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AKI CKD Transition

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By Isabel Acosta-Ochoa Nephrology senior staff. Valladolid. Spain
https://www.readbyqxmd.com/read/28768271/long-term-outcomes-and-associated-risk-factors-of-post-hospitalization-dialysis-dependent-acute-kidney-injury-patients
#1
Ajay S Rathore, Tushar Chopra, Jennie Z Ma, Wenjun Xin, Emaad M Abdel-Rahman
BACKGROUND/AIMS: Acute kidney injury requiring dialysis (AKI-D) is associated with poor outcomes. Centers for Medicare and Medicaid Services have reversed their clarification allowing AKI-D patients to be dialyzed at outpatient dialysis units. Data assessing long-term outcomes of AKI-D patients and their predictors is needed to adopt guidelines to ensure adequate management. We assessed long-term outcomes and associated risk factors of AKI-D patients who survived 90 days post-hemodialysis (HD) initiation...
July 29, 2017: Nephron
https://www.readbyqxmd.com/read/28778365/follow-up-care-in-acute-kidney-injury-lost-in-transition
#2
REVIEW
Samuel A Silver, Edward D Siew
Acute kidney injury (AKI) is an increasingly common condition that is associated with long-term health outcomes. Recent studies have demonstrated that AKI, particularly when severe or persistent, is associated with all-cause mortality, CKD, ESRD, cardiovascular events, and reduced quality of life. However, data from multiple health care systems indicate that most patients do not see a nephrologist, although 1 study has suggested patients with AKI requiring dialysis may benefit from doing so. These observations raise the greater questions of what are the elements of care that may improve outcomes in survivors of AKI and which survivors need to be seen...
July 2017: Advances in Chronic Kidney Disease
https://www.readbyqxmd.com/read/28709597/outcomes-and-renal-function-trajectory-after-acute-kidney-injury-the-narrow-road-to-perdition
#3
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/28614822/drug-discovery-to-halt-the-progression-of-acute-kidney-injury-to-chronic-kidney-disease-a-case-for-phenotypic-drug-discovery-in-acute-kidney-injury
#4
Neil Hukriede, Andreas Vogt, Mark de Caestecker
The cellular responses that occur following acute kidney injury (AKI) are complex and dynamic, involving multiple cells types and molecular pathways. For this reason, early selection of defined molecular targets for therapeutic intervention is unlikely to be effective in complex in vivo models of AKI, let alone Phase 3 clinical trials in patients with even more complex AKI pathobiology. Phenotypic screening using zebrafish provides an attractive alternative that does not require prior knowledge of molecular targets and may identify compounds that modify multiple targets that might be missed in more traditional target-based screens...
June 15, 2017: Nephron
https://www.readbyqxmd.com/read/28615146/novel-insights-into-acute-kidney-injury-chronic-kidney-disease-continuum-and-the-role-of-renin-angiotensin-system
#5
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...
June 11, 2017: Journal of the Formosan Medical Association, Taiwan Yi Zhi
https://www.readbyqxmd.com/read/28595180/fibrotic-changes-mediating-acute-kidney-injury-to-chronic-kidney-disease-transition
#6
Eoghainín Ó hAinmhire, Benjamin D Humphreys
End-stage renal disease (ESRD) is common, costly, and it results from progressive chronic kidney disease (CKD). ESRD claims many lives every year. It is increasingly recognized that episodes of acute kidney injury (AKI) predispose to the future development of CKD and ESRD. While our understanding of the pathophysiology of the AKI to CKD transition is improving, there are no validated therapeutic strategies to prevent this transition. In this review, we summarize the recent progress made in defining the cellular and molecular events underlying the AKI to CKD transition and highlight potential therapeutic targets and strategies to reduce the incidence of CKD following AKI...
June 9, 2017: Nephron
https://www.readbyqxmd.com/read/28595179/epigenetic-changes-in-the-acute-kidney-injury-to-chronic-kidney-disease-transition
#7
Masaomi Nangaku, Yosuke Hirakawa, Imari Mimura, Reiko Inagi, Tetsuhiro Tanaka
Previously acute kidney injury (AKI) had been believed to be a transient event, and recovery from AKI had been thought to lead to no consequences. However, recent epidemiological studies have shown that even if there is complete recovery of the kidney function, AKI can eventually result in chronic kidney disease (CKD) and eventually in end-stage kidney disease in the long term. Transition of AKI to CKD is mediated by multiple mechanisms, including aberrant cell cycle arrest and hypoxia. Hypoxia of the kidney is induced by rarefaction of the peritubular capillaries after AKI episodes, and induces inflammation and fibrosis...
June 9, 2017: Nephron
https://www.readbyqxmd.com/read/28534107/a-nephrologist-should-be-consulted-in-all-cases-of-acute-kidney-injury-in-the-icu-no
#8
EDITORIAL
John A Kellum, Eric A J Hoste
No abstract text is available yet for this article.
May 22, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28416224/post-discharge-kidney-function-is-associated-with-subsequent-ten-year-renal-progression-risk-among%C3%A2-survivors-of-acute-kidney-injury
#9
Simon Sawhney, Angharad Marks, Nick Fluck, Adeera Levin, David McLernon, Gordon Prescott, Corri Black
The extent to which renal progression after acute kidney injury (AKI) arises from an initial step drop in kidney function (incomplete recovery), or from a long-term trajectory of subsequent decline, is unclear. This makes it challenging to plan or time post-discharge follow-up. This study of 14651 hospital survivors in 2003 (1966 with AKI, 12685 no AKI) separates incomplete recovery from subsequent renal decline by using the post-discharge estimated glomerular filtration rate (eGFR) rather than the pre-admission as a new reference point for determining subsequent renal outcomes...
August 2017: Kidney International
https://www.readbyqxmd.com/read/28406186/renin-angiotensin-system-inhibitor-is-associated-with-lower-risk-of-ensuing-chronic-kidney-disease-after-functional-recovery-from-acute-kidney-injury
#10
Yu-Hsiang Chou, Tao-Min Huang, Szu-Yu Pan, Chin-Hao Chang, Chun-Fu Lai, Vin-Cent Wu, Ming-Shiou Wu, Kwan-Dun Wu, Tzong-Shinn Chu, Shuei-Liong Lin
Acute kidney injury (AKI) is an independent risk factor for ensuing chronic kidney disease (CKD). Animal studies have demonstrated that renin-angiotensin system (RAS) inhibitor can reduce ensuing CKD after functional recovery from AKI. Here we study the association between ensuing CKD and use of RAS inhibitor including angiotensin converting enzyme inhibitor or angiotensin II type 1a receptor blocker starting after renal functional recovery in our prospectively collected observational AKI cohort. Adult patients who had cardiac surgery-associated AKI (CSA-AKI) are studied...
April 13, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28412020/cardiac-surgery-in-patients-with-congenital-heart-disease-is-associated-with-acute-kidney-injury-and-the-risk-of-chronic-kidney-disease
#11
Nicolas L Madsen, Stuart L Goldstein, Trine Frøslev, Christian F Christiansen, Morten Olsen
Cardiac surgery associated-acute kidney injury (CS-AKI) occurs in 30-50% of patients undergoing surgery for congenital heart disease. Here we determine if CS-AKI is associated with chronic kidney disease (CKD) in patients with congenital heart disease. Using Danish regional population-based registries, our cohort study included patients with congenital heart disease born between 1990-2010 with first cardiac surgery between 2005 and 2010 (under 15 years of age). Utilizing in- and out-patient laboratory serum creatinine data, we identified individuals fulfilling KDIGO stages of AKI within 5 days of cardiac surgery...
April 12, 2017: Kidney International
https://www.readbyqxmd.com/read/28391314/continued-monitoring-of-acute-kidney-injury-survivors-might-not-be-necessary-in-those-regaining-an-estimated-glomerular-filtration-rate-60%C3%A2-ml-min-at-1-year
#12
Sokratis Stoumpos, Patrick B Mark, Emily P McQuarrie, Jamie P Traynor, Colin C Geddes
Background.: Severe acute kidney injury (AKI) among hospitalized patients often necessitates initiation of short-term dialysis. Little is known about the long-term outcome of those who recover to normal renal function. The aim of this study was to determine the long-term renal outcome of patients experiencing AKI requiring dialysis secondary to hypoperfusion injury and/or sepsis who recovered to apparently normal renal function. Methods.: All adult patients with AKI requiring dialysis in our centre between 1 January 1980 and 31 December 2010 were identified...
January 1, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28364303/acute-kidney-injury-in-sepsis
#13
REVIEW
Rinaldo Bellomo, John A Kellum, Claudio Ronco, Ron Wald, Johan Martensson, Matthew Maiden, Sean M Bagshaw, Neil J Glassford, Yugeesh Lankadeva, Suvi T Vaara, Antoine Schneider
Acute kidney injury (AKI) and sepsis carry consensus definitions. The simultaneous presence of both identifies septic AKI. Septic AKI is the most common AKI syndrome in ICU and accounts for approximately half of all such AKI. Its pathophysiology remains poorly understood, but animal models and lack of histological changes suggest that, at least initially, septic AKI may be a functional phenomenon with combined microvascular shunting and tubular cell stress. The diagnosis remains based on clinical assessment and measurement of urinary output and serum creatinine...
March 31, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28360257/three-year-outcomes-after-acute-kidney-injury-results-of-a-prospective-parallel-group-cohort-study
#14
Kerry L Horne, Rebecca Packington, John Monaghan, Timothy Reilly, Nicholas M Selby
OBJECTIVES: Using a prospective study design, we aimed to characterise the effect of acute kidney injury (AKI) on long-term changes in renal function in a general hospital population. PARTICIPANTS: Hospitalised patients with AKI (exposed) and hospitalised patients without AKI (non-exposed), recruited at 3 months after hospital admission. DESIGN: Prospective, matched parallel group cohort study, in which renal function and proteinuria were measured at 3 months, 1 year and 3 years...
March 29, 2017: BMJ Open
https://www.readbyqxmd.com/read/28336720/preventing-the-progression-of-aki-to-ckd-the-role-of-mitochondria
#15
EDITORIAL
Sophie de Seigneux, Pierre-Yves Martin
No abstract text is available yet for this article.
May 2017: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/28239173/acute-kidney-disease-and-renal-recovery-consensus-report-of-the-acute-disease-quality-initiative-adqi-16-workgroup
#16
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/28193259/acute-kidney-injury-increases-the-risk-of-end-stage-renal-disease-after-cardiac-surgery-in-an-asian-population-a-prospective-cohort-study
#17
Sophia Tsong Huey Chew, Roderica Rui Ge Ng, Weiling Liu, Khuan Yew Chow, Lian Kah Ti
BACKGROUND: Acute kidney injury (AKI) after cardiac surgery is associated with increased morbidity and mortality. The long-term association between AKI and end-stage renal disease (ESRD) in an Asian population is unknown. Given the high prevalence of diabetes and a younger age of presentation for cardiac surgery, it is important to track this progression of kidney disease. Therefore, we studied the long-term risk of ESRD and mortality in our Asian patients who developed AKI after cardiac surgery...
February 13, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28167630/early-phase-mast-cell-activation-determines-the-chronic-outcome-of-renal-ischemia-reperfusion-injury
#18
Luca Danelli, Lydia Celia Madjene, Iris Madera-Salcedo, Gregory Gautier, Emeline Pacreau, Sanae Ben Mkaddem, Nicolas Charles, Eric Daugas, Pierre Launay, Ulrich Blank
Ischemia-reperfusion injury (IRI) is an important cause of acute kidney injury that can lead to end-stage renal failure. Although the ensuing inflammatory response can restore homeostasis, a consecutive maladaptive repair and persistent inflammation represent important risk factors for postischemic chronic kidney disease development. In this study, we investigated the role of mast cells in both the early and late phases of the inflammatory response in experimental models of acute and chronic renal IRI using our recently developed mouse model that allows conditional ablation of mast cells...
February 6, 2017: Journal of Immunology: Official Journal of the American Association of Immunologists
https://www.readbyqxmd.com/read/28139396/heme-oxygenase-1-as-a-therapeutic-target-in-acute-kidney-injury
#19
REVIEW
Subhashini Bolisetty, Abolfazl Zarjou, Anupam Agarwal
A common clinical condition, acute kidney injury (AKI) significantly influences morbidity and mortality, particularly in critically ill patients. The pathophysiology of AKI is complex and involves multiple pathways, including inflammation, autophagy, cell-cycle progression, and oxidative stress. Recent evidence suggests that a single insult to the kidney significantly enhances the propensity to develop chronic kidney disease. Therefore, the generation of effective therapies against AKI is timely. In this context, the cytoprotective effects of heme oxygenase 1 (HO-1) in animal models of AKI are well documented...
April 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28133685/impact-of-acute-kidney-injury-on-long-term-mortality-and-progression-to-chronic-kidney-disease-among-critically-ill-children
#20
Najlaa G Al-Otaibi, Maryam Zeinelabdin, Mohamed A Shalaby, Norah Khathlan, Ghadi D Mashat, Amal A Zahrani, Sundus Mw NoorSaeed, Nora M Shalabi, Khalid A Alhasan, Sara N Sharief, Amr S Albanna, Jameela A Kari
To determine the 2-year outcome of acute kidney injury (AKI) following admission to pediatric critical care units (PICU). Methods: A retrospective cohort study was conducted between January 2012 and December 2013. We followed 131 children admitted to PICU, King Abdulaziz University Hospital, Jeddah, Kingdom of Saudi Arabia with a diagnosis of AKI, based on pRIFLE (pediatric risk, injury, failure, loss, and end-stage renal disease), for 2 years. During the study period, 46 children died and 38 of survivors completed the follow-up...
February 2017: Saudi Medical Journal
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