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AKI Risk Factors

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By Isabel Acosta-Ochoa Nephrology senior staff. Valladolid. Spain
Lilia Maria Rizo-Topete, Mitchell H Rosner, Claudio Ronco
Acute kidney Injury (AKI) is a serious medical condition affecting more than 10 million people around the world annually and resulting in poor outcomes. It has been suggested that late recognition of the syndrome may lead to delayed interventions with increased morbidity and mortality. Early diagnosis and timely therapeutic strategies may be the cornerstone of future improvement in outcomes. The purpose of this article is to provide a practical model to identify patients at high risk for AKI in different environments, with the goal to prevent AKI...
December 3, 2016: Blood Purification
Dana Y Fuhrman, John A Kellum
PURPOSE OF REVIEW: Acute kidney injury (AKI) remains a serious complication of cardiac surgery. An understanding of the epidemiology and pathophysiology of AKI in cardiac surgery patients is crucial to early recognition and proper management. RECENT FINDINGS: The article will review the current criteria used for defining AKI and the most recently published incidence rates of AKI in the cardiac surgery population. Variables associated with AKI will be reviewed. The cause of cardiac surgery-associated AKI is multifactorial involving genetic factors as well as insults because of nephrotoxins, ischemia and reperfusion, cardiac dysfunction, venous congestion, inflammation, and oxidative stress...
November 4, 2016: Current Opinion in Anaesthesiology
Min Shao, Shengyu Wang, Praveen Kolumam Parameswaran
PURPOSE: The increased likelihood of poor outcomes in critically ill patients with hypoalbuminemia is well recognized. However, hypoalbuminemia remains poorly defined as an independent predictor of acute kidney injury (AKI) and stage 4 chronic kidney diseases (CKD4). The aim of this study was to assess the role of hypoalbuminemia as an independent risk factor for AKI and CKD4 in critically ill patients. DESIGN: A retrospective cohort study. SETTING: General intensive care unit (ICU) at Anhui Provincial Hospital, PR China...
November 5, 2016: International Urology and Nephrology
S M Kendale, P N Lapis, S M Melhem, J D Blitz
We used multivariate analyses to assess the association of pre-operative variables with kidney function in 41,523 adults after scheduled surgery in a single large academic hospital. Eight variables were independently associated with a reduction in postoperative estimated glomerular filtration rate: pre-operative renal function; age; ASA physical status; cardiac failure; anaemia; cancer; type of surgery; and the lowest quartile of pre-operative mean arterial blood pressure (< 71 mmHg). The estimated glomerular filtration rate fell by a mean (95% CI) of 2...
December 2016: Anaesthesia
Rasheed A Balogun, Bolanle A Omotoso, Wenjun Xin, Jennie Z Ma, Kenneth W Scully, Fatiu A Arogundade, Emaad M Abdel-Rahman
BACKGROUND: The prevalence of depression and its relationship to poor outcomes in chronic kidney disease are established facts. Such prognostic impact in acute kidney injury (AKI) is not known. This study determines the prognostic implication of a diagnosis of depression on renal recovery and major adverse cardiovascular events (MACE), a new diagnosis of myocardial infarction, cerebrovascular disease (CVD, stroke or transient ischemic attack) or congestive heart failure (CHF) after hospitalization with AKI...
September 22, 2016: Nephron
Guosheng Wu, Yongqiang Xiao, Chen Wang, Xudong Hong, Yu Sun, Bing Ma, Guangyi Wang, Zhaofan Xia
Acute kidney injury (AKI) is a fatal complication of burn injury. Few systematic reviews to date have focused on the risk factors predisposing to AKI in patients with burn injury. The aim of this article is to identify the risk factors for the occurrence of AKI in burn patients, thus providing theoretical evidence for prevention and treatment. We performed a systematic review and meta-analysis of studies determining the prevalence, risk factors, and outcomes of AKI in patients with burn injury. An electronic search (up to April 2016) was performed using Pubmed, Embase, Web of Knowledge, and the Cochrane Library databases...
September 9, 2016: Journal of Burn Care & Research: Official Publication of the American Burn Association
Bixiao Zhao, Qiongshi Lu, Yuwei Cheng, Justin M Belcher, Edward D Siew, David E Leaf, Simon C Body, Amanda A Fox, Sushrut W Waikar, Charles D Collard, Heather Thiessen-Philbrook, T Alp Ikizler, Lorraine B Ware, Charles L Edelstein, Amit X Garg, Murim Choi, Jennifer A Schaub, Hongyu Zhao, Richard P Lifton, Chirag R Parikh
RATIONALE: Acute kidney injury is a common and severe complication of critical illness and cardiac surgery. Despite significant attempts at developing treatments, therapeutic advances to attenuate acute kidney injury and expedite recovery have largely failed. OBJECTIVES: Identifying genetic loci associated with increased risk of acute kidney injury may reveal novel pathways for therapeutic development. METHODS: We conducted an exploratory genome-wide association study to identify single-nucleotide polymorphisms associated with genetic susceptibility to in-hospital acute kidney injury...
August 30, 2016: American Journal of Respiratory and Critical Care Medicine
R R Singh, Dharmendra Uraiya, Anoop Kumar, Neeraj Tripathi
AIMS: This study was conducted retrospectively to define early demographic and clinical predictors for acute kidney injury (AKI) among snake bite patients at the time of hospital admission. MATERIALS AND METHODS: We analyzed 138 cases with a poisonous snake bite. Patients were classified into two groups according to the presence and absence of AKI. The data regarding clinical features and demographic profile of these patients were collected from the hospital records in a prestructured pro forma and statistically compared...
July 2016: Indian Journal of Critical Care Medicine
Ha-Jung Kim, Won-Uk Koh, Sae-Gyeol Kim, Hyeok-Seong Park, Jun-Gol Song, Young-Jin Ro, Hong-Seuk Yang
Hypoalbuminemia has been reported to be an independent risk factor for acute kidney injury (AKI). However, little is known about the relationship between the albumin level and the incidence of AKI in patients undergoing total knee arthroplasty (TKA). The aim of our study was to assess incidence and risk factors for AKI and to evaluate the relationship between albumin level and AKI following TKA.The study included a retrospective review of medical records of 1309 consecutive patients who underwent TKA between January 2008 and December 2014...
August 2016: Medicine (Baltimore)
Jean-Michel Hougardy, Perrine Revercez, Aline Pourcelet, Bachar El Oumeiri, Judith Racapé, Alain Le Moine, Frédéric Vanden Eynden, Daniel De Backer
BACKGROUND: Cardiac surgery-associated acute kidney injury (CSA-AKI) is a common complication and is associated with the poorest outcomes. Therefore, early prediction of CSA-AKI remains a major issue. Severity scores such as the STS score could estimate the risk of AKI preoperatively. The main objective of this study was to evaluate the risk factors of on-pump CSA-AKI and to assess the performance of the STS score in order to predict CSA-AKI. PATIENTS: We identified 252 patients with on-pump cardiac surgery, and the STS score was defined retrospectively...
June 2, 2016: Acta Chirurgica Belgica
Trijntje J W Rennie, Andrea Patton, Tobias Dreischulte, Samira Bell
BACKGROUND: Incidence of acute kidney injury (AKI), requiring dialysis, is on the rise globally and is associated with high mortality and morbidity. AIM: This study is aimed at examining the incidence of AKI requiring renal replacement therapy (RRT) in the Tayside region of Scotland and the impact of RRT for AKI on morbidity, mortality and length of hospital stay. METHODS: One hundred seventy eight patients (>18 years of age) who received acute RRT between January 1, 2012 and December 31, 2012 were retrospectively selected for inclusion in the longitudinal cohort study...
2016: Nephron
Chung Wei Nah, Lian Kah Ti, Weiling Liu, Roderica Rui Ge Ng, Liang Shen, Sophia Tsong Huey Chew
OBJECTIVES: Acute kidney injury (AKI) post-cardiac surgery is associated with significant in-hospital and long-term morbidity. This study aimed to develop a risk score for postoperative AKI in a Southeast-Asian population. METHODS: A total of 2508 patients underwent cardiac surgery at the two main heart centres in Singapore between July 2008 and November 2011, of which 2385 met the inclusion criteria. The primary outcome was AKI, defined using the Acute Kidney Injury Network (AKIN) criteria...
November 2016: Interactive Cardiovascular and Thoracic Surgery
Shao-Wei Chen, Chih-Hsiang Chang, Pei-Chun Fan, Yung-Chang Chen, Pao-Hsien Chu, Tien-Hsing Chen, Victor Chien-Chia Wu, Su-Wei Chang, Pyng-Jing Lin, Feng-Chun Tsai
OBJECTIVES: Acute kidney injury (AKI) after coronary artery bypass grafting (CABG) is associated with short-term and long-term adverse outcomes. The European System for Cardiac Operative Risk Evaluation (EuroSCORE), EuroSCORE II, the Society of Thoracic Surgeons (STS) score and Age, Creatinine and Ejection Fraction (ACEF) score, have been widely used for predicting the operative risk of cardiac surgery. The aim of this study is to investigate the discriminant ability among current available models in predicting postoperative AKI...
2016: BMJ Open
Atike Tekeli Kunt, Hakan Parlar, Orhan Findik, Cagri Duzyol, Ozgur Baris, Canan Balci
BACKGROUND: Metabolic syndrome (MetS) is defined as a cluster of systemic abnormalities: hyperglycemia, dyslipidemia, abdominal obesity, and hypertension. Acute kidney injury (AKI) is one of the devastating complications after cardiac surgery. Age, DM, preexisting renal dysfunction, hypertension, impaired left ventricular function, and severe arteriosclerosis of the aorta are the major risk factors for the development of AKI. The purpose of the current study was to analyze the influence of MetS on AKI occurring after coronary artery bypass grafting (CABG)...
2016: Heart Surgery Forum
Orhan Findik, Ufuk Aydin, Ozgur Baris, Hakan Parlar, Gokcen Atilboz Alagoz, Yusuf Ata, Tamer Turk, Atike Tekeli Kunt
BACKGROUND: Acute kidney injury is a common complication of cardiac surgery that increases morbidity and mortality. The aim of the present study is to analyze the association of preoperative serum albumin levels with acute kidney injury and the requirement of renal replacement therapy after isolated coronary artery bypass graft surgery (CABG). METHODS: We retrospectively reviewed the prospectively collected data of 530 adult patients who underwent isolated CABG surgery with normal renal function...
2016: Heart Surgery Forum
Khalid Abusaada, Cai Yuan, Rafay Sabzwari, Khurram Butt, Aadil Maqsood
BACKGROUND: Acute kidney injury (AKI) is common in patients with acute myocardial infarction. AKI in this setting is associated with short- and long-term adverse events. The aim of this study was to develop a simple score to predict AKI in patients presenting with acute myocardial infarction based on data available at time of admission. METHODS: This was a retrospective analysis of data collected as part of the Acute Coronary Treatment and Intervention Outcomes Network (ACTION) registry at a tertiary care center between 1/1/2011 and 12/31/2013...
June 14, 2016: Journal of Nephrology
Yan-Bei Sun, Bi-Cheng Liu, Yun Zou, Jia-Rong Pan, Yuan Tao, Min Yang
OBJECTIVES: To study the risk factors for acute kidney injury (AKI) in-patients with acute myocardial infarction (AMI). METHODS: A total of 1371 cases of adult in-patients with AMI in the First People's Hospital of Changzhou from January 2008 to December 2012 were retrospectively analyzed. Based on the occurrence of AKI diagnosed according to the 2012 KDIGO AKI criteria, they were divided into AKI group and non-AKI group and further into conservative treatment groups, coronary angiography (CAG) groups, and coronary artery bypass grafting (CABG) groups based on the timing of AKI occurrence, respectively...
June 14, 2016: Renal Failure
Salwa Farooqi, Jeffrey G Dickhout
Acute kidney injury (AKI) is commonly seen amongst critically ill and hospitalized patients. Individuals with certain co-morbid diseases have an increased risk of developing AKI. Thus, recognizing the co-morbidities that predispose patients to AKI is important in AKI prevention and treatment. Some of the most common co-morbid disease processes that increase the risk of AKI are diabetes, cancer, cardiac surgery and human immunodeficiency virus (HIV) acquired immune deficiency syndrome (AIDS). This review article identifies the increased risk of acquiring AKI with given co-morbid diseases...
March 6, 2016: World Journal of Nephrology
Selma Ishag, Charuhas V Thakar
Perioperative acute kidney injury (AKI) is associated with an increased morbidity and mortality. The incidence of AKI varies depending on preoperative risk factors and the surgical setting. Preoperative risk stratification is critical for informed consent and perioperative planning. Perioperative renal protection strategies are potentially invaluable in the prevention of AKI. Current advances in the development of biomarkers may offer the opportunity for early diagnosis and the implementation of therapeutic strategies...
March 2016: Anesthesiology Clinics
Scott M Sutherland, Lakhmir S Chawla, Sandra L Kane-Gill, Raymond K Hsu, Andrew A Kramer, Stuart L Goldstein, John A Kellum, Claudio Ronco, Sean M Bagshaw
The data contained within the electronic health record (EHR) is "big" from the standpoint of volume, velocity, and variety. These circumstances and the pervasive trend towards EHR adoption have sparked interest in applying big data predictive analytic techniques to EHR data. Acute kidney injury (AKI) is a condition well suited to prediction and risk forecasting; not only does the consensus definition for AKI allow temporal anchoring of events, but no treatments exist once AKI develops, underscoring the importance of early identification and prevention...
2016: Canadian Journal of Kidney Health and Disease
2016-03-02 12:27:42
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