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AKI Treatment

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58 papers 25 to 100 followers
By Isabel Acosta-Ochoa Nephrology senior staff. Valladolid. Spain
https://www.readbyqxmd.com/read/27853353/update-on-sepsis-associated-acute-kidney-injury-emerging-targeted-therapies
#1
REVIEW
James F Doyle, Lui G Forni
Sepsis-associated acute kidney injury (SA-AKI) is an independent predictor of increased mortality and morbidity. It is essential that further advances in the treatment of sepsis should prioritize targeted therapies in SA-AKI in order to improve these bleak outcomes. As yet, a unique therapy that effectively reduces the impact of acute kidney injury has not been demonstrated. However, the emergence of novel targeted therapies, perhaps in combination, has the possibility of significantly reducing the long-term sequelae of an episode of SA-AKI...
2016: Biologics: Targets & Therapy
https://www.readbyqxmd.com/read/27820741/does-fluid-management-affect-the-occurrence-of-acute-kidney-injury
#2
Johan Mårtensson, Rinaldo Bellomo
PURPOSE OF REVIEW: To describe the potential impact of different fluid management strategies on renal outcomes in critically ill and postoperative patients. RECENT FINDINGS: Uncritical fluid administration may induce renal compartment syndrome and renal venous congestion, which contribute to kidney dysfunction. In more than 5000 randomized surgical or septic patients, goal-directed therapy did not reduce fluid accumulation, acute kidney injury (AKI) development or need for renal replacement therapy...
November 4, 2016: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/27769920/allopurinol-attenuates-rhabdomyolysis-associated-acute-kidney-injury-renal-and-muscular-protection
#3
Pedro H F Gois, Daniele Canale, Rildo A Volpini, Daniela Ferreira, Mariana M Veras, Vinicius Andrade-Oliveira, Niels O S Câmara, Maria H M Shimizu, Antonio C Seguro
BACKGROUND: Acute kidney injury (AKI) is the most severe complication of rhabdomyolysis. Allopurinol (Allo), a xanthine oxidase inhibitor, has been in the spotlight in the last decade due to new therapeutic applications related to its potent antioxidant effect. The aim of this study was to evaluate the efficacy of Allo in the prevention and treatment of rhabdomyolysis-associated AKI. METHODS: Male Wistar rats were divided into five groups: saline control group; prophylactic Allo (300mg/L of drinking water, 7 days); glycerol (50%, 5ml/kg, IM); prophylactic Allo + glycerol; and therapeutic Allo (50mg/Kg, IV, 30min after glycerol injection) + glycerol...
October 18, 2016: Free Radical Biology & Medicine
https://www.readbyqxmd.com/read/27721835/mesenchymal-stem-cell-based-therapy-for-kidney-disease-a-review-of-clinical-evidence
#4
REVIEW
Anna Julie Peired, Alessandro Sisti, Paola Romagnani
Mesenchymal stem cells form a population of self-renewing, multipotent cells that can be isolated from several tissues. Multiple preclinical studies have demonstrated that the administration of exogenous MSC could prevent renal injury and could promote renal recovery through a series of complex mechanisms, in particular via immunomodulation of the immune system and release of paracrine factors and microvesicles. Due to their therapeutic potentials, MSC are being evaluated as a possible player in treatment of human kidney disease, and an increasing number of clinical trials to assess the safety, feasibility, and efficacy of MSC-based therapy in various kidney diseases have been proposed...
2016: Stem Cells International
https://www.readbyqxmd.com/read/27719676/nomenclature-for-renal-replacement-therapy-and-blood-purification-techniques-in-critically-ill-patients-practical-applications
#5
Gianluca Villa, Mauro Neri, Rinaldo Bellomo, Jorge Cerda, A Raffaele De Gaudio, Silvia De Rosa, Francesco Garzotto, Patrick M Honore, John Kellum, Anna Lorenzin, Didier Payen, Zaccaria Ricci, Sara Samoni, Jean-Louis Vincent, Julia Wendon, Marta Zaccaria, Claudio Ronco
This article reports the conclusions of the second part of a consensus expert conference on the nomenclature of renal replacement therapy (RRT) techniques currently utilized to manage acute kidney injury and other organ dysfunction syndromes in critically ill patients. A multidisciplinary approach was taken to achieve harmonization of definitions, components, techniques, and operations of the extracorporeal therapies. The article describes the RRT techniques in detail with the relevant technology, procedures, and phases of treatment and key aspects of volume management/fluid balance in critically ill patients...
October 10, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27719682/nomenclature-for-renal-replacement-therapy-in-acute-kidney-injury-basic-principles
#6
REVIEW
Mauro Neri, Gianluca Villa, Francesco Garzotto, Sean Bagshaw, Rinaldo Bellomo, Jorge Cerda, Fiorenza Ferrari, Silvia Guggia, Michael Joannidis, John Kellum, Jeong Chul Kim, Ravindra L Mehta, Zaccaria Ricci, Alberto Trevisani, Silvio Marafon, William R Clark, Jean-Louis Vincent, Claudio Ronco
This article reports the conclusions of a consensus expert conference on the basic principles and nomenclature of renal replacement therapy (RRT) currently utilized to manage acute kidney injury (AKI). This multidisciplinary consensus conference discusses common definitions, components, techniques, and operations of the machines and platforms used to deliver extracorporeal therapies, utilizing a "machine-centric" rather than a "patient-centric" approach. We provide a detailed description of the performance characteristics of membranes, filters, transmembrane transport of solutes and fluid, flows, and methods of measurement of delivered treatment, focusing on continuous renal replacement therapies (CRRT) which are utilized in the management of critically ill patients with AKI...
October 10, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27678541/study-protocol-for-a-multicentre-randomised-controlled-trial-safety-tolerability-efficacy-and-quality-of-life-of-a-human-recombinant-alkaline-phosphatase-in-patients-with-sepsis-associated-acute-kidney-injury-stop-aki
#7
Esther Peters, Ravindra L Mehta, Patrick T Murray, Jürgen Hummel, Michael Joannidis, John A Kellum, Jacques Arend, Peter Pickkers
INTRODUCTION: Acute kidney injury (AKI) occurs in 55-60% of critically ill patients, and sepsis is the most common underlying cause. No pharmacological treatment options are licensed to treat sepsis-associated AKI (SA-AKI); only supportive renal replacement therapy (RRT) is available. One of the limited number of candidate compounds in clinical development to treat SA-AKI is alkaline phosphatase (AP). The renal protective effect of purified bovine intestinal AP has been demonstrated in critically ill sepsis patients...
September 27, 2016: BMJ Open
https://www.readbyqxmd.com/read/27634440/cell-cycle-arrest-as-a-therapeutic-target-of-acute-kidney-injury
#8
Wei-Gang Wang, Wei-Xia Sun, Bao-Shan Gao, Xin Lian, Hong-Lan Zhou
The current lack of complete understanding of the pathogenesis of acute kidney injury (AKI) is a significant barrier to its early diagnosis and treatment. Cell cycle arrest plays an important role in the protection of renal tubular epithelial cells and maladaptive repair following AKI. G1 phase cell arrest serves as a protective mechanism following AKI, avoiding replication of damaged DNA. Insulin-like growth factor-binding protein 7 (IGFBP7) and tissue inhibitor of metalloproteinase-2 (TIMP-2) are closely associated with G1 cell cycle arrest during the very early phase of cellular damage and can serve as an ideal biomarker to predict AKI...
September 15, 2016: Current Protein & Peptide Science
https://www.readbyqxmd.com/read/27603173/lipoic-acid-in-the-prevention-of-acute-kidney-injury
#9
Jun Zhang, Peter A McCullough
Hypoxia, reactive oxygen species (ROS) and oxidative stress contribute to contrast-induced acute kidney injury (CI-AKI) and ischemic reperfusion injury (IRI) in the kidney and heart. Imbalance between the increased formation of ROS by hypoxia in the cardiac and renal tissue and the low availability of endogenous antioxidants is a common cause of cellular and tissue damage. Therefore, a strategy to inhibit ROS generation or to scavenger free radicals becomes an important intervention to prevent CI-AKI and myocardial IRI...
2016: Nephron
https://www.readbyqxmd.com/read/27575558/timing-is-everything-reconciling-the-results-of-recent-trials-in-acute-kidney-injury
#10
Christina M Wyatt, Steven G Coca
Observational studies have failed to establish the optimal timing of renal replacement therapy in critically ill adults with acute kidney injury, with some studies suggesting benefit and others suggesting the potential for harm with earlier initiation. Two recent randomized trials have addressed this controversy, also with conflicting results. Careful consideration of differences between the 2 studies is essential when applying the results to clinical practice in the intensive care unit.
October 2016: Kidney International
https://www.readbyqxmd.com/read/27530232/does-furosemide-increase-oxidative-stress-in-acute-kidney-injury
#11
Benjamin I Silbert, Kwok M Ho, Jeffrey Lipman, Jason A Roberts, Tomas B Corcoran, David J Morgan, Warren Pavey, Emilie Mas, Anne E Barden, Trevor A Mori
Furosemide, a loop diuretic, is used to increase urine output in patients with acute kidney injury (AKI). It remains uncertain whether the benefits of furosemide in AKI outweigh its potential harms. We investigated if furosemide influenced oxidative stress in 30 critically ill patients with AKI by measuring changes in F2-isoprostanes (F2-IsoPs), markers of in vivo oxidative stress, in plasma and urine following intravenous furosemide. Urine F2-IsoPs were higher in sepsis (p = 0.001) and increased in proportion to urine furosemide (p = 0...
September 15, 2016: Antioxidants & Redox Signaling
https://www.readbyqxmd.com/read/27504633/the-promise-of-mineralocorticoid-antagonism-in-acute-kidney-injury
#12
Kiran B Chandrashekar, Arnaldo Lopez-Ruiz, Luis A Juncos
Acute kidney injury (AKI) is a major cause of morbidity and mortality in hospitalized patients. Despite substantial progress being made in understanding the mechanisms contributing to the pathophysiology of AKI, we have so far been unsuccessful in devising adequate therapeutic strategies against the disease. A growing body of evidence suggests that the activation of mineralocorticoid receptors (MRs) may contribute to the exacerbation of AKI. Indeed, several studies have demonstrated the potential of MR antagonists in preventing and treating certain forms of experimental AKI...
August 10, 2016: Nephron
https://www.readbyqxmd.com/read/27505178/initiation-time-of-renal-replacement-therapy-on-patients-with-acute-kidney-injury-a-systematic-review-and-meta-analysis-of-8179-participants
#13
Caixia Wang, Lin-Sheng Lv, Hui Huang, Jianqiang Guan, Zengchun Ye, Shaomin Li, Yanni Wang, Tanqi Lou, Xun Liu
The early initiation of renal replacement therapy has been recommended for patients with acute renal failure by some studies, but its effects on mortality and renal recovery are unknown. We conducted an updated meta-analysis to provide quantitative evaluations of the association between the early initiation of renal replacement therapy and mortality for patients with acute kidney injury. After applying inclusion/exclusion criteria, 51 studies, including 10 randomized controlled trials, with a total of 8179 patients were analyzed...
August 9, 2016: Nephrology
https://www.readbyqxmd.com/read/27484681/fluid-overload-in-the-icu-evaluation-and-management
#14
Rolando Claure-Del Granado, Ravindra L Mehta
BACKGROUND: Fluid overload is frequently found in acute kidney injury patients in critical care units. Recent studies have shown the relationship of fluid overload with adverse outcomes; hence, manage and optimization of fluid balance becomes a central component of the management of critically ill patients. DISCUSSION: In critically ill patients, in order to restore cardiac output, systemic blood pressure and renal perfusion an adequate fluid resuscitation is essential...
August 2, 2016: BMC Nephrology
https://www.readbyqxmd.com/read/27485542/timing-of-initiation-of-renal-replacement-therapy-for-acute-kidney-injury-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#15
Yongxing Xu, Jianjun Gao, Xinming Zheng, Bo Zhong, Yu Na, Jiamei Wei
BACKGROUND: The effects of early renal replacement therapy (RRT) on mortality and renal recovery in patients with acute kidney injury (AKI) remain controversial. A systematic review and meta-analysis of randomized-controlled trials (RCTs) was performed. METHODS: MEDLINE, EMBASE and the Cochrane Library database (Cochrane Central Register of Controlled Trials) were searched to identify RCTs, investigating the effects of early RRT on patients with AKI. RESULTS: Six studies with a total of 1257 participants were included in this meta-analysis...
August 2, 2016: Clinical and Experimental Nephrology
https://www.readbyqxmd.com/read/27462016/therapeutic-application-of-extracellular-vesicles-in-acute-and-chronic-renal-injury
#16
Jordi Rovira, Fritz Diekmann, Josep M Campistol, María José Ramírez-Bajo
A new cell-to-cell communication system was discovered in the 1990s, which involves the release of vesicles into the extracellular space. These vesicles shuttle bioactive particles, including proteins, mRNA, miRNA, metabolites, etc. This particular communication has been conserved throughout evolution, which explains why most cell types are capable of producing vesicles. Extracellular vesicles (EVs) are involved in the regulation of different physiological processes, as well as in the development and progression of several diseases...
July 23, 2016: Nefrología: Publicación Oficial de la Sociedad Española Nefrologia
https://www.readbyqxmd.com/read/27347331/sesamin-protects-against-renal-ischemia-reperfusion-injury-by-promoting-cd39-adenosine-a2ar-signal-pathway-in-mice
#17
Ke Li, Xia Gong, Ge Kuang, Rong Jiang, Jingyuan Wan, Bin Wang
Ischemia reperfusion injury (IRI) is a leading cause of acute kidney injury with high morbidity and mortality due to limited therapy. Here, we examine whether sesamin attenuates renal IRI in an animal model and explore the underlying mechanisms. Male mice were subjected to right renal ischemia for 30 min followed by reperfusion for 24 h with sesamin (100 mg/kg) during which the left kidney was removed. Renal damage and function were assessed subsequently. The results showed that sesamin reduced kidney ischemia reperfusion injury, as assessed by decreased serum creatinine (Scr) and Blood urea nitrogen (BUN), alleviated tubular damage and apoptosis...
2016: American Journal of Translational Research
https://www.readbyqxmd.com/read/27355823/comparison-of-intraoperative-aminophylline-versus-furosemide-in-treatment-of-oliguria-during-pediatric-cardiac-surgery
#18
Ali Mirza Onder, David Rosen, Charles Mullett, Lesley Cottrell, Sherry Kanosky, Oulimata Kane Grossman, Hafiz Imran Iqbal, Eric Seachrist, Lennie Samsell, Kelly Gustafson, Larry Rhodes, Robert Gustafson
OBJECTIVES: To determine if intraoperative aminophylline was superior to furosemide to prevent or attenuate postoperative cardiac surgery-associated acute kidney injury. DESIGN: Single-center, historical control, retrospective cohort study. SETTING: PICU, university-affiliated children's hospital. PATIENTS: Children with congenital heart disease in PICU who received furosemide or aminophylline to treat intraoperative oliguria...
August 2016: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/27339380/an-overview-of-pathways-of-regulated-necrosis-in-acute-kidney-injury
#19
REVIEW
Jesper Kers, Jaklien C Leemans, Andreas Linkermann
Necrosis is the predominant form of regulated cell death in acute kidney injury (AKI) and represents results in the formation of casts that appear in the urine sedimentation, referred to as muddy brown casts, which are part of the diagnosis of AKI. Pathologists referred to this typical feature as acute tubular necrosis. We are only beginning to understand the dynamics and the molecular pathways that underlie such typical necrotic morphology. In this review, we provide an overview of candidate pathways and summarize the emerging evidence for the relative contribution of these pathways of regulated necrosis, such as necroptosis, ferroptosis, mitochondrial permeability transition-mediated regulated necrosis, parthanatos, and pyroptosis...
May 2016: Seminars in Nephrology
https://www.readbyqxmd.com/read/27236667/mesenchymal-stem-cells-in-kidney-repair
#20
Marina Morigi, Cinzia Rota, Giuseppe Remuzzi
Every year 13.3 million people suffer acute kidney injury (AKI), which is associated with a high risk of death or development of long-term chronic kidney disease (CKD) in a substantial percentage of patients besides other organ dysfunctions. To date, the mortality rate per year for AKI exceeds 50 % at least in patients requiring early renal replacement therapy and is higher than the mortality for breast and prostate cancer, heart failure and diabetes combined.Until now, no effective treatments able to accelerate renal recovery and improve survival post AKI have been developed...
2016: Methods in Molecular Biology
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