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AKI Prevention

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40 papers 0 to 25 followers
By Isabel Acosta-Ochoa Nephrology senior staff. Valladolid. Spain
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...
October 22, 2016: American Journal of Cardiovascular Drugs: Drugs, Devices, and Other Interventions
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
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
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
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)
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
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
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
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
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.
2016: Critical Care: the Official Journal of the Critical Care Forum
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
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
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
Jiachang Hu, Shaopeng Liu, Ping Jia, Xialian Xu, Nana Song, Ting Zhang, Rongyi Chen, Xiaoqiang Ding
BACKGROUND: Remote ischemic preconditioning (RIPC) is a promising approach to preventing acute kidney injury (AKI), but its efficacy is controversial. METHODS: A systematic review of 30 randomized controlled trials was conducted to investigate the effects of RIPC on the incidence and outcomes of AKI. Random effects model meta-analyses and meta-regressions were used to generate summary estimates and explore sources of heterogeneity. The primary outcome was incidence of AKI and hospital mortality...
April 20, 2016: Critical Care: the Official Journal of the Critical Care Forum
Bingjue Li, Xiabing Lang, Luxi Cao, Yuchen Wang, Yingying Lu, Shi Feng, Yi Yang, Jianghua Chen, Hong Jiang
It is currently controversial whether remote ischemic preconditioning (RIPC) reduces the incidence of acute kidney injury (AKI) in patients undergoing cardiovascular interventions. The main objective of this meta-analysis was to investigate whether RIPC provides renal protection for patients undergoing cardiac or vascular surgery. We searched the PubMed database (1966-Oct 2015), Embase database (1966-Oct 2015), Google Scholar, Cochrane Library, ClinicalTrials Database and Open Grey. Then we conducted a meta-analysis of the randomized controlled trials that met the inclusion criteria of our study...
April 18, 2016: Journal of Nephrology
Lutfiye Derya Karademir, Fatma Dogruel, Ismail Kocyigit, Cevat Yazici, Aydin Unal, Murat Hayri Sipahioglu, Oktay Oymak, Bulent Tokgoz
OBJECTIVE: Cisplatin is a potent antineoplastic agent used and its major limiting side effect is nephrotoxicity. The aims of the study are early detection of acute kidney injury (AKI) with biomarkers and investigation of the potential nephron-protective effects of theophylline. METHODS: Glomerular filtration rates (GFR), neutrophil gelatinase-associated lipocalin (NGAL), cystatin C were measured at 5th day of treatment in all of the patients. In addition, these parameters were measured repeatedly after the administration of cisplatin, at 2nd hour, 5th and 20th days...
June 2016: Renal Failure
Florian E Tögel, Jon D Ahlstrom, Ying Yang, Zhuma Hu, Ping Zhang, Christof Westenfelder
Erythropoietin (EPO) may be a beneficial tissue-protective cytokine. However, high doses of EPO are associate with adverse effects, including thrombosis, tumor growth, and hypertension. Carbamylated erythropoietin (CEPO) lacks both erythropoietic and vasoconstrictive actions. In this study, we compared the renoprotective, hemodynamic, and hematologic activities and survival effects of identical EPO and CEPO doses in rat models of clinically relevant AKI presentations, including ischemia-reperfusion-induced AKI superimposed on CKD (5000 U/kg EPO or CEPO; three subcutaneous injections) and ischemia-reperfusion-induced AKI in old versus young animals and male versus female animals (1000 U/kg EPO or CEPO; three subcutaneous injections)...
November 2016: Journal of the American Society of Nephrology: JASN
Heather M Perry, Liping Huang, Hong Ye, Chong Liu, Sun-Sang J Sung, Kevin R Lynch, Diane L Rosin, Amandeep Bajwa, Mark D Okusa
Epithelial and endothelial injury and a cascade of immune and interstitial cell activation in the kidney lead to AKI. After mild to moderate AKI, the epithelium can regenerate and restore kidney function, yet little is known about the endothelium during these repair processes. Sphingosine 1-phosphate receptor 1 (S1P1), a G protein-coupled receptor, is necessary for vascular homeostasis. Here, we used an inducible genetic approach in a mouse model of AKI, ischemia-reperfusion injury (IRI), to determine the temporal effects of endothelial S1P1 during AKI...
November 2016: Journal of the American Society of Nephrology: JASN
Sebastian Schmid, Barbara Kapfer, Markus Heim, Ralph Bogdanski, Aida Anetsberger, Manfred Blobner, Bettina Jungwirth
BACKGROUND: Acute kidney injury is a common complication after major surgery. In this study, we investigated whether an algorithm-guided goal-directed haemodynamic therapy (GDT) can improve renal outcome compared to good standard clinical care. METHODS: A total of 180 patients undergoing major abdominal surgery were prospectively and randomly assigned to one of two groups: in the GDT group, patients were treated with a GDT algorithm using transpulmonary thermodilution while standard care was applied to the control patients...
March 8, 2016: Critical Care: the Official Journal of the Critical Care Forum
Giovani José Dal Poggetto Molinari, Ana Terezinha Guillaumon, Andréia Marques de Oliveira Dalbem
INTRODUCTION: Despite the patient and medical staff exposure to radiation in endovascular aneurysm repair, the benefits of this abdominal aortic aneurysm type of surgical management are justified by minor recovery time and hospitalization, as well as an option for patients not elected to conventional open repair. In this minimally invasive surgical approach, time of procedure and radiation doses can be substantial--and the increasing frequency of these procedures and it's complexity have impelled vascular surgeons to face additional and successive risk to occupational radiation exposure...
November 2015: Brazilian Journal of Cardiovascular Surgery
2016-03-07 14:10:35
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