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AKI Treatment

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114 papers 25 to 100 followers
By Isabel Acosta-Ochoa Nephrology senior staff. Valladolid. Spain
https://www.readbyqxmd.com/read/29661746/effects-of-oral-vitamin-d-3-supplementation-in-stage-3-chronic-kidney-disease-subjects-insulin-resistance-syndrome-and-hormonal-disturb-interactions
#1
Amina Tahar, Faiza Zerdoumi, Messaoud Saidani, Lakhdar Griene, Elhadj-Ahmed Koceir
The 1-25-hydroxyvitamine D (1-25OHD) or calcitriol deficiency in chronic kidney disease (CKD) patients was associated with increases vascular calcification risk, nephrons reduction, bone deficit and cardiovascular mortality by atherosclerosis. The objective of this study was to investigate the pleiotropic effects of 200.000 IU (D200 group) every 3 months versus 30.000 IU (D30 group) every month dose vitamin D supplementation in stage 3 CKD patients. A cohort of 132 adult subjects was randomized into 2 groups according to dose vitamin D supplementation in deficient subjects (25OHD <50 nmol/L or <20 ng/mL)...
April 16, 2018: Annales de Biologie Clinique
https://www.readbyqxmd.com/read/29635792/haste-makes-waste-should-current-guideline-recommendations-for-initiation-of-renal-replacement-therapy-for-acute-kidney-injury-be-changed
#2
EDITORIAL
Jill Vanmassenhove, Raymond Vanholder, Wim Van Biesen, Norbert Lameire
There is broad consensus among guideline organizations that renal replacement therapy (RRT) should not be delayed in case of life-threatening conditions. However, in case of severe acute kidney injury (AKI) without these conditions, it is unclear whether immediate RRT has an advantage over delayed RRT. Two recently published randomized controlled trials (AKIKI and ELAIN) with seemingly opposite results have reignited the discussion whether guideline recommendations on initiation strategies in severe AKI should be adapted...
April 10, 2018: Seminars in Dialysis
https://www.readbyqxmd.com/read/29636853/hydrogen-sulfide-attenuates-lps-induced-acute-kidney-injury-by-inhibiting-inflammation-and-oxidative-stress
#3
Yuhong Chen, Sheng Jin, Xu Teng, Zhenjie Hu, Zhihong Zhang, Xuan Qiu, Danyang Tian, Yuming Wu
In order to investigate the protective mechanism of hydrogen sulfide (H2 S) in sepsis-associated acute kidney injury (SA-AKI), ten AKI patients and ten healthy controls were enrolled. In AKI patients, levels of creatinine (Cre), urea nitrogen (BUN), tumor necrosis factor- α (TNF- α ) and interleukin-1 β (IL-1 β ), and myeloperoxidase (MPO) activity as well as concentrations of malondialdehyde (MDA) and hydrogen peroxide (H2 O2 ) were significantly increased compared with those of controls. However, plasma level of H2 S decreased and was linearly correlated with levels of Cre and BUN...
2018: Oxidative Medicine and Cellular Longevity
https://www.readbyqxmd.com/read/28931521/pgc1%C3%AE-in-the-kidney
#4
Matthew R Lynch, Mei T Tran, Samir M Parikh
Acute kidney injury (AKI) arising from diverse etiologies is characterized by mitochondrial dysfunction. The peroxisome proliferator-activated receptor γ coactivator-1alpha (PGC1α), a master regulator of mitochondrial biogenesis, has been shown to be protective in AKI. Interestingly, reduction of PGC1α has also been implicated in the development of diabetic kidney disease and renal fibrosis. The beneficial renal effects of PGC1α make it a prime target for therapeutics aimed at ameliorating AKI, forms of chronic kidney disease (CKD), and their intersection...
January 1, 2018: American Journal of Physiology. Renal Physiology
https://www.readbyqxmd.com/read/28289816/current-state-of-the-art-for-renal-replacement-therapy-in-critically-ill-patients-with-acute-kidney-injury
#5
REVIEW
Sean M Bagshaw, Michael Darmon, Marlies Ostermann, Fredric O Finkelstein, Ron Wald, Ashita J Tolwani, Stuart L Goldstein, David J Gattas, Shigehiko Uchino, Eric A Hoste, Stephane Gaudry
Acute kidney injury (AKI) is associated with incremental risk for death and chronic kidney disease and represents a mounting clinical challenge for healthcare professionals. Renal replacement therapy (RRT) use in ICU settings is rising, likely in response to similar trends in AKI, taken together with an ageing population burdened by high prevalence of multi-morbidity and high illness acuity. Numerous features of RRT prescription and delivery are not standardized, nor are they supported from high-quality evidence derived from randomized trials...
June 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/29616470/peritoneal-dialysis-as-initial-dialysis-modality-a-viable-option-for-late-presenting-end-stage-renal-disease
#6
REVIEW
Muhammad Masoom Javaid, Behram Ali Khan, Srinivas Subramanian
Late-presenting end-stage renal disease is a significant problem worldwide. Up to 70% of patients start dialysis in an unplanned manner without a definitive dialysis access in place. Haemodialysis via a central venous catheter is the default modality for the majority of such patients, and peritoneal dialysis is usually not considered as a feasible option. However, in the recent years, some reports on urgent-start peritoneal dialysis in the late-presenting end-stage renal disease have been published. The collective experience shows that PD can be a safe, efficient and cost-effective alternative to haemodialysis in late-presenting end-stage renal disease with comparable outcomes to the conventional peritoneal dialysis and urgent-start haemodialysis...
April 3, 2018: Journal of Nephrology
https://www.readbyqxmd.com/read/29478864/management-of-acute-kidney-injury-core-curriculum-2018
#7
Peter K Moore, Raymond K Hsu, Kathleen D Liu
Acute kidney injury (AKI) is a heterogeneous disorder that is common in hospitalized patients and associated with short- and long-term morbidity and mortality. When AKI is present, prompt workup of the underlying cause should be pursued, with specific attention to reversible causes. Measures to prevent AKI include optimization of volume status and avoidance of nephrotoxic medications. Crystalloids are preferred over colloids for most patients, and hydroxyethyl starches should be avoided. Volume overload in the setting of AKI is associated with adverse outcomes, so attention should be paid to overall fluid balance...
February 22, 2018: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/29355173/paradigms-of-acute-kidney-injury-in-the-intensive-care-setting
#8
REVIEW
John A Kellum, John R Prowle
Acute kidney injury (AKI) is a heterogeneous clinical syndrome that has multiple aetiologies, variable pathogenesis and diverse outcomes. However, these heterogeneities are not reflected in current approaches to the diagnosis and, to some degree, treatment of AKI. For example, congestive heart failure and dehydration can produce identical changes in serum creatinine level and urine output (parameters that are used to define AKI); however, they differ vastly in their physiological contexts and demand completely opposite treatments...
April 2018: Nature Reviews. Nephrology
https://www.readbyqxmd.com/read/29324487/renal-replacement-therapy-in-critically-ill-patients-who-when-why-and-how
#9
Melanie Meersch, Alexander Zarbock
PURPOSE OF REVIEW: The increasing incidence of acute kidney injury has the immediate effect of a growing need for renal replacement therapy (RRT). Shedding light on the questions of who, when, why, and how RRT should be performed is difficult to accomplish because of ambiguous study results, poor quality evidence, and low standardization. RECENT FINDINGS: Critically ill patients are exposed to multiple factors known to deteriorate kidney function. Especially severe fluid overload is strongly associated with worse outcome and may be considered as a trigger for initiating RRT...
April 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29270416/stem-cell-extracellular-vesicles-and-kidney-injury
#10
REVIEW
Cristina Grange, Corinne Iampietro, Benedetta Bussolati
Extracellular vesicles (EVs) appear as a new promising cell-free therapy for acute and chronic renal diseases. EVs retain characteristics of the cell of origin and those derived from stem cells may mimic their regenerative properties per se . In fact, EVs contain many active molecules such as proteins and RNA species that act on target cells through different mechanisms, stimulating proliferation and angiogenesis and reducing apoptosis and inflammation. There are several reports that demonstrate a general regenerative potential of EVs derived from mesenchymal stromal cells (MSCs) of different sources in kidney injury models...
2017: Stem Cell Investigation
https://www.readbyqxmd.com/read/29270486/novel-therapies-for-acute-kidney-injury
#11
REVIEW
Huaizhen Chen, Laurence William Busse
Acute kidney injury (AKI) is a common disease with a complex pathophysiology. The old paradigm of identifying renal injury based on location-prerenal, intrarenal, and postrenal-is now being supplanted with a new paradigm based on observable kidney injury patterns. The pathophysiology of AKI on a molecular and microanatomical level includes inflammation, immune dysregulation, oxidative injury, and impaired microcirculation. Treatment has traditionally been supportive, including the avoidance of nephrotoxins, judicious volume and blood pressure management, hemodynamic monitoring, and renal replacement therapy...
September 2017: KI Reports
https://www.readbyqxmd.com/read/29245956/combination-therapy-of-exendin-4-and-allogenic-adipose-derived-mesenchymal-stem-cell-preserved-renal-function-in-a-chronic-kidney-disease-and-sepsis-syndrome-setting-in-rats
#12
Chih-Hung Chen, Ben-Chung Cheng, Kuan-Hung Chen, Pei-Lin Shao, Pei-Hsun Sung, Hsin-Ju Chiang, Chih-Chao Yang, Kun-Chen Lin, Cheuk-Kwan Sun, Jiunn-Jye Sheu, Hsueh-Wen Chang, Mel S Lee, Hon-Kan Yip
Combined therapy with exendin-4 (Ex4) and allogenic adipose-derived mesenchymal stem cells (ADMSC) was tested against either therapy alone for protecting kidney function against chronic kidney disease (CKD) complicated by sepsis syndrome (SS) [i.e., by intraperitoneal injection of cecal-derived bacteria (1.0 × 104 ) cells/milliliter/total 5.0 cc].Adult-male-Sprague Dawley rats (n=36) were equally divided into group 1 (sham-control), group 2 (CKD), group 3 (CKD-SS), group 4 (CKD-SS-Ex4), group 5 (CKD-SS-ADMSC) and group 6 (CKD-SS-Ex4-ADMSC)...
November 21, 2017: Oncotarget
https://www.readbyqxmd.com/read/29248144/renal-replacement-therapy-for-aki-when-how-much-when-to-stop
#13
REVIEW
Stefano Romagnoli, William R Clark, Zaccaria Ricci, Claudio Ronco
Severe acute kidney injury (AKI) requiring renal replacement therapy (RRT) is a serious clinical disorder in the intensive care unit (ICU), occurring in a significant proportion of critically ill patients. However, many questions remain about the optimal administration of RRT with regard to several important considerations, including treatment dose, timing of treatment initiation and cessation, therapy mode, type of anticoagulation, and management of fluid overload. While Level 1 evidence exists for RRT dosing in AKI, all the studies contributing to this evidence base employed fixed-dose regimens throughout a patient's continuous RRT (CRRT) course, without regard for the possibility of individualizing treatment dose according to the clinical status of a given patient at a specific time...
September 2017: Best Practice & Research. Clinical Anaesthesiology
https://www.readbyqxmd.com/read/29257336/autophagy-a-new-treatment-strategy-for-msc-based-therapy-in-acute-kidney-injury-review
#14
Haoyuan Jia, Yongmin Yan, Zhaofeng Liang, Nitin Tandra, Bin Zhang, Juanjuan Wang, Wenrong Xu, Hui Qian
Acute kidney injury (AKI) is a common and serious medical condition associated with poor health outcomes. Autophagy is a conserved multistep pathway that serves a major role in many biological processes and diseases. Recent studies have demonstrated that autophagy is induced in proximal tubular cells during AKI. Autophagy serves a pro‑survival or pro‑death role under certain conditions. Furthermore, mesenchymal stem cells (MSCs) have therapeutic potential in the repair of renal injury. This review summarizes the recent progress on the role of autophagy in AKI and MSCs‑based therapy for AKI...
March 2018: Molecular Medicine Reports
https://www.readbyqxmd.com/read/29247527/high-volume-forced-diuresis-with-matched-hydration-using-the-renalguard-system-to-prevent-contrast-induced-nephropathy-a-meta-analysis-of-randomized-trials
#15
Rahman Shah, Sarah J Wood, Sajjad A Khan, Amina Chaudhry, M Rehan Khan, Mohamed S Morsy
BACKGROUND: Contrast-induced nephropathy (CIN) is a well-recognized complication of coronary angiography that is associated with poor outcomes. Several small randomized controlled trials (RCTs) have recently shown that in patients with chronic kidney disease (CKD), furosemide-induced forced diuresis with matched hydration using the RenalGuard system can prevent its occurrence. However, individual studies have been underpowered and thus cannot show significant differences in major clinical endpoints...
December 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/29196304/long-term-clinical-outcomes-after-early-initiation-of-rrt-in-critically-ill-patients-with-aki
#16
Melanie Meersch, Mira Küllmar, Christoph Schmidt, Joachim Gerss, Toni Weinhage, Andreas Margraf, Thomas Ermert, John A Kellum, Alexander Zarbock
Whether earlier initiation of RRT in critically ill patients with AKI can improve outcomes remains debated. We examined follow-up data from a large clinical trial to prospectively investigate the long-term outcomes associated with the timing of RRT initiation in such patients. We extended the follow-up of patients in the Early Versus Delayed Initiation of RRT in Critically Ill Patients with AKI (ELAIN) Trial from 90 days to 1 year after randomization for 230 (99.6%) patients. The primary outcome was a composite of major adverse kidney events (persistent renal dysfunction, dialysis dependence, and mortality) at 1 year...
March 2018: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/29186517/renal-replacement-therapy-intensity-for-acute-kidney-injury-and-recovery-to-dialysis-independence-a-systematic-review-and-individual-patient-data-meta-analysis
#17
Ying Wang, Martin Gallagher, Qiang Li, Serigne Lo, Alan Cass, Simon Finfer, John Myburgh, Catherine Bouman, Robert Faulhaber-Walter, John A Kellum, Paul M Palevsky, Claudio Ronco, Patrick Saudan, Ashita Tolwani, Rinaldo Bellomo
Background: There is no consensus whether higher intensity dose renal replacement therapy (RRT) compared with standard intensity RRT has survival benefit and achieves better renal recovery in acute kidney injury (AKI). Methods: In an individual patient data meta-analysis, we merged individual patient data from randomized controlled trials (RCTs) comparing high with standard intensity RRT in intensive care unit patients with severe AKI. The primary outcome was all-cause mortality...
November 23, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/29188454/a-narrative-review-of-the-impact-of-interventions-in-acute-kidney-injury
#18
REVIEW
Lynne Sykes, Rob Nipah, Philip Kalra, Darren Green
Acute kidney injury (AKI) is independently associated with significant morbidity and mortality, and is thus an important challenge facing physicians in modern healthcare. This narrative review assesses the impact of strategies employed to tackle AKI following the 2009 NCEPOD report on acute kidney injury (Sterwart et al. Acute kidney injury: adding insult to injury, pp 1-22, 2009). There is scarce and heterogeneous research into hard end points such as mortality and AKI progression for AKI interventions. This review found that e-alerts have varying effects on mortality and AKI progression, but decrease the incidence of contrast-induced AKI...
November 29, 2017: Journal of Nephrology
https://www.readbyqxmd.com/read/29155815/allopurinol-attenuates-acute-kidney-injury-following-bothrops-jararaca-envenomation
#19
Pedro Henrique França Gois, Monique Silva Martines, Daniela Ferreira, Rildo Volpini, Daniele Canale, Ceila Malaque, Renato Crajoinas, Adriana Castello Costa Girardi, Maria Heloisa Massola Shimizu, Antonio Carlos Seguro
Snakebites have been recognized as a neglected public health problem in several tropical and subtropical countries. Bothrops snakebites frequently complicate with acute kidney injury (AKI) with relevant morbidity and mortality. To date, the only treatment available for Bothrops envenomation is the intravenous administration of antivenom despite its several limitations. Therefore, the study of novel therapies in Bothrops envenomation is compelling. The aim of this study was to evaluate the protective effect of Allopurinol (Allo) in an experimental model of Bothrops jararaca venom (BJ)-associated AKI...
November 2017: PLoS Neglected Tropical Diseases
https://www.readbyqxmd.com/read/29097621/clinical-decision-support-for-in-hospital-aki
#20
Mohammed Al-Jaghbeer, Dilhari Dealmeida, Andrew Bilderback, Richard Ambrosino, John A Kellum
AKI carries a significant mortality and morbidity risk. Use of a clinical decision support system (CDSS) might improve outcomes. We conducted a multicenter, sequential period analysis of 528,108 patients without ESRD before admission, from October of 2012 to September of 2015, to determine whether use of a CDSS reduces hospital length of stay and in-hospital mortality for patients with AKI. We compared patients treated 12 months before (181,696) and 24 months after (346,412) implementation of the CDSS. Coprimary outcomes were hospital mortality and length of stay adjusted by demographics and comorbidities...
February 2018: Journal of the American Society of Nephrology: JASN
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