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AKI Prevention

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47 papers 0 to 25 followers
By Isabel Acosta-Ochoa Nephrology senior staff. Valladolid. Spain
https://www.readbyqxmd.com/read/28268210/leveraging-big-data-and-electronic-health-records-to-enhance-novel-approaches-to-acute-kidney-injury-research-and-care
#1
Scott M Sutherland, Stuart L Goldstein, Sean M Bagshaw
While acute kidney injury (AKI) has been poorly defined historically, a decade of effort has culminated in a standardized, consensus definition. In parallel, electronic health records (EHRs) have been adopted with greater regularity, clinical informatics approaches have been refined, and the field of EHR-enabled care improvement and research has burgeoned. Although both fields have matured in isolation, uniting the 2 has the capacity to redefine AKI-related care and research. This article describes how the application of a consistent AKI definition to the EHR dataset can accurately and rapidly diagnose and identify AKI events...
March 8, 2017: Blood Purification
https://www.readbyqxmd.com/read/28202365/optimising-the-use-of-medicines-to-reduce-acute-kidney-injury-in-children-and-babies
#2
REVIEW
L Oni, D B Hawcutt, M A Turner, M W Beresford, S McWilliam, C Barton, B K Park, P Murray, B Wilm, I Copple, R Floyd, M Peak, A Sharma, D J Antoine
The majority of medications in children are administered in an unlicensed or off-label manner. Paediatricians are obliged to prescribe using the limited evidence available. The 2007 EU regulation on the use of paediatric drugs means pharmaceutical companies are now obliged to (and receive incentives for) contributing to paediatric drug data and carrying out paediatric clinical trials. This is important, as the efficacy and adverse effect profiles of medicines vary across childhood. Additionally, there are significant age-related changes in the pharmacodynamic and pharmacokinetic activity of many drugs...
February 12, 2017: Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/28091757/-renal-protection-in-intensive-care-myths-and-facts
#3
REVIEW
S John
BACKGROUND: Acute kidney injury (AKI) is a common and severe complication in patients on the intensive care unit with a significant impact on patient mortality, morbidity and costs of care; therefore, renal protective therapy is most important in these severely ill patients. AIM OF THE REVIEW: Many renal protective strategies have been postulated during the last decades, which are sometimes still in place as a kind of "myth" but which are not always proven by evidence-based "facts"...
February 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28110412/prevention-of-cardiac-surgery-associated-aki-by-implementing-the-kdigo-guidelines-in-high-risk-patients-identified-by-biomarkers-the-prevaki-randomized-controlled-trial
#4
Melanie Meersch, Christoph Schmidt, Andreas Hoffmeier, Hugo Van Aken, Carola Wempe, Joachim Gerss, Alexander Zarbock
PURPOSE: Care bundles are recommended in patients at high risk for acute kidney injury (AKI), although they have not been proven to improve outcomes. We sought to establish the efficacy of an implementation of the Kidney Disease Improving Global Outcomes (KDIGO) guidelines to prevent cardiac surgery-associated AKI in high risk patients defined by renal biomarkers. METHODS: In this single-center trial, we examined the effect of a "KDIGO bundle" consisting of optimization of volume status and hemodynamics, avoidance of nephrotoxic drugs, and preventing hyperglycemia in high risk patients defined as urinary [TIMP-2]·[IGFBP7] > 0...
January 21, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28062569/inhibition-of-%C3%AE-v%C3%AE-5-integrin-attenuates-vascular-permeability-and-protects-against-renal-ischemia-reperfusion-injury
#5
Amy McCurley, Stella Alimperti, Silvia B Campos-Bilderback, Ruben M Sandoval, Jenna E Calvino, Taylor L Reynolds, Catherine Quigley, Joshua W Mugford, William J Polacheck, Ivan G Gomez, Jennifer Dovey, Graham Marsh, Angela Huang, Fang Qian, Paul H Weinreb, Brian M Dolinski, Shaun Moore, Jeremy S Duffield, Christopher S Chen, Bruce A Molitoris, Shelia M Violette, Michael A Crackower
Ischemia-reperfusion injury (IRI) is a leading cause of AKI. This common clinical complication lacks effective therapies and can lead to the development of CKD. The αvβ5 integrin may have an important role in acute injury, including septic shock and acute lung injury. To examine its function in AKI, we utilized a specific function-blocking antibody to inhibit αvβ5 in a rat model of renal IRI. Pretreatment with this anti-αvβ5 antibody significantly reduced serum creatinine levels, diminished renal damage detected by histopathologic evaluation, and decreased levels of injury biomarkers...
January 6, 2017: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/27940189/hydrocortisone-vitamin-c-and-thiamine-for-the-treatment-of-severe-sepsis-and-septic-shock-a-retrospective-before-after-study
#6
Paul E Marik, Vikramjit Khangoora, Racquel Rivera, Michael H Hooper, John Catravas
BACKGROUND: The global burden of sepsis is estimated as 15 to 19 million cases annually with a mortality rate approaching 60% in low income countries. METHODS: In this retrospective before-after clinical study, we compared the outcome and clinical course of consecutive septic patients treated with intravenous vitamin C, hydrocortisone and thiamine during a 7-month period (treatment group) compared to a control group treated in our ICU during the preceding 7 months...
December 6, 2016: Chest
https://www.readbyqxmd.com/read/27997877/effects-of-low-dose-atrial-natriuretic-peptide-infusion-on-cardiac-surgery-associated-acute-kidney-injury-a-multicenter-randomized-controlled-trial
#7
Chieko Mitaka, Tetsu Ohnuma, Takanori Murayama, Fumio Kunimoto, Michio Nagashima, Tetsuhiro Takei, Naoya Iguchi, Makoto Tomita
PURPOSE: To evaluate the effects of atrial natriuretic peptide (ANP) on renal function and medical costs in patients with acute kidney injury (AKI) associated with cardiac surgery. MATERIALS AND METHODS: The Japanese trial for AKI in Post-cardiovascular surgery patients by ANP (JAPAN) was a prospective, multicenter, randomized, double-blind, placebo-controlled study conducted in 11 hospitals in Japan. Acute kidney injury was defined as an increase in serum creatinine of at least 0...
April 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/27770407/recent-perioperative-pharmacological-prevention-of-acute-kidney-injury-after-cardiac-surgery-a-narrative-review
#8
REVIEW
Shurong Li, Shufang Fu, Yichen Xiao, Gaosi Xu
Acute kidney injury (AKI) is a common and severe complication of cardiac surgery, and related rates of both hospitalization and long-term mortality are increasing. A number of studies have explored the preventive effects of perioperative pharmacological therapy on AKI after cardiac surgery. However, the mechanisms of AKI are multifaceted, and no universal treatment has been confirmed as beneficial. We review and analyze several current perioperative pharmacological therapies for AKI after cardiac surgery to identify promising preventive strategies...
February 2017: American Journal of Cardiovascular Drugs: Drugs, Devices, and Other Interventions
https://www.readbyqxmd.com/read/27684548/levosimendan-administration-in-limb-ischemia-multicomponent-signaling-serving-kidney-protection
#9
Peter Onody, Peter Aranyi, Zsolt Turoczi, Rita Stangl, Andras Fulop, Emese Dudas, Gabor Lotz, Attila Szijarto
AIMS AND OBJECTIVES: Acute renal failure is a severe complication of lower extremity major arterial reconstructions, which could even be fatal. Levosimendan is a dual-acting positive inotropic and vasodilatory agent, which is suspected to have protective effects against cardiac ischemia. However, there is no data available on lower limb or remote organ ischemic injuries therefore the aim of the study was to investigate the effect of levosimendan on lower limb ischemia-reperfusion injury and the corollary renal dysfunction...
2016: PloS One
https://www.readbyqxmd.com/read/27648014/evaluation-of-nephroprotective-efficacy-of-hypoxic-preconditioning-in-patients-undergoing-coronary-artery-bypass-surgery
#10
Zhaneta V Vesnina, Yury B Lishmanov, Ekaterina A Alexandrova, Evgeniy A Nesterov
BACKGROUND: Nonpulsatile blood flow plays an important role in the pathogenesis of renal dysfunction in patients with extracorporeal circulation. In our opinion, hypoxic preconditioning (HP) can be used to protect kidneys from postsurgical dysfunction. The aim of this study was to evaluate nephroprotective efficacy of HP in myocardial revascularization with extracorporeal circulation. METHODS: The randomized, controlled trial was performed in 63 patients undergoing coronary artery bypass grafting (CABG)...
August 2016: Cardiorenal Medicine
https://www.readbyqxmd.com/read/27633727/development-of-a-multicenter-ward-based-aki-prediction-model
#11
Jay L Koyner, Richa Adhikari, Dana P Edelson, Matthew M Churpek
BACKGROUND AND OBJECTIVES: Identification of patients at risk for AKI on the general wards before increases in serum creatinine would enable preemptive evaluation and intervention to minimize risk and AKI severity. We developed an AKI risk prediction algorithm using electronic health record data on ward patients (Electronic Signal to Prevent AKI). DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: All hospitalized ward patients from November of 2008 to January of 2013 who had serum creatinine measured in five hospitals were included...
November 7, 2016: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/27631199/remote-ischemic-preconditioning-for-prevention-of-acute-kidney-injury-in-patients-undergoing-on-pump-cardiac-surgery-a-systematic-review-and-meta-analysis
#12
REVIEW
Yabing Zhang, Xiyang Zhang, Dongmei Chi, Siyang Wang, Hua Wei, Hong Yu, Qian Li, Bin Liu
Remote ischemic preconditioning (RIPC) may attenuate acute kidney injury (AKI). However, results of studies evaluating the effect of RIPC on AKI after cardiac surgery have been controversial and contradictory.The aim of this meta-analysis is to examine the association between RIPC and AKI after on-pump cardiac surgery.The authors searched relevant studies in PubMed, EMBASE, and the Cochrane Library through December 2015.We considered for inclusion all randomized controlled trials that the role of RIPC in reducing AKI and renal replacement therapy (RRT) among patients underwent on-pump cardiac surgical procedures...
September 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27486809/possible-underlying-mechanisms-of-the-renoprotective-effect-of-remote-limb-ischemic-preconditioning-against-renal-ischemia-reperfusion-injury-a-role-of-osteopontin-transforming-growth-factor-beta-and-survivin
#13
Abdelaziz M Hussein, Hussein F Sakr, Faris Q Alenzi
BACKGROUND: It has been documented that remote limb ischemic preconditioning (rIPC) protect kidneys against renal ischemia/reperfusion (I/R). We hypothesized that osteopontin (OPN), transforming growth factor beta (TGF-β), apoptotic proteins (survivin and caspase-3) and oxidative stress play role in the renoprotective effects of rIPC. MATERIALS AND METHODS: Fifty-four male Sprague-Dawley rats were randomized into 3 equal groups: sham group, I/R group (left renal 45 min ischemia) and rIPC group (as I/R group with 3 cycles of left hind limb ischemia just before renal ischemia)...
2016: Nephron
https://www.readbyqxmd.com/read/27449672/preventing-acute-kidney-injury-a-qualitative-study-exploring-sick-day-rules-implementation-in-primary-care
#14
Rebecca L Morris, Darren Ashcroft, Denham Phipps, Peter Bower, Donal O'Donoghue, Paul Roderick, Sarah Harding, Andrew Lewington, Thomas Blakeman
BACKGROUND: In response to growing demand for urgent care services there is a need to implement more effective strategies in primary care to support patients with complex care needs. Improving primary care management of kidney health through the implementation of 'sick day rules' (i.e. temporary cessation of medicines) to prevent Acute Kidney Injury (AKI) has the potential to address a major patient safety issue and reduce unplanned hospital admissions. The aim of this study is to examine processes that may enable or constrain the implementation of 'sick day rules' for AKI prevention into routine care delivery in primary care...
July 22, 2016: BMC Family Practice
https://www.readbyqxmd.com/read/27398602/nephroprotective-effect-of-the-leaves-of-aloe-barbadensis-aloe-vera-against-toxicity-induced-by-diclofenac-sodium-in-albino-rabbits
#15
A Iftkhar, I J Hasan, M Sarfraz, L Jafri, M A Ashraf
Background: The present study was designed to evaluate the nephroprotective effect of the leaves of Aloe barbadensis against toxicity induced by diclofenac sodium in albino rabbits. Subjects and Method: Thirty-six healthy albino rabbits were randomly divided into six groups each with six animals. Group 1 served as the untreated control, group 2 was treated only with diclofenac sodium, group 3 with the nephroprotective drug silymarin and groups 4, 5, and 6 were treated with different doses of Aloe barbadensis,ie 200 mg/kg, 400 mg/kg and 600 mg/kg, respectively after being treated with diclofenac sodium...
April 18, 2016: West Indian Medical Journal
https://www.readbyqxmd.com/read/27419130/prediction-and-prevention-of-acute-kidney-injury-after-cardiac-surgery
#16
REVIEW
Su Rin Shin, Won Ho Kim, Dong Joon Kim, Il-Woo Shin, Ju-Tae Sohn
The incidence of acute kidney injury after cardiac surgery (CS-AKI) ranges from 33% to 94% and is associated with a high incidence of morbidity and mortality. The etiology is suggested to be multifactorial and related to almost all aspects of perioperative management. Numerous studies have reported the risk factors and risk scores and novel biomarkers of AKI have been investigated to facilitate the subclinical diagnosis of AKI. Based on the known independent risk factors, many preventive interventions to reduce the risk of CS-AKI have been tested...
2016: BioMed Research International
https://www.readbyqxmd.com/read/27342646/goal-directed-therapy-and-acute-kidney-injury-as-good-as-it-gets
#17
James F Doyle, Marlies Ostermann, Lui G Forni
The use of goal-directed therapy as part of an enhanced recovery programme is well established in terms of management of the modern high-risk surgical patient in order to reduce both morbidity and mortality. The mechanisms behind this improvement are debated, but a reduction in the development of post-operative complications including acute kidney injury may be relevant. A recent study examining this relationship has been reported and is discussed here.
June 25, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27344977/impact-of-antioxidant-supplementations-on-cardio-renal-protection-in-cardiac-surgery-an-updated-and-comprehensive-meta-analysis-and-systematic-review
#18
REVIEW
Sadegh Ali-Hassan-Sayegh, Seyed Jalil Mirhosseini, Mahbube Tahernejad, Parisa Mahdavi, Azadeh Shahidzadeh, Ali Akbar Karimi-Bondarabadi, Ali-Mohammad Dehghan, Elham Rahimizadeh, Fatemeh Haddad, Zahra Ghodratipour, Zahra Sarrafan-Chaharsoughi, Arezoo Shahidzadeh, Azam Ghanei, Mohammadreza Lotfaliani, Mohamed Zeriouh, Alexander Weymann, Aron-Frederik Popov, Anton Sabashnikov
This systematic review with meta-analysis sought to determine the strength of evidence in terms of the impact of common antioxidant supplementations, such as N-acetylcysteine (NAC), vitamin C, and polyunsaturated fatty acids (PUFA) on perioperative outcomes after cardiac surgery with particular focus on the incidence of atrial fibrillation (AF) and acute kidney injury (AKI) with associated mortality. A total of 29 trials were identified that reported incidence of AF and 17 trials that reported incidence of AKI...
October 2016: Cardiovascular Therapeutics
https://www.readbyqxmd.com/read/27217196/a-sustained-quality-improvement-program-reduces-nephrotoxic-medication-associated-acute-kidney-injury
#19
Stuart L Goldstein, Theresa Mottes, Kendria Simpson, Cynthia Barclay, Stephen Muething, David B Haslam, Eric S Kirkendall
Exposure to nephrotoxic medication is among the most common causes of acute kidney injury (AKI) in hospitalized patients. Here we conducted a prospective quality improvement project implementing a systematic Electronic Health Record screening and decision support process (trigger) in our quaternary pediatric inpatient hospital. Eligible patients were noncritically ill hospitalized children receiving an intravenous aminoglycoside for more than 3 days or more than 3 nephrotoxins simultaneously (exposure) from September 2011 through March 2015...
July 2016: Kidney International
https://www.readbyqxmd.com/read/27108948/renoprotective-approaches-and-strategies-in-acute-kidney-injury
#20
REVIEW
Yuan Yang, Meifang Song, Yu Liu, Hong Liu, Lin Sun, Youming Peng, Fuyou Liu, Manjeri A Venkatachalam, Zheng Dong
Acute kidney injury (AKI) is a major renal disease associated with high mortality rate and increasing prevalence. Decades of research have suggested numerous chemical and biological agents with beneficial effects in AKI. In addition, cell therapy and molecular targeting have been explored for reducing kidney tissue damage and promoting kidney repair or recovery from AKI. Mechanistically, these approaches may mitigate oxidative stress, inflammation, cell death, and mitochondrial and other organellar damage, or activate cytoprotective mechanisms such as autophagy and pro-survival factors...
July 2016: Pharmacology & Therapeutics
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