seung Hyeok Han
BACKGROUND: Many epidemiologic studies have reported on the controversial concept of the obesity paradox. The presence of acute kidney injury (AKI) can accelerate energy-consuming processes, particularly in patients requiring continuous renal replacement therapy (CRRT). Thus, we aimed to investigate whether obesity can provide a survival benefit in this highly catabolic condition. METHODS: We conducted an observational study in 212 patients who had undergone CRRT owing to various causes of AKI between 2010 and 2014...
March 2017: Kidney Research and Clinical Practice
https://www.readbyqxmd.com/read/28239173/acute-kidney-disease-and-renal-recovery-consensus-report-of-the-acute-disease-quality-initiative-adqi-16-workgroup
#10
Lakhmir S Chawla, Rinaldo Bellomo, Azra Bihorac, Stuart L Goldstein, Edward D Siew, Sean M Bagshaw, David Bittleman, Dinna Cruz, Zoltan Endre, Robert L Fitzgerald, Lui Forni, Sandra L Kane-Gill, Eric Hoste, Jay Koyner, Kathleen D Liu, Etienne Macedo, Ravindra Mehta, Patrick Murray, Mitra Nadim, Marlies Ostermann, Paul M Palevsky, Neesh Pannu, Mitchell Rosner, Ron Wald, Alexander Zarbock, Claudio Ronco, John A Kellum
Consensus definitions have been reached for both acute kidney injury (AKI) and chronic kidney disease (CKD) and these definitions are now routinely used in research and clinical practice. The KDIGO guideline defines AKI as an abrupt decrease in kidney function occurring over 7 days or less, whereas CKD is defined by the persistence of kidney disease for a period of >90 days. AKI and CKD are increasingly recognized as related entities and in some instances probably represent a continuum of the disease process...
April 2017: Nature Reviews. Nephrology
https://www.readbyqxmd.com/read/28167845/acute-kidney-injury-diagnostic-approaches-and-controversies
#11
REVIEW
Konstantinos Makris, Loukia Spanou
Acute kidney injury (AKI) is a significant independent risk factor for morbidity and mortality. In the last ten years a large number of publications have highlighted the limitations of traditional approaches and the inadequacies of conventional biomarkers to diagnose and monitor renal insufficiency in the acute setting. A great effort was directed not only to the discovery and validation of new biomarkers aimed to detect AKI more accurately but also to standardise the definition of AKI. Despite the advances in both areas, biomarkers have not yet entered into routine clinical practice and the definition of this syndrome has many areas of uncertainty...
December 2016: Clinical Biochemist. Reviews
https://www.readbyqxmd.com/read/28138736/the-intensive-care-medicine-agenda-on-acute-kidney-injury
#12
REVIEW
Peter Pickkers, Marlies Ostermann, Michael Joannidis, Alexander Zarbock, Eric Hoste, Rinaldo Bellomo, John Prowle, Michael Darmon, Joseph V Bonventre, Lui Forni, Sean M Bagshaw, Miet Schetz
Acute kidney injury (AKI) is a common complication in the critically ill. Current standard of care mainly relies on identification of patients at risk, haemodynamic optimization, avoidance of nephrotoxicity and the use of renal replacement therapy (RRT) in established AKI. The detection of early biomarkers of renal tissue damage is a recent development that allows amending the late and insensitive diagnosis with current AKI criteria. Increasing evidence suggests that the consequences of an episode of AKI extend long beyond the acute hospitalization...
January 30, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28120015/-acute-kidney-injury-often-overlooked-and-still-fatal
#13
EDITORIAL
A Zarbock
No abstract text is available yet for this article.
February 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28130688/akipredictor-an-online-prognostic-calculator-for-acute-kidney-injury-in-adult-critically-ill-patients-development-validation-and-comparison-to-serum-neutrophil-gelatinase-associated-lipocalin
#14
Marine Flechet, Fabian Güiza, Miet Schetz, Pieter Wouters, Ilse Vanhorebeek, Inge Derese, Jan Gunst, Isabel Spriet, Michaël Casaer, Greet Van den Berghe, Geert Meyfroidt
PURPOSE: Early diagnosis of acute kidney injury (AKI) remains a major challenge. We developed and validated AKI prediction models in adult ICU patients and made these models available via an online prognostic calculator. We compared predictive performance against serum neutrophil gelatinase-associated lipocalin (NGAL) levels at ICU admission. METHODS: Analysis of the large multicenter EPaNIC database. Model development (n = 2123) and validation (n = 2367) were based on clinical information available (1) before and (2) upon ICU admission, (3) after 1 day in ICU and (4) including additional monitoring data from the first 24 h...
January 27, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28119408/a-decision-making-algorithm-for-initiation-and-discontinuation-of-rrt-in-severe-aki
#15
Mallika L Mendu, George R Ciociolo, Sarah R McLaughlin, Dionne A Graham, Roya Ghazinouri, Siddharth Parmar, Alissa Grossier, Rebecca Rosen, Karl R Laskowski, Leonardo V Riella, Emily S Robinson, David M Charytan, Joseph V Bonventre, Jeffrey O Greenberg, Sushrut S Waikar
BACKGROUND AND OBJECTIVES: AKI is an increasingly common and devastating complication in hospitalized patients. Severe AKI requiring RRT is associated with in-hospital mortality rates exceeding 40%. Clinical decision making related to RRT initiation for patients with AKI in the medical intensive care unit is not standardized. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We conducted a 13-month (November of 2013 to December of 2014) prospective cohort study in an academic medical intensive care unit involving the implementation of an AKI Standardized Clinical Assessment and Management Plan, a decision-making algorithm to assist front-line clinicians caring for patients with AKI...
February 7, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28095822/hyperuricemia-increases-the-risk-of-acute-kidney-injury-a-systematic-review-and-meta-analysis
#16
Xialian Xu, Jiachang Hu, Nana Song, Rongyi Chen, Ting Zhang, Xiaoqiang Ding
BACKGROUND: Mounting evidence indicated that the elevated serum uric acid level was associated with an increased risk of acute kidney injury (AKI). Our goal was to systematically evaluate the correlation of serum uric acid (SUA) level and incidence of AKI by longitudinal cohort studies. METHODS: We searched electronic databases and the reference lists of relevant articles. 18 cohort studies with 75,200 patients were analyzed in this random-effect meta-analysis. Hyperuricemia was defined as SUA levels greater than 360-420 μmol/L (6-7 mg/dl), which was various according to different studies...
January 17, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28049623/acute-kidney-injury-culprits-cures-and-consequences
#17
EDITORIAL
Richard Solomon, Harold L Dauerman
No abstract text is available yet for this article.
January 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/27990707/acute-kidney-injury-and-mortality-prognosis-in-acute-coronary-syndrome-patients-a-meta-analysis
#18
John W Pickering, Isabella Rh Blunt, Martin P Than
AIM: To provide a robust estimates of mortality risk in acute coronary syndrome (ACS) associated acute kidney injury (AKI) to inform clinical practice and policy. METHODS: A meta-analysis of cohort studies evaluating outcomes of ACS and which reported AKI and AKI associated mortality. Studies were excluded if they incorporated patients not admitted through the emergency department (i.e. for elective procedures), were limited to cardiogenic shock or cardiac arrest, or relied on registry data for outcomes without further adjudication...
December 19, 2016: Nephrology
https://www.readbyqxmd.com/read/27561544/latent-aki-is%C3%A2-still-aki-the-quantification-of-the-burden-of-renal-dysfunction
#19
Zaccaria Ricci, Stefano Romagnoli, Luca Di Chiara
The association between pediatric cardiac surgery, acute kidney injury (AKI), and clinical outcomes has been studied several times in the recent literature. In this issue of Critical Care an interesting and original study analyzed the path from causal AKI entities to clinical AKI consequences through the application of structural equation modeling. The authors described the complex connections linking duration of cardiopulmonary bypass, cross clamp-time, and descriptors of low cardiac output syndrome to AKI modeled as a complex variable composed of post-operative serum creatinine increase of 50 % over baseline, urine output <0...
August 26, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27622526/international-criteria-for-acute-kidney-injury-advantages-and-remaining-challenges
#20
Nicholas M Selby, Richard J Fluck, Nitin V Kolhe, Maarten W Taal
Nicholas Selby and colleagues describe how the definition of acute kidney injury brings opportunities and challenges in identifying patients at higher risk of adverse outcomes.
September 2016: PLoS Medicine
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