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AKI

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285 papers 100 to 500 followers
By Isabel Acosta-Ochoa Nephrology senior staff. Valladolid. Spain
https://www.readbyqxmd.com/read/29383636/the-dark-side-of-the-kidney-in-cardio-renal-syndrome-renal-venous-hypertension-and-congestive-kidney-failure
#1
REVIEW
Pierpaolo Di Nicolò
Renal involvement in some forms of acute or chronic diseases, such as heart failure or sepsis, presents with a complex pathophysiological basis that is not always clearly distinguishable. In these clinical settings, kidney failure is traditionally and almost exclusively attributed to renal hypoperfusion and it is commonly accepted that causal elements are pre-renal, such as a reduction in the ejection fraction or absolute or relative hypovolemia acting directly on oxygen transport mechanisms and renal autoregulation systems, causing a reduction of glomerular filtration rate...
January 31, 2018: Heart Failure Reviews
https://www.readbyqxmd.com/read/29271132/-post-obstructive-diuresis-diagnosis-and-management
#2
M Piraprez, K Quinonez, M Sempels, D Waltrégny, J-M Krzesinski, F Jouret
The syndrome of "post-obstructive diuresis" corresponds to a massive polyuria and natriuresis occurring after the drainage of an obstructive acute kidney injury. Such a complication needs to be readily detected and managed because of the significant risk for haemodynamic disorders. On the basis of a clinical observation, we describe the pathophysiology of post-obstructive diuresis, as well as its diagnostic and therapeutic management.
December 2017: Revue Médicale de Liège
https://www.readbyqxmd.com/read/29274596/pragmatic-studies-for-acute-kidney-injury-consensus-report-of-the-acute-disease-quality-initiative-adqi-19-workgroup
#3
Zhiyong Peng, Kaijiang Yu, Marlies Ostermann, XiuMing Xi, Raymond Hsu, Jean-Louis Vincent, John R Prowle, Bin Du, Martin Gallagher, Changsong Wang, Raghavan Murugan, Haibo Qiu, Thomas Rimmelé, Jianguo Li, Lui G Forni, Kianoush Kashani, Claudio Ronco, John A Kellum
PURPOSE: Acute kidney injury (AKI) has become a major medical and financial burden in China along with the rest of the world. There have been considerable advances in the understanding of the epidemiology and pathogenesis of AKI. However, there is no consensus regarding the optimal care for patients. The Acute Disease Quality Initiative (ADQI) 19 meeting focused on identifying and designing relevant and achievable AKI-related studies in China. MATERIALS & METHODS: The working group developed a list of preliminary questions and objectives and performed analysis of the existing literature...
December 12, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/29224207/acute-kidney-injury-is-under-recognised-and-under-reported-in-hospitalised-patients-in-australia
#4
Tim Mitchell, Elisabeth Feher, Gillian Mitchell, Aron Chakera
Acute kidney injury (AKI) in hospitalised patients is associated with adverse outcomes; however, it remains unrecognised and under-reported. A total of 48 045 serum creatinine results from 8129 tertiary hospital inpatients were reviewed. The prevalence of AKI was 4.33%. Mortality was significantly higher in patients with AKI (16.76%) compared to those without AKI (1.88%, P < 0.001). Documentation of AKI in discharge summaries was poor.
December 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/29188454/a-narrative-review-of-the-impact-of-interventions-in-acute-kidney-injury
#5
REVIEW
Lynne Sykes, Rob Nipah, Philip Kalra, Darren Green
Acute kidney injury (AKI) is independently associated with significant morbidity and mortality, and is thus an important challenge facing physicians in modern healthcare. This narrative review assesses the impact of strategies employed to tackle AKI following the 2009 NCEPOD report on acute kidney injury (Sterwart et al. Acute kidney injury: adding insult to injury, pp 1-22, 2009). There is scarce and heterogeneous research into hard end points such as mortality and AKI progression for AKI interventions. This review found that e-alerts have varying effects on mortality and AKI progression, but decrease the incidence of contrast-induced AKI...
November 29, 2017: Journal of Nephrology
https://www.readbyqxmd.com/read/29162339/acute-kidney-injury-and-risk-of-incident-heart-failure-among-us-veterans
#6
Nisha Bansal, Michael E Matheny, Robert A Greevy, Svetlana K Eden, Amy M Perkins, Sharidan K Parr, James Fly, Khaled Abdel-Kader, Jonathan Himmelfarb, Adriana M Hung, Theodore Speroff, T Alp Ikizler, Edward D Siew
BACKGROUND: Acute kidney injury (AKI) is common and associated with poor outcomes. Heart failure is a leading cause of cardiovascular disease among patients with chronic kidney disease. The relationship between AKI and heart failure remains unknown and may identify a novel mechanistic link between kidney and cardiovascular disease. STUDY DESIGN: Observational study. SETTING & PARTICIPANTS: We studied a national cohort of 300,868 hospitalized US veterans (2004-2011) without a history of heart failure...
November 18, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/29162340/effects-of-intensive-blood-pressure-treatment-on-acute-kidney-injury-events-in-the-systolic-blood-pressure-intervention-trial-sprint
#7
Michael V Rocco, Kaycee M Sink, Laura C Lovato, Dawn F Wolfgram, Thomas B Wiegmann, Barry M Wall, Kausik Umanath, Frederic Rahbari-Oskoui, Anna C Porter, Roberto Pisoni, Cora E Lewis, Julia B Lewis, James P Lash, Lois A Katz, Amret T Hawfield, William E Haley, Barry I Freedman, Jamie P Dwyer, Paul E Drawz, Mirela Dobre, Alfred K Cheung, Ruth C Campbell, Udayan Bhatt, Srinivasan Beddhu, Paul L Kimmel, David M Reboussin, Glenn M Chertow
BACKGROUND: Treating to a lower blood pressure (BP) may increase acute kidney injury (AKI) events. STUDY DESIGN: Data for AKI resulting in or during hospitalization or emergency department visits were collected as part of the serious adverse events reporting process of the Systolic Blood Pressure Intervention Trial (SPRINT). SETTING & PARTICIPANTS: 9,361 participants 50 years or older with 1 or more risk factors for cardiovascular disease...
November 18, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/29149864/kinetic-estimated-glomerular-filtration-rate-in-critically-ill-patients-beyond-the-acute-kidney-injury-severity-classification-system
#8
Flávio de Oliveira Marques, Saulo Aires Oliveira, Priscila Ferreira de Lima E Souza, Wandervânia Gomes Nojoza, Maiara da Silva Sena, Taynara Muniz Ferreira, Bruno Gabriele Costa, Alexandre Braga Libório
BACKGROUND: Although significant advances have been achieved in acute kidney injury (AKI) research following its classification, potential pitfalls can be identified in clinical practice. The nonsteady-state (kinetic) estimated glomerular filtration rate (KeGFR) could add clinical and prognostic information in critically ill patients beyond the current AKI classification system. METHODS: This was a retrospective analysis using data from the Multiparameter Intelligent Monitoring in Intensive Care II project...
November 18, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28729384/characteristics-and-outcomes-of-patients-discharged-home-from-an-emergency-department-with-aki
#9
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
#10
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
#11
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...
November 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/28633144/standardized-renal-endpoints-for-perioperative-clinical-trials-the-standardized-endpoints-in-perioperative-medicine-initiative
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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...
September 2017: Intensive Care Medicine
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