Acute Kidney Injury: Abrupt reduction in kidney function. Acute kidney injury encompasses the entire spectrum of the syndrome including acute kidney failure; ACUTE KIDNEY TUBULAR NECROSIS; and other less severe conditions.Lipocalins: A diverse family of extracellular proteins that bind to small hydrophobic molecules. They were originally characterized as transport proteins, however they may have additional roles such as taking part in the formation of macromolecular complexes with other proteins and binding to CELL SURFACE RECEPTORS.Kidney: Body organ that filters blood for the secretion of URINE and that regulates ion concentrations.Renal Replacement Therapy: Procedures which temporarily or permanently remedy insufficient cleansing of body fluids by the kidneys.CreatinineAcute-Phase Proteins: Proteins that are secreted into the blood in increased or decreased quantities by hepatocytes in response to trauma, inflammation, or disease. These proteins can serve as inhibitors or mediators of the inflammatory processes. Certain acute-phase proteins have been used to diagnose and follow the course of diseases or as tumor markers.Azotemia: A biochemical abnormality referring to an elevation of BLOOD UREA NITROGEN and CREATININE. Azotemia can be produced by KIDNEY DISEASES or other extrarenal disorders. When azotemia becomes associated with a constellation of clinical signs, it is termed UREMIA.Kidney Diseases: Pathological processes of the KIDNEY or its component tissues.Reperfusion Injury: Adverse functional, metabolic, or structural changes in ischemic tissues resulting from the restoration of blood flow to the tissue (REPERFUSION), including swelling; HEMORRHAGE; NECROSIS; and damage from FREE RADICALS. The most common instance is MYOCARDIAL REPERFUSION INJURY.Critical Illness: A disease or state in which death is possible or imminent.Kidney Tubular Necrosis, Acute: Acute kidney failure resulting from destruction of EPITHELIAL CELLS of the KIDNEY TUBULES. It is commonly attributed to exposure to toxic agents or renal ISCHEMIA following severe TRAUMA.Kidney Function Tests: Laboratory tests used to evaluate how well the kidneys are working through examination of blood and urine.Biological Markers: Measurable and quantifiable biological parameters (e.g., specific enzyme concentration, specific hormone concentration, specific gene phenotype distribution in a population, presence of biological substances) which serve as indices for health- and physiology-related assessments, such as disease risk, psychiatric disorders, environmental exposure and its effects, disease diagnosis, metabolic processes, substance abuse, pregnancy, cell line development, epidemiologic studies, etc.Rhabdomyolysis: Necrosis or disintegration of skeletal muscle often followed by myoglobinuria.Kidney Tubules: Long convoluted tubules in the nephrons. They collect filtrate from blood passing through the KIDNEY GLOMERULUS and process this filtrate into URINE. Each renal tubule consists of a BOWMAN CAPSULE; PROXIMAL KIDNEY TUBULE; LOOP OF HENLE; DISTAL KIDNEY TUBULE; and KIDNEY COLLECTING DUCT leading to the central cavity of the kidney (KIDNEY PELVIS) that connects to the URETER.Wounds and Injuries: Damage inflicted on the body as the direct or indirect result of an external force, with or without disruption of structural continuity.Cystatin C: An extracellular cystatin subtype that is abundantly expressed in bodily fluids. It may play a role in the inhibition of interstitial CYSTEINE PROTEASES.Oliguria: Decreased URINE output that is below the normal range. Oliguria can be defined as urine output of less than or equal to 0.5 or 1 ml/kg/hr depending on the age.Intensive Care Units: Hospital units providing continuous surveillance and care to acutely ill patients.Glomerular Filtration Rate: The volume of water filtered out of plasma through glomerular capillary walls into Bowman's capsules per unit of time. It is considered to be equivalent to INULIN clearance.Sepsis: Systemic inflammatory response syndrome with a proven or suspected infectious etiology. When sepsis is associated with organ dysfunction distant from the site of infection, it is called severe sepsis. When sepsis is accompanied by HYPOTENSION despite adequate fluid infusion, it is called SEPTIC SHOCK.Kidney Tubules, Proximal: The renal tubule portion that extends from the BOWMAN CAPSULE in the KIDNEY CORTEX into the KIDNEY MEDULLA. The proximal tubule consists of a convoluted proximal segment in the cortex, and a distal straight segment descending into the medulla where it forms the U-shaped LOOP OF HENLE.Cardiac Surgical Procedures: Surgery performed on the heart.Blood Urea Nitrogen: The urea concentration of the blood stated in terms of nitrogen content. Serum (plasma) urea nitrogen is approximately 12% higher than blood urea nitrogen concentration because of the greater protein content of red blood cells. Increases in blood or serum urea nitrogen are referred to as azotemia and may have prerenal, renal, or postrenal causes. (From Saunders Dictionary & Encyclopedia of Laboratory Medicine and Technology, 1984)Urinalysis: Examination of urine by chemical, physical, or microscopic means. Routine urinalysis usually includes performing chemical screening tests, determining specific gravity, observing any unusual color or odor, screening for bacteriuria, and examining the sediment microscopically.Renal Dialysis: Therapy for the insufficient cleansing of the BLOOD by the kidneys based on dialysis and including hemodialysis, PERITONEAL DIALYSIS, and HEMODIAFILTRATION.Risk Factors: An aspect of personal behavior or lifestyle, environmental exposure, or inborn or inherited characteristic, which, on the basis of epidemiologic evidence, is known to be associated with a health-related condition considered important to prevent.Time Factors: Elements of limited time intervals, contributing to particular results or situations.Retrospective Studies: Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons.Hospital Mortality: A vital statistic measuring or recording the rate of death from any cause in hospitalized populations.Prospective Studies: Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group.Crush Syndrome: Severe systemic manifestation of trauma and ischemia involving soft tissues, principally skeletal muscle, due to prolonged severe crushing. It leads to increased permeability of the cell membrane and to the release of potassium, enzymes, and myoglobin from within cells. Ischemic renal dysfunction secondary to hypotension and diminished renal perfusion results in acute tubular necrosis and uremia.Fluid Therapy: Therapy whose basic objective is to restore the volume and composition of the body fluids to normal with respect to WATER-ELECTROLYTE BALANCE. Fluids may be administered intravenously, orally, by intermittent gavage, or by HYPODERMOCLYSIS.Cardiopulmonary Bypass: Diversion of the flow of blood from the entrance of the right atrium directly to the aorta (or femoral artery) via an oxygenator thus bypassing both the heart and lungs.Kidney Transplantation: The transference of a kidney from one human or animal to another.Brain Injuries: Acute and chronic (see also BRAIN INJURIES, CHRONIC) injuries to the brain, including the cerebral hemispheres, CEREBELLUM, and BRAIN STEM. Clinical manifestations depend on the nature of injury. Diffuse trauma to the brain is frequently associated with DIFFUSE AXONAL INJURY or COMA, POST-TRAUMATIC. Localized injuries may be associated with NEUROBEHAVIORAL MANIFESTATIONS; HEMIPARESIS, or other focal neurologic deficits.Contrast Media: Substances used to allow enhanced visualization of tissues.Early Diagnosis: Methods to determine in patients the nature of a disease or disorder at its early stage of progression. Generally, early diagnosis improves PROGNOSIS and TREATMENT OUTCOME.Severity of Illness Index: Levels within a diagnostic group which are established by various measurement criteria applied to the seriousness of a patient's disorder.Kidney Failure, Chronic: The end-stage of CHRONIC RENAL INSUFFICIENCY. It is characterized by the severe irreversible kidney damage (as measured by the level of PROTEINURIA) and the reduction in GLOMERULAR FILTRATION RATE to less than 15 ml per min (Kidney Foundation: Kidney Disease Outcome Quality Initiative, 2002). These patients generally require HEMODIALYSIS or KIDNEY TRANSPLANTATION.Nephrology: A subspecialty of internal medicine concerned with the anatomy, physiology, and pathology of the kidney.Treatment Outcome: Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series.Interleukin-18: A cytokine which resembles IL-1 structurally and IL-12 functionally. It enhances the cytotoxic activity of NK CELLS and CYTOTOXIC T-LYMPHOCYTES, and appears to play a role both as neuroimmunomodulator and in the induction of mucosal immunity.Acute Disease: Disease having a short and relatively severe course.Anuria: Absence of urine formation. It is usually associated with complete bilateral ureteral (URETER) obstruction, complete lower urinary tract obstruction, or unilateral ureteral obstruction when a solitary kidney is present.Disease Models, Animal: Naturally occurring or experimentally induced animal diseases with pathological processes sufficiently similar to those of human diseases. They are used as study models for human diseases.Ischemia: A hypoperfusion of the BLOOD through an organ or tissue caused by a PATHOLOGIC CONSTRICTION or obstruction of its BLOOD VESSELS, or an absence of BLOOD CIRCULATION.Renal Insufficiency, Chronic: Conditions in which the KIDNEYS perform below the normal level for more than three months. Chronic kidney insufficiency is classified by five stages according to the decline in GLOMERULAR FILTRATION RATE and the degree of kidney damage (as measured by the level of PROTEINURIA). The most severe form is the end-stage renal disease (CHRONIC KIDNEY FAILURE). (Kidney Foundation: Kidney Disease Outcome Quality Initiative, 2002)Preoperative Period: The period before a surgical operation.Acute Lung Injury: A condition of lung damage that is characterized by bilateral pulmonary infiltrates (PULMONARY EDEMA) rich in NEUTROPHILS, and in the absence of clinical HEART FAILURE. This can represent a spectrum of pulmonary lesions, endothelial and epithelial, due to numerous factors (physical, chemical, or biological).Thrombotic Microangiopathies: Diseases that result in THROMBOSIS in MICROVASCULATURE. The two most prominent diseases are PURPURA, THROMBOTIC THROMBOCYTOPENIC; and HEMOLYTIC-UREMIC SYNDROME. Multiple etiological factors include VASCULAR ENDOTHELIAL CELL damage due to SHIGA TOXIN; FACTOR H deficiency; and aberrant VON WILLEBRAND FACTOR formation.Kidney Cortex Necrosis: Death of cells in the KIDNEY CORTEX, a common final result of various renal injuries including HYPOXIA; ISCHEMIA; and drug toxicity.Risk Assessment: The qualitative or quantitative estimation of the likelihood of adverse effects that may result from exposure to specified health hazards or from the absence of beneficial influences. (Last, Dictionary of Epidemiology, 1988)Postoperative Complications: Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery.Intensive Care: Advanced and highly specialized care provided to medical or surgical patients whose conditions are life-threatening and require comprehensive care and constant monitoring. It is usually administered in specially equipped units of a health care facility.Athletic Injuries: Injuries incurred during participation in competitive or non-competitive sports.Incidence: The number of new cases of a given disease during a given period in a specified population. It also is used for the rate at which new events occur in a defined population. It is differentiated from PREVALENCE, which refers to all cases, new or old, in the population at a given time.Hemofiltration: Extracorporeal ULTRAFILTRATION technique without HEMODIALYSIS for treatment of fluid overload and electrolyte disturbances affecting renal, cardiac, or pulmonary function.Predictive Value of Tests: In screening and diagnostic tests, the probability that a person with a positive test is a true positive (i.e., has the disease), is referred to as the predictive value of a positive test; whereas, the predictive value of a negative test is the probability that the person with a negative test does not have the disease. Predictive value is related to the sensitivity and specificity of the test.Mice, Inbred C57BLMultiple Organ Failure: A progressive condition usually characterized by combined failure of several organs such as the lungs, liver, kidney, along with some clotting mechanisms, usually postinjury or postoperative.Spinal Cord Injuries: Penetrating and non-penetrating injuries to the spinal cord resulting from traumatic external forces (e.g., WOUNDS, GUNSHOT; WHIPLASH INJURIES; etc.).Uromodulin: A glycosyl-phosphatidyl-inositol (GPI) - anchored membrane protein found on the thick ascending limb of the LOOP OF HENLE. The cleaved form of the protein is found abundantly in URINE.Proto-Oncogene Proteins: Products of proto-oncogenes. Normally they do not have oncogenic or transforming properties, but are involved in the regulation or differentiation of cell growth. They often have protein kinase activity.Prognosis: A prediction of the probable outcome of a disease based on a individual's condition and the usual course of the disease as seen in similar situations.Cardio-Renal Syndrome: Condition where a primary dysfunction of either heart or kidney results in failure of the other organ (e.g., HEART FAILURE with worsening RENAL INSUFFICIENCY).Length of Stay: The period of confinement of a patient to a hospital or other health facility.Kidney Cortex: The outer zone of the KIDNEY, beneath the capsule, consisting of KIDNEY GLOMERULUS; KIDNEY TUBULES, DISTAL; and KIDNEY TUBULES, PROXIMAL.Cohort Studies: Studies in which subsets of a defined population are identified. These groups may or may not be exposed to factors hypothesized to influence the probability of the occurrence of a particular disease or other outcome. Cohorts are defined populations which, as a whole, are followed in an attempt to determine distinguishing subgroup characteristics.Rats, Sprague-Dawley: A strain of albino rat used widely for experimental purposes because of its calmness and ease of handling. It was developed by the Sprague-Dawley Animal Company.Renal Circulation: The circulation of the BLOOD through the vessels of the KIDNEY.Nephritis: Inflammation of any part of the KIDNEY.Renal Insufficiency: Conditions in which the KIDNEYS perform below the normal level in the ability to remove wastes, concentrate URINE, and maintain ELECTROLYTE BALANCE; BLOOD PRESSURE; and CALCIUM metabolism. Renal insufficiency can be classified by the degree of kidney damage (as measured by the level of PROTEINURIA) and reduction in GLOMERULAR FILTRATION RATE.Immune System Processes: Mechanisms of action and interactions of the components of the IMMUNE SYSTEM.Hemodiafiltration: The combination of hemodialysis and hemofiltration either simultaneously or sequentially. Convective transport (hemofiltration) may be better for removal of larger molecular weight substances and diffusive transport (hemodialysis) for smaller molecular weight solutes.ROC Curve: A graphic means for assessing the ability of a screening test to discriminate between healthy and diseased persons; may also be used in other studies, e.g., distinguishing stimuli responses as to a faint stimuli or nonstimuli.Logistic Models: Statistical models which describe the relationship between a qualitative dependent variable (that is, one which can take only certain discrete values, such as the presence or absence of a disease) and an independent variable. A common application is in epidemiology for estimating an individual's risk (probability of a disease) as a function of a given risk factor.APACHE: An acronym for Acute Physiology and Chronic Health Evaluation, a scoring system using routinely collected data and providing an accurate, objective description for a broad range of intensive care unit admissions, measuring severity of illness in critically ill patients.Kidney Glomerulus: A cluster of convoluted capillaries beginning at each nephric tubule in the kidney and held together by connective tissue.Proteinuria: The presence of proteins in the urine, an indicator of KIDNEY DISEASES.Critical Care: Health care provided to a critically ill patient during a medical emergency or crisis.Iothalamate Meglumine: A radiopaque medium used for urography, angiography, venography, and myelography. It is highly viscous and binds to plasma proteins.Sodium Bicarbonate: A white, crystalline powder that is commonly used as a pH buffering agent, an electrolyte replenisher, systemic alkalizer and in topical cleansing solutions.Receptors, Virus: Specific molecular components of the cell capable of recognizing and interacting with a virus, and which, after binding it, are capable of generating some signal that initiates the chain of events leading to the biological response.Nephrectomy: Excision of kidney.Nephritis, Interstitial: Inflammation of the interstitial tissue of the kidney. This term is generally used for primary inflammation of KIDNEY TUBULES and/or surrounding interstitium. For primary inflammation of glomerular interstitium, see GLOMERULONEPHRITIS. Infiltration of the inflammatory cells into the interstitial compartment results in EDEMA, increased spaces between the tubules, and tubular renal dysfunction.Apoptosis: One of the mechanisms by which CELL DEATH occurs (compare with NECROSIS and AUTOPHAGOCYTOSIS). Apoptosis is the mechanism responsible for the physiological deletion of cells and appears to be intrinsically programmed. It is characterized by distinctive morphologic changes in the nucleus and cytoplasm, chromatin cleavage at regularly spaced sites, and the endonucleolytic cleavage of genomic DNA; (DNA FRAGMENTATION); at internucleosomal sites. This mode of cell death serves as a balance to mitosis in regulating the size of animal tissues and in mediating pathologic processes associated with tumor growth.Iodine Compounds: Inorganic compounds that contain iodine as an integral part of the molecule.Burns: Injuries to tissues caused by contact with heat, steam, chemicals (BURNS, CHEMICAL), electricity (BURNS, ELECTRIC), or the like.Patient Outcome AssessmentInjury Severity Score: An anatomic severity scale based on the Abbreviated Injury Scale (AIS) and developed specifically to score multiple traumatic injuries. It has been used as a predictor of mortality.Snake Bites: Bites by snakes. Bite by a venomous snake is characterized by stinging pain at the wound puncture. The venom injected at the site of the bite is capable of producing a deleterious effect on the blood or on the nervous system. (Webster's 3d ed; from Dorland, 27th ed, at snake, venomous)Delayed Graft Function: General dysfunction of an organ occurring immediately following its transplantation. The term most frequently refers to renal dysfunction following KIDNEY TRANSPLANTATION.Cisplatin: An inorganic and water-soluble platinum complex. After undergoing hydrolysis, it reacts with DNA to produce both intra and interstrand crosslinks. These crosslinks appear to impair replication and transcription of DNA. The cytotoxicity of cisplatin correlates with cellular arrest in the G2 phase of the cell cycle.Leg Injuries: General or unspecified injuries involving the leg.Kidney Medulla: The internal portion of the kidney, consisting of striated conical masses, the renal pyramids, whose bases are adjacent to the cortex and whose apices form prominent papillae projecting into the lumen of the minor calyces.Diuretics: Agents that promote the excretion of urine through their effects on kidney function.Survival Rate: The proportion of survivors in a group, e.g., of patients, studied and followed over a period, or the proportion of persons in a specified group alive at the beginning of a time interval who survive to the end of the interval. It is often studied using life table methods.Lung Injury: Damage to any compartment of the lung caused by physical, chemical, or biological agents which characteristically elicit inflammatory reaction. These inflammatory reactions can either be acute and dominated by NEUTROPHILS, or chronic and dominated by LYMPHOCYTES and MACROPHAGES.Neutrophil Infiltration: The diffusion or accumulation of neutrophils in tissues or cells in response to a wide variety of substances released at the sites of inflammatory reactions.Tertiary Care Centers: A medical facility which provides a high degree of subspecialty expertise for patients from centers where they received SECONDARY CARE.Inflammation: A pathological process characterized by injury or destruction of tissues caused by a variety of cytologic and chemical reactions. It is usually manifested by typical signs of pain, heat, redness, swelling, and loss of function.Mice, Knockout: Strains of mice in which certain GENES of their GENOMES have been disrupted, or "knocked-out". To produce knockouts, using RECOMBINANT DNA technology, the normal DNA sequence of the gene being studied is altered to prevent synthesis of a normal gene product. Cloned cells in which this DNA alteration is successful are then injected into mouse EMBRYOS to produce chimeric mice. The chimeric mice are then bred to yield a strain in which all the cells of the mouse contain the disrupted gene. Knockout mice are used as EXPERIMENTAL ANIMAL MODELS for diseases (DISEASE MODELS, ANIMAL) and to clarify the functions of the genes.Chi-Square Distribution: A distribution in which a variable is distributed like the sum of the squares of any given independent random variable, each of which has a normal distribution with mean of zero and variance of one. The chi-square test is a statistical test based on comparison of a test statistic to a chi-square distribution. The oldest of these tests are used to detect whether two or more population distributions differ from one another.Trauma Severity Indices: Systems for assessing, classifying, and coding injuries. These systems are used in medical records, surveillance systems, and state and national registries to aid in the collection and reporting of trauma.Fibrosis: Any pathological condition where fibrous connective tissue invades any organ, usually as a consequence of inflammation or other injury.Russell's Viper: A genus of snakes of the family VIPERIDAE. It is distributed in West Pakistan, most of India, Burma, Ceylon, Thailand, southeast China, Taiwan, and a few islands of Indonesia. It hisses loudly when disturbed and strikes with great force and speed. Very prolific, it gives birth to 20-60 young. This viper is the leading cause of snakebite in India and Burma. (Moore: Poisonous Snakes of the World, 1980, p127)Acetylglucosaminidase: A beta-N-Acetylhexosaminidase that catalyzes the hydrolysis of terminal, non-reducing 2-acetamido-2-deoxy-beta-glucose residues in chitobiose and higher analogs as well as in glycoproteins. Has been used widely in structural studies on bacterial cell walls and in the study of diseases such as MUCOLIPIDOSIS and various inflammatory disorders of muscle and connective tissue.Recovery of Function: A partial or complete return to the normal or proper physiologic activity of an organ or part following disease or trauma.Iopamidol: A non-ionic, water-soluble contrast agent which is used in myelography, arthrography, nephroangiography, arteriography, and other radiological procedures.Administration, Intravenous: Delivery of substances through VENIPUNCTURE into the VEINS.Water-Electrolyte Balance: The balance of fluid in the BODY FLUID COMPARTMENTS; total BODY WATER; BLOOD VOLUME; EXTRACELLULAR SPACE; INTRACELLULAR SPACE, maintained by processes in the body that regulate the intake and excretion of WATER and ELECTROLYTES, particularly SODIUM and POTASSIUM.Interleukin-6: A cytokine that stimulates the growth and differentiation of B-LYMPHOCYTES and is also a growth factor for HYBRIDOMAS and plasmacytomas. It is produced by many different cells including T-LYMPHOCYTES; MONOCYTES; and FIBROBLASTS.Mice, 129 Strain: Strains of mice arising from a parental inbred stock that was subsequently used to produce substrains of knockout and other mutant mice with targeted mutations.Hospitalization: The confinement of a patient in a hospital.Acetylcysteine: The N-acetyl derivative of CYSTEINE. It is used as a mucolytic agent to reduce the viscosity of mucous secretions. It has also been shown to have antiviral effects in patients with HIV due to inhibition of viral stimulation by reactive oxygen intermediates.MyoglobinuriaNephrogenic Fibrosing Dermopathy: A chronic, acquired, idiopathic, progressive eruption of the skin that occurs in the context of RENAL FAILURE. It is sometimes accompanied by systemic fibrosis. The pathogenesis seems to be multifactorial, with postulated involvement of circulating fibrocytes. There is a strong association between this disorder and the use of gadolinium-based contrast agents.Oxidative Stress: A disturbance in the prooxidant-antioxidant balance in favor of the former, leading to potential damage. Indicators of oxidative stress include damaged DNA bases, protein oxidation products, and lipid peroxidation products (Sies, Oxidative Stress, 1991, pxv-xvi).Thoracic Surgery: A surgical specialty concerned with diagnosis and treatment of disorders of the heart, lungs, and esophagus. Two major types of thoracic surgery are classified as pulmonary and cardiovascular.Bleaching Agents: Chemicals that are used to oxidize pigments and thus effect whitening.Models, Animal: Non-human animals, selected because of specific characteristics, for use in experimental research, teaching, or testing.Iatrogenic Disease: Any adverse condition in a patient occurring as the result of treatment by a physician, surgeon, or other health professional, especially infections acquired by a patient during the course of treatment.Water-Electrolyte Imbalance: Disturbances in the body's WATER-ELECTROLYTE BALANCE.Sesame Oil: The refined fixed oil obtained from the seed of one or more cultivated varieties of Sesamum indicum. It is used as a solvent and oleaginous vehicle for drugs and has been used internally as a laxative and externally as a skin softener. It is used also in the manufacture of margarine, soap, and cosmetics. (Dorland, 28th ed & Random House Unabridged Dictionary, 2d ed)Eye Injuries: Damage or trauma inflicted to the eye by external means. The concept includes both surface injuries and intraocular injuries.Urine: Liquid by-product of excretion produced in the kidneys, temporarily stored in the bladder until discharge through the URETHRA.Shock, Septic: Sepsis associated with HYPOTENSION or hypoperfusion despite adequate fluid resuscitation. Perfusion abnormalities may include, but are not limited to LACTIC ACIDOSIS; OLIGURIA; or acute alteration in mental status.Disease Progression: The worsening of a disease over time. This concept is most often used for chronic and incurable diseases where the stage of the disease is an important determinant of therapy and prognosis.Kidney Tubules, Distal: The portion of renal tubule that begins from the enlarged segment of the ascending limb of the LOOP OF HENLE. It reenters the KIDNEY CORTEX and forms the convoluted segments of the distal tubule.Case-Control Studies: Studies which start with the identification of persons with a disease of interest and a control (comparison, referent) group without the disease. The relationship of an attribute to the disease is examined by comparing diseased and non-diseased persons with regard to the frequency or levels of the attribute in each group.Multivariate Analysis: A set of techniques used when variation in several variables has to be studied simultaneously. In statistics, multivariate analysis is interpreted as any analytic method that allows simultaneous study of two or more dependent variables.Necrosis: The pathological process occurring in cells that are dying from irreparable injuries. It is caused by the progressive, uncontrolled action of degradative ENZYMES, leading to MITOCHONDRIAL SWELLING, nuclear flocculation, and cell lysis. It is distinct it from APOPTOSIS, which is a normal, regulated cellular process.Hyperuricemia: Excessive URIC ACID or urate in blood as defined by its solubility in plasma at 37 degrees C; greater than 0.42mmol per liter (7.0mg/dL) in men or 0.36mmol per liter (6.0mg/dL) in women. This condition is caused by overproduction of uric acid or impaired renal clearance. Hyperuricemia can be acquired, drug-induced or genetically determined (LESCH-NYHAN SYNDROME). It is associated with HYPERTENSION and GOUT.Endotoxemia: A condition characterized by the presence of ENDOTOXINS in the blood. On lysis, the outer cell wall of gram-negative bacteria enters the systemic circulation and initiates a pathophysiologic cascade of pro-inflammatory mediators.Gentamicins: A complex of closely related aminoglycosides obtained from MICROMONOSPORA purpurea and related species. They are broad-spectrum antibiotics, but may cause ear and kidney damage. They act to inhibit PROTEIN BIOSYNTHESIS.Terminology as Topic: The terms, expressions, designations, or symbols used in a particular science, discipline, or specialized subject area.Mesenchymal Stem Cell Transplantation: Transfer of MESENCHYMAL STEM CELLS between individuals within the same species (TRANSPLANTATION, HOMOLOGOUS) or transfer within the same individual (TRANSPLANTATION, AUTOLOGOUS).Triiodobenzoic Acids: Triiodo-substituted derivatives of BENZOIC ACID.Abortion, Septic: Any type of abortion, induced or spontaneous, that is associated with infection of the UTERUS and its appendages. It is characterized by FEVER, uterine tenderness, and foul discharge.Ureteral Obstruction: Blockage in any part of the URETER causing obstruction of urine flow from the kidney to the URINARY BLADDER. The obstruction may be congenital, acquired, unilateral, bilateral, complete, partial, acute, or chronic. Depending on the degree and duration of the obstruction, clinical features vary greatly such as HYDRONEPHROSIS and obstructive nephropathy.Intensive Care Units, Pediatric: Hospital units providing continuous surveillance and care to acutely ill infants and children. Neonates are excluded since INTENSIVE CARE UNITS, NEONATAL is available.Earthquakes: Sudden slips on a fault, and the resulting ground shaking and radiated seismic energy caused by the slips, or by volcanic or magmatic activity, or other sudden stress changes in the earth. Faults are fractures along which the blocks of EARTH crust on either side have moved relative to one another parallel to the fracture.Albuminuria: The presence of albumin in the urine, an indicator of KIDNEY DISEASES.Bioartificial Organs: Artificial organs that are composites of biomaterials and cells. The biomaterial can act as a membrane (container) as in BIOARTIFICIAL LIVER or a scaffold as in bioartificial skin.Urodynamics: The mechanical laws of fluid dynamics as they apply to urine transport.Kaplan-Meier Estimate: A nonparametric method of compiling LIFE TABLES or survival tables. It combines calculated probabilities of survival and estimates to allow for observations occurring beyond a measurement threshold, which are assumed to occur randomly. Time intervals are defined as ending each time an event occurs and are therefore unequal. (From Last, A Dictionary of Epidemiology, 1995)Neck Injuries: General or unspecified injuries to the neck. It includes injuries to the skin, muscles, and other soft tissues of the neck.Up-Regulation: A positive regulatory effect on physiological processes at the molecular, cellular, or systemic level. At the molecular level, the major regulatory sites include membrane receptors, genes (GENE EXPRESSION REGULATION), mRNAs (RNA, MESSENGER), and proteins.Animals, Outbred Strains: Animals that are generated from breeding two genetically dissimilar strains of the same species.

Acute renal failure caused by nephrotoxins. (1/3360)

Renal micropuncture studies have greatly changed our views on the pathophysiology of acute renal failure caused by nephrotoxins. Formerly, this type of renal insufficiency was attributed to a direct effect of the nephrotoxins on tubule epithelial permeability. According to that theory, glomerular filtration was not greatly diminished, the filtrate formed being absorbed almost quantitatively and nonselectively across damaged tubule epithelium. Studies in a wide variety of rat models have now shown glomerular filtration to be reduced to a level which will inevitably cause renal failure in and of itself. Passive backflow of filtrate across tubular epithelium is either of minor degree or nonexistent even in models where frank tubular necrosis has occurred. This failure of filtration cannot be attributed to tubular obstruction since proximal tubule pressure is distinctly subnormal in most models studied. Instead, filtration failure appears best attributed to intrarenal hemodynamic alterations. While certain facts tend to incriminate the renin-angiotensin system as the cause of the hemodynamic aberrations, others argue to the contrary. The issue is underactive investigation.  (+info)

Sodium reabsorption and distribution of Na+/K+-ATPase during postischemic injury to the renal allograft. (2/3360)

BACKGROUND: A loss of proximal tubule cell polarity is thought to activate tubuloglomerular feedback, thereby contributing to glomerular filtration rate depression in postischemic acute renal failure (ARF). METHODS: We used immunomicroscopy to evaluate the segmental distribution of Na+/K+-ATPase in tubules of recipients of cadaveric renal allografts. Fractional excretion (FE) of sodium and lithium was determined simultaneously. Observations were made on two occasions: one to three hours after graft reperfusion (day 0) and again on post-transplant day 7. An inulin clearance below or above 25 ml/min on day 7 was used to divide subjects into groups with sustained (N = 15) or recovering (N = 16) ARF, respectively. RESULTS: In sustained ARF, the fractional excretion of sodium (FENa) was 40 +/- 6% and 11 +/- 5%, and the fractional excretion of lithium (FELi) was 76 +/- 5% and 70 +/- 2% on days 0 and 7, respectively. Corresponding findings in recovering ARF were 28 +/- 2% and 6 +/- 2% for the FENa and 77 +/- 4% and 55 +/- 3% (P < 0.05 vs. sustained) for FELi. Na+/K+-ATPase distribution in both groups was mainly basolateral in distal straight and convoluted tubule segments and collecting ducts. However, Na+/K+-ATPase was poorly retained in the basolateral membrane of proximal convoluted and straight tubule segments in sustained and recovering ARF on both days 0 and 7. CONCLUSIONS: We conclude that loss of proximal tubule cell polarity for Na+/K+-ATPase distribution is associated with enhanced delivery of filtered Na+ to the macula densa for seven days after allograft reperfusion. Whether an ensuing activation of tubuloglomerular feedback is an important cause of glomerular filtration rate depression in this form of ARF remains to be determined.  (+info)

Endothelin up-regulation and localization following renal ischemia and reperfusion. (3/3360)

BACKGROUND: Endothelin (ET), a potent vasoconstrictor, is known to play a role in ischemic acute renal failure. Although preproET-1 (ppET-1) mRNA is known to be up-regulated following ischemia/reperfusion injury, it has not been determined which component of the injury (ischemia or reperfusion) leads to initial gene up-regulation. Likewise, although ET-1 peptide expression has been localized in the normal kidney, its expression pattern in the ischemic kidney has not been determined. Therefore, the purpose of this study was twofold: (a) to determine whether ischemia alone or ischemia plus reperfusion is required for the up-regulation of ppET-1 mRNA to occur, and (b) to localize ET-1 peptide expression following ischemia in the rat kidney to clarify better the role of ET in the pathophysiology of ischemia-induced acute renal failure. METHODS: Male Lewis rats underwent clamping of the right renal vascular pedicle for either 30 minutes of ischemia (group 1), 60 minutes of ischemia (group 2), 30 minutes of ischemia followed by 30 minutes of reperfusion (group 3), or 60 minutes of ischemia followed by three hours of reperfusion (group 4). The contralateral kidney acted as a control. ppET-1 mRNA up-regulation and ET-1 peptide expression were examined using the reverse transcription-polymerase chain reaction and immunohistochemistry, respectively. RESULTS: Reverse transcription-polymerase chain reaction yielded a control (nonischemic) value of 0.6 +/- 0.2 densitometric units (DU) of ppET-1 mRNA in the kidney. Group 1 levels (30 min of ischemia alone) were 1.8 +/- 0.4 DU, a threefold increase (P < 0.05). Group 2 levels (60 min of ischemia alone) increased almost six times above baseline, 3.5 +/- 0.2 DU (P < 0.01), whereas both group 3 and group 4 (ischemia plus reperfusion) did not experience any further significant increases in mRNA levels (1.9 +/- 0.4 DU and 2.8 +/- 0.6 DU, respectively) beyond levels in group 1 or 2 animals subjected to similar ischemic periods. ET-1 peptide expression in the ischemic kidneys was significantly increased over controls and was clearly localized to the endothelium of the peritubular capillary network of the kidney. CONCLUSIONS: Initial ET-1 gene up-regulation in the kidney occurs secondary to ischemia, but reperfusion most likely contributes to sustaining this up-regulation. The marked increase of ET-1 in the peritubular capillary network suggests that ET-induced vasoconstriction may have a pathophysiological role in ischemic acute tubular necrosis.  (+info)

Ex vivo evaluation of a Taylor-Couette flow, immobilized heparinase I device for clinical application. (4/3360)

Efficient and safe heparin anticoagulation has remained a problem for continuous renal replacement therapies and intermittent hemodialysis for patients with acute renal failure. To make heparin therapy safer for the patient with acute renal failure at high risk of bleeding, we have proposed regional heparinization of the circuit via an immobilized heparinase I filter. This study tested a device based on Taylor-Couette flow and simultaneous separation/reaction for efficacy and safety of heparin removal in a sheep model. Heparinase I was immobilized onto agarose beads via cyanogen bromide activation. The device, referred to as a vortex flow plasmapheretic reactor, consisted of two concentric cylinders, a priming volume of 45 ml, a microporous membrane for plasma separation, and an outer compartment where the immobilized heparinase I was fluidized separately from the blood cells. Manual white cell and platelet counts, hematocrit, total protein, and fibrinogen assays were performed. Heparin levels were indirectly measured via whole-blood recalcification times (WBRTs). The vortex flow plasmapheretic reactor maintained significantly higher heparin levels in the extracorporeal circuit than in the sheep (device inlet WBRTs were 1. 5 times the device outlet WBRTs) with no hemolysis. The reactor treatment did not effect any physiologically significant changes in complete blood cell counts, platelets, and protein levels for up to 2 hr of operation. Furthermore, gross necropsy and histopathology did not show any significant abnormalities in the kidney, liver, heart, brain, and spleen.  (+info)

Abysmal prognosis of patients with type 2 diabetes entering dialysis. (5/3360)

INTRODUCTION: The importance of non-insulin-dependent diabetes mellitus (type II diabetes) as a leading cause of end-stage renal disease is now widely recognized. The purpose of this study was to assess life-prognosis and its predictors in a cohort of patients newly entering dialysis. MATERIAL AND METHODS: Eighty-four consecutive type II diabetes patients (40% of all patients) starting dialysis between 01/01/95 and 31/12/96 were studied retrospectively, focusing on clinical data at inception and life-prognosis after a mean follow-up of 211 days. Patients were divided into three groups, according to onset of renal failure: acute 11% (9/84), chronic 61% (51/84) and acutely aggravated chronic renal failure 28% (25/84). RESULTS: Patients (mean age 67 years) had long-standing diabetes (mean duration approximately 15 years), heavy proteinuria (approximately 3 g/24h) and diabetic retinopathy (67%). The average creatinine clearance (Cockcroft's formula) was 13 ml/min. Cardiovascular diseases were highly prevalent at the start of dialysis: history of myocardial infarction (26%), angina (36%) and acute left ventricular dysfunction (67%). More than 80% of the patients underwent the first session dialysis under emergency conditions, a situation in part related to late referral to the nephrology division (63% for chronic patients). A great majority of the patients were overhydrated when starting dialysis, as evidenced by the average weight loss of 6 kg, during the first month of dialysis, required to reach dry weight. Nearly 64% of the patients presented high blood pressure (> 140/90 mmHg) when starting dialysis despite antihypertensive therapy (mean: 2.3 drugs). The outcome of this type II diabetes population was dramatic: 32% (27/84) died after a mean follow-up of 211 days, mostly from cardiovascular diseases. The rate of recovery of renal function was low in both the acute and the acutely aggravated renal failure group (30% and 24%, respectively). Of note, iatrogenic nephrotoxic agents accounted for renal function impairment in nearly 30% of patients. CONCLUSION: Our observational study illustrates the high burden of cardiovascular diseases contrasting with sub-optimal cardiovascular therapeutic interventions in type II diabetes patients entering dialysis. Factors aggravating renal failure were mainly iatrogenic, and therefore largely avoidable. Late referral generally implied a poor clinical condition at the start of dialysis.  (+info)

Treatment of malarial acute renal failure by hemodialysis. (6/3360)

We studied 112 patients with malarial acute renal failure (ARF) during the period 1991-1997 at Bangkok Hospital for Tropical Diseases (Mahidol University, Bangkok, Thailand). Hemodialysis was performed in 101 (90.2%) of these patients. The mean number of times the patients were hemodialyzed was 6.5 (range = 1-27). Ninety-three (83.0%) patients were oliguric and the remainder were nonoliguric. Patients who had oliguric renal failure required more hemodialyses and had more complications than the nonoliguric patients. The oliguric patients had an eight-fold higher risk of requiring six or more hemodialyses (95% confidence interval = 1.2-53.9, P = 0.0008). The overall mortality rate was 10.7% (12 of 112). Eleven of the patients who died were jaundiced and eight of them had cerebral malaria with a Glasgow Coma Score < or = 8. We conclude that hemodialysis is a useful treatment for oliguric and nonoliguric ARF from severe malaria, particularly when initiated early in the course of the illness.  (+info)

Intranephron distribution and regulation of endothelin-converting enzyme-1 in cyclosporin A-induced acute renal failure in rats. (7/3360)

Endothelin-1 (ET-1) is thought to play a significant role in acute renal failure induced by cyclosporin A (CsA). The cDNA sequence encoding endothelin-converting enzyme-1 (ECE-1), which produces the active form of ET-1 from big ET-1, was recently reported. To elicit the role of ECE-1 in the glomerular and tubular dysfunction induced by CsA, the effects of CsA on mRNA and protein expression of ECE-1 in rat kidney and on mRNA expression of prepro-ET-1 and ET A- and B-type receptors in glomeruli were studied. ECE-1 mRNA was detected in glomeruli and in whole nephron segments. ECE-1 mRNA expression was downregulated in all nephron segments at 24 h after CsA injection. Protein levels were also downregulated in glomeruli and in the outer and inner medulla. CsA rapidly increased prepro-ET-1 mRNA expression in glomeruli at 30 to 60 min after injection; this rapid increase was followed by an increase in plasma ET-1 levels. These increases were followed by decreased expression of ECE-1, ET A-type receptor, and ET B-type receptor mRNA at 6 h after injection, and serum creatinine levels were increased at 24 h after CsA injection. It is suggested that downregulation of glomerular and tubular ECE-1 expression may be caused by increased ET-1 synthesis in CsA-induced acute renal failure.  (+info)

Prevalence and clinical outcome associated with preexisting malnutrition in acute renal failure: a prospective cohort study. (8/3360)

Malnutrition is a frequent finding in hospitalized patients and is associated with an increased risk of subsequent in-hospital morbidity and mortality. Both prevalence and prognostic relevance of preexisting malnutrition in patients referred to nephrology wards for acute renal failure (ARF) are still unknown. This study tests the hypothesis that malnutrition is frequent in such clinical setting, and is associated with excess in-hospital morbidity and mortality. A prospective cohort of 309 patients admitted to a renal intermediate care unit during a 42-mo period with ARF diagnosis was studied. Patients with malnutrition were identified at admission by the Subjective Global Assessment of nutritional status method (SGA); nutritional status was also evaluated by anthropometric, biochemical, and immunologic parameters. Outcome measures included in-hospital mortality and morbidity, and use of health care resources. In-hospital mortality was 39% (120 of 309); renal replacement therapies (hemodialysis or continuous hemofiltration) were performed in 67% of patients (206 of 309); APACHE II score was 23.1+/-8.2 (range, 10 to 52). Severe malnutrition by SGA was found in 42% of patients with ARF; anthropometric, biochemical, and immunologic nutritional indexes were significantly reduced in this group compared with patients with normal nutritional status. Severely malnourished patients, as compared to patients with normal nutritional status, had significantly increased morbidity for sepsis (odds ratio [OR] 2.88; 95% confidence interval [CI], 1.53 to 5.42, P < 0.001), septic shock (OR 4.05; 95% CI, 1.46 to 11.28, P < 0.01), hemorrhage (OR 2.98; 95% CI, 1.45 to 6.13, P < 0.01), intestinal occlusion (OR 5.57; 95% CI, 1.57 to 19.74, P < 0.01), cardiac dysrhythmia (OR 2.29; 95% CI, 1.36 to 3.85, P < 0.01), cardiogenic shock (OR 4.39; 95% CI, 1.83 to 10.55, P < .001), and acute respiratory failure with mechanical ventilation need (OR 3.35; 95% CI, 3.35 to 8.74, P < 0.05). Hospital length of stay was significantly increased (P < 0.01), and the presence of severe malnutrition was associated with a significant increase of in-hospital mortality (OR 7.21; 95% CI, 4.08 to 12.73, P < 0.001). Preexisting malnutrition was a statistically significant, independent predictor of in-hospital mortality at multivariable logistic regression analysis both with comorbidities (OR 2.02; 95% CI, 1.50 to 2.71, P < 0.001), and with comorbidities and complications (OR 2.12; 95% CI, 1.61 to 2.89, P < 0.001). Malnutrition is highly prevalent among ARF patients and increases the likelihood of in-hospital death, complications, and use of health care resources.  (+info)

The inflammatory response has been shown to be a major contributor to acute kidney injury. Considering that laparoscopic surgery is beneficial in reducing the inflammatory response, we compared the incidence of postoperative acute kidney injury between laparoscopic liver resection and open liver resection. Among 1173 patients who underwent liver resection surgery, 222 of 926 patients who underwent open liver resection were matched with 222 of 247 patients who underwent laparoscopic liver resection, by using propensity score analysis. The incidence of postoperative acute kidney injury assessed according to the creatinine criteria of the Kidney Disease: Improving Global Outcomes definition was compared between those 1:1 matched groups. A total 77 (6.6%) cases of postoperative acute kidney injury occurred. Before matching, the incidence of acute kidney injury after laparoscopic liver resection was significantly lower than that after open liver resection [1.6% (4/247) vs. 7.9% (73/926), P < 0.001]. ...
Click the title to purchase the article.. Summary:. "We have evaluated the effect of a colloid solution on acute kidney injury in paediatric cardiac surgery. A total of 195 patients were ramdomly divided into an hydroxyethyl starch group and a control group. In the starch group, 6% hydroxyethyl starch 130/0.4 (Volulyte®) was used as the primary fluid for volume resuscitation but was limited to 30 ml.kg−1. In the control group, only crystalloid fluid was used during the peri-operative period. The incidence of acute kidney injury, peri-operative transfusion, clinical outcomes and laboratory data were compared. The incidence of acute kidney injury determined by Paediatric Risk, Injury, Failure, Loss, End-stage renal disease (pRIFLE) and Acute Kidney Injury Network (AKIN) criteria were no different between the two groups (starch group 40.8% vs. control group 30.0%; p = 0.150 using pRIFLE; 19.6% vs. 21.1% respectively, p = 0.602 using AKIN). There were no differences in clinical outcomes such as ...
Amin AP, Salisbury AC, McCullough PA, et al. Trends in the incidence of acute kidney injury in patients hospitalized with acute myocardial infarction. Arch Intern Med. 2012;172:246-253. Available at: http://archinte.ama-assn.org/cgi/content/full/172/3/246.. Hsu RK, Hsu C. Acute kidney injury: comment on "Trends in the incidence of acute kidney injury in patients hospitalized with acute myocardial infarction." Arch Intern Med. 2012;172:253-254.. Parikh CR, Coca SG, Wang Y, et al. Long-term prognosis of acute kidney injury after acute myocardial infarction. Arch Intern Med. 2008;168:987-995.. Aengus Murphy C, Robb SD, Weir RA, et al. Declining renal function after myocardial infarction predicts poorer long-term outcome. Eur J Cardiovasc Prev Rehabil. 2010;17:181-186.. Chertow GM, Burdick E, Honour M, et al. Acute kidney injury, mortality, length of stay, and costs in hospitalized patients. J Am Soc Nephrol. 2005;16:3365-3370.. Molitoris BA, Levin A, Warnock DG; et al, Acute Kidney Injury Network ...
Honokiol is a low-molecular-weight natural product and has been reported to exhibit anti-inflammatory activity. Our study aimed to investigate the influence of honokiol on sepsis-induced acute kidney injury (AKI) in a mouse model. A cecal ligation and puncture (CLP) surgical operation was performed to establish a sepsis-induced acute kidney injury model in mice. Renal histomorphological analysis was performed with periodic acid-Schiff (PAS) staining. The levels of inflammatory markers in serum were measured by ELISA assay. The mRNA and protein levels were assayed by RT-qPCR and western blotting, respectively. Annexin V-FITC/PI staining was used to evaluate glomerular mesangial cell (GMC) apoptosis. The results revealed that honokiol significantly increased the survival rate in mice undergoing a CLP operation. Inflammatory cytokines, such as TNF-α, IL-6 and IL-1β, were significantly inhibited in honokiol-treated septic mice compared with the CLP group. In addition, honokiol showed the ability to
Contrast-induced acute kidney injury (CI-AKI), also known as contrast-induced nephropathy, is a common complication of intra-arterial administration of iodinated radiographic contrast medium (IRCM) that may prolong the duration of hospitalization and increase the risk of death (1,2). CI-AKI is characterized by an increase in serum creatinine beginning within the first 24 h of IRCM exposure and peaking at up to 5 days after exposure. CI-AKI is defined most commonly as a rise in serum creatinine concentration ≥0.5 mg/dl or 25% above baseline assessed 48 to 72 h after exposure to contrast (1,2). More recently, the Acute Kidney Injury Network defined CI-AKI as a rise in serum creatinine of ≥0.3 mg/dl above baseline with oliguria (1).. Patients with chronic kidney disease (CKD) are vulnerable to CI-AKI, particularly in the presence of risk factors such as diabetes mellitus and clinical states associated with decreased renal perfusion (1,2). McCullough (1) proposed a pathophysiologic sequence for ...
TY - JOUR. T1 - Macrophages contribute to the development of renal fibrosis following ischaemia/reperfusion-induced acute kidney injury. AU - Ko, Gang Jee. AU - Boo, Chang Su. AU - Jo, Sang Kyung. AU - Cho, Won Yong. AU - Kim, Hyoung Kyu. PY - 2008/3/1. Y1 - 2008/3/1. N2 - Background. Ischaemia/reperfusion is a major cause of acute kidney injury and can result in poor long-term graft function. Although most of the patients with acute kidney injury recover their renal function, significant portion of patients suffer from progressive deterioration of renal function. A persistent inflammatory response might be associated with long-term changes following acute ischaemia/reperfusion. Macrophages are known to infiltrate into tubulointersitium in animal models of chronic kidney disease. However, the role of macrophages in long-term changes after ischaemia/reperfusion remains unknown. We aimed to investigate the role of macrophages on the development of tubulointerstitial fibrosis and functional ...
Global Markets Directs, Acute Renal Failure (ARF) (Acute Kidney Injury) - Pipeline Review, H2 2012, provides an overview of the indications therapeutic pipeline. This report provides information on the therapeutic development for Acute Renal Failure (ARF) (Acute Kidney Injury), complete with latest updates, and special features on late-stage and discontinued projects. It also reviews key players involved in the therapeutic development for Acute Renal Failure (ARF) (Acute Kidney Injury). Acute Renal Failure (ARF) (Acute Kidney Injury) - Pipeline Review, Half Year is built using data and information sourced from Global Markets Directs proprietary databases, Company/University websites, SEC filings, investor presentations and featured press releases from company/university sites and industry-specific third party sources, put together by Global Markets Directs team.
South and Southeast Asia and Latin American together comprise 46 countries and are home to approximately 40% of the world population. The sociopolitical and economic heterogeneity, tropical climate, and malady transitions characteristic of the region strongly influence disease behavior and health care delivery. Acute kidney injury epidemiology mirrors these inequalities. In addition to hospital-acquired acute kidney injury in tertiary care centers, these countries face a large preventable burden of community-acquired acute kidney injury secondary to tropical infectious diseases or animal venoms, affecting previously healthy young individuals. This article reviews the epidemiology, clinical picture, prevention, risk factors, and pathophysiology of acute kidney injury associated with tropical diseases (malaria, dengue, leptospirosis, scrub typhus, and yellow fever) and animal venom (snakes, bees, caterpillars, spiders, and scorpions) in tropical regions of Asia and Latin America, and discusses the ...
Acute Kidney Failure, Read about Acute Kidney Failure symptoms, causes, diagnosis, and treatment. Also read Acute Kidney Failure articles about how to live with Acute Kidney Failure, and more.
acute renal failure (ARF); Acute kidney injury (AKI) or acute kidney failure information available. Treat acute kidney injury AKI and problems with kidney functions and renal issues
Infective endocarditis is one of the most common infections among intravenous drug addicts. Its complications can affect many systems, and these can include acute renal failure. There is a scarcity of cases in the literature related to acute renal failure secondary to infective endocarditis treated with peritoneal dialysis. In this paper, the case of a 48-year-old Saudi male is reported, who presented with features suggestive of infective endocarditis and who developed acute kidney injury that was treated successfully with high tidal volume automated peritoneal dialysis. To our knowledge, this is the second report of such an association in the literature. A 48-year-old Saudi gentleman diagnosed to have a glucose-6-phosphate dehydrogenase deficiency and hepatitis C infection for the last 9 years, presented to the emergency department with a history of fever of 2 days duration. On examination: his temperature = 41 °C, there was clubbing of the fingers bilaterally and a pansystolic murmur in the left
Hilmi Umut nal, Yal n Ba aran, Hadim Ako lu. Contrast-induced acute kidney injury/contrast-induced nephropathy may be related to additional risk factors. Anatol J Cardiol. 2018; 19(2): 155- ...
Hyperuricemia has been reported to be associated with the development of postoperative acute kidney injury (pAKI). However, it remains underdetermined whether hyperuricemia treatment could decrease the potential risk of pAKI. Here, we investigated this hypothesis among hyperuricemia patients with previously normal renal function by performing a retrospective database analysis. The study screened 18,169 patients, and were examined preoperative serum creatinine, uric acid, and postoperative serum creatinine. Eight hundred thirty-six patients were finally analyzed for the study, of whom 232 were in the treatment group and 604 were in the non-treatment control group. After adjustment for multi-covariates including baseline (pre-treatment) serum uric acid (SUA) levels, the incidence of pAKI in the treatment group (9.05%; 95% CI 6.04-12.1%) was significantly lower than that in the control group (14.2%; 95% CI 11.2-17.2%). On the other hand, further adjusting for preoperative SUA levels, there was no
Acute kidney injury (AKI) is a common condition with significant associated morbidity and mortality. Although impressive progress has been made in the understanding of the molecular and biochemical mechanisms of kidney injury, as well as in the clinical care of patients with AKI, outcomes have remained disturbingly static over the last 40-50 years. This new book presents topical research data in the study of the causes, diagnosis and treatment of acute kidney injury. Topics discussed include classification of AKI; acute renal failure in the newborn; kidney ischemia and reperfusion injury; pandemic H1N1 influenza A infection and AKI; the role of oxidative stress in renal ischemia; biomarkers in acute kidney injury and B2 adrenoceptor therapy in AKI. (Imprint: Nova Biomedical). ...
Acute kidney injury after cardiac surgery is a common complication and outcome may be devastating with a mortality-risk of up to 90% [6, 11, 16-19]. According to AKIN classification, changes in serum creatinine concentrations and reduced urine output define acute kidney injury. Therefore, changes of kidney function are detected with substantial delay. Changes of diuresis and/or serum creatinine levels that appear in the postoperative period can be directly ascribed to CPB, but also to various factors, as haemolysis, blood transfusions, volume deficit, haemodynamic instability, systemic inflammatory response (SIRS), or reduction of renal perfusion in the elderly [15, 20]. Nevertheless, early prediction of the occurrence of AKI after surgery is of crucial importance.. NGAL is a multi-potent 25-kDa protein mainly secreted by neutrophils, playing a fundamental role in iron metabolism [21, 22]. Although the dimeric NGAL is also expressed by other organs [23], the monomeric form is expressed by ...
Acute Kidney Injury (AKI) or Acute renal failure (ARF) is the temporary rapid breakdown of renal (kidney) function that occurs with high levels of uremic toxins (waste products of the bodys metabolism) accumulate in the blood. AKI occurs when the kidneys are unable to excrete (discharge) the daily load of toxins in the urine. Both kidneys are failing when Acute Kidney Injury (AKI) occurs. One normally functioning kidney can maintain adequate blood filtering. AKI affects approximately 1% of patients on admission to the hospital, 2% to 5% during the hospital stay, and 4% to 15% after cardiopulmonary bypass surgery. Based on the amount of urine that is excreted over a 24-hour period, patients with Acute Kidney Injury (AKI) are separated into two groups: Oliguric: patients who excrete less than 500 milliliters per day (, 16 oz/day) Nonoliguric: patients who excrete more than 500 milliliters per day (, 16 oz/day) In nonoliguric patients, the urine is of poor quality (i.e., contains little waste) ...
TY - JOUR. T1 - Analyses of acute kidney injury biomarkers by ultra-high performance liquid chromatography with mass spectrometry. AU - ZaAbi, Mohammed Al. AU - Ali, Badreldin H.. AU - ALOthman, Zeid A.. AU - Ali, Imran. PY - 2016/1/1. Y1 - 2016/1/1. N2 - The newly developed acute kidney injury biomarkers are very important for the early and timely detection of kidney diseases. This review contains details of the analyses of several acute kidney injury biomarkers using ultra-high performance liquid chromatography-mass spectrometry in urine and plasma samples. In this review we attempt to discuss some aspects of the types of the biomarkers, patents, sample preparation, and the analyses. Besides, efforts were also made to discuss the possible uses of superficially porous (core-shell) columns in traditional and inexpensive high-performance liquid chromatography instruments. Additionally, the challenges and the future prospects are also highlighted. The present review will be useful for the ...
Abstract Eight patients with acute renal failure following snakebite were studied. Intravascular hemolysis and disseminated intravascular coagulation contributed to the development of acute renal failure in 6 patients. Direct nephrotoxicity causing acute renal failure is postulated in 2 patients, 1 of whom also revealed evidence of mild, disseminated intravascular coagulation. Three patients had histopathological lesions of acute symmetrical cortical necrosis and 3 had acute tubular necrosis. In 1 patient with acute tubular necrosis, in whom direct nephrotoxicity seemed to be responsible for renal failure, the striking histological feature was a uniform debasement and disappearance of tubular epithelium. In 2 patients with a clinical course of acute tubular necrosis, histological lesions could not be documented. All the 5 patients with acute tubular necrosis regained full recovery of renal function, 3 of them with the help of dialysis and 2 with conservative management. None of the 3 patients with acute
Acute kidney injury is characterized by abrupt deterioration in kidney function, manifested by an increase in serum creatinine level with or without reduced urine output. The spectrum of injury ranges from mild to advanced, sometimes requiring renal replacement therapy. The diagnostic evaluation can be used to classify acute kidney injury as prerenal, intrinsic renal, or postrenal. The initial workup includes a patient history to identify the use of nephrotoxic medications or systemic illnesses that might cause poor renal perfusion or directly impair renal function. Physical examination should assess intravascular volume status and identify skin rashes indicative of systemic illness. The initial laboratory evaluation should include measurement of serum creatinine level, complete blood count, urinalysis, and fractional excretion of sodium. Ultrasonography of the kidneys should be performed in most patients, particularly in older men, to rule out obstruction. Management of acute kidney injury involves
Pharmacological interventions for the prevention of contrast-induced acute kidney injury in high-risk adult patients undergoing coronary angiography: a systematic review and meta-analysis of randomised controlled trials ...
Ischemic Acute Kidney Injury Perturbs Homeostasis of Serine Enantiomers in the Body Fluid in Mice: Early Detection of Renal Dysfunction Using the Ratio of Serine Enantiomers. . Biblioteca virtual para leer y descargar libros, documentos, trabajos y tesis universitarias en PDF. Material universiario, documentación y tareas realizadas por universitarios en nuestra biblioteca. Para descargar gratis y para leer online.
Dialysis may be required in patients with severe acute kidney injury (AKI, acute renal failure [ARF]). Most patients have been treated with hemodialysis, with the dialysis prescription varying in part with the presence or absence of hypercatabolism.
Liu Y-hui, Wang S-qi, Xue J-hua, et al. Hundred top-cited articles focusing on acute kidney injury: a bibliometric analysis. BMJ Open 2016;6:e011630. The published affiliations of the authors in this article were incorrect. The correct affiliations are given below.. Ning Tan, Yuan-hui Liu, Yong Liu, Ji-yan Chen, Peng-cheng He and Ning Tan: Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510100, Guangdong, China;. Sheng-qi Wang: 1Department of Mammary Disease, Guangdong Provincial Hospital of Chinese Medicine, The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China; 2Department of Pharmacy, Nanfang Hospital, Southern Medical University, 1038 Guangzhou, China.. Guo-feng Li: Department of Pharmacy, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China.. Jin-hua Xue: 1Department of ...
In Addition, A Significant Drug-Drug Interaction Between The Concomitant Use Of Fluoroquinolones And Renin-Angiotensin-System Blockers (Posted by Tom Lamb at DrugInjuryWatch.com) An article published by the Canadian Medical Association during June 2013 in its medical journal CMAJ, Risk of acute kidney injury associated with the use of fluoroquinolones, reported on a study that revealed serious renal side effects in some men who used the popular Levaquin, Cipro, or Avelox, i.e., fluoroquinolone class of antibiotics. From the Abstract for this June 2013 CMAJ article: Background: Case reports indicate that the use of fluoroquinolones may lead to acute kidney injury. We studied the association between the use of oral fluoroquinolones and acute kidney injury, and we examined interaction with renin-angiotensin-system blockers. Methods: We formed a nested cohort of men aged 40-85 enrolled in the United States IMS LifeLink Health Plan Claims Database between 2001 and 2011.... to assess the rate ratio (RR) for
There is a potential that taking oral vitamin B3 might not only treat but also prevent acute kidney injuries. Researchers however have come across vitamin B3 as a potential treatment for acute kidney injury. This article highlights how vitamin B3 can treat acute kidney injury.
Authors: Eun-Ho Lee, M.D. et al. Anesthesiology 5 2016, Vol.124, 1001-1011. Background: Hypoalbuminemia may increase the risk of acute kidney injury (AKI). The authors investigated whether the immediate preoperative administration of 20% albumin solution affects the incidence of AKI after off-pump coronary artery bypass surgery.. Methods: In this prospective, single-center, randomized, parallel-arm double-blind trial, 220 patients with preoperative serum albumin levels less than 4.0 g/dl were administered 100, 200, or 300 ml of 20% human albumin according to the preoperative serum albumin level (3.5 to 3.9, 3.0 to 3.4, or less than 3.0 g/dl, respectively) or with an equal volume of saline before surgery. The primary outcome measure was AKI incidence after surgery. Postoperative AKI was defined by maximal AKI Network criteria based on creatinine changes.. Results: Patient characteristics and perioperative data except urine output during surgery were similar between the two groups studied, the ...
Abstract Twenty-nine patients with acute renal failure following bites by snakes of the genera Crotalus and Bothrops were treated in an Intensive Care Unit (ICU). Eight were given conservative treatment. Peritoneal dialysis was necessary in 21 patients, and hemodialysis in one of these. The main complications occurring while the patients were in the ICU were pulmonary edema (5 cases), respiratory failure (4), cardiac arrest (4), and hypovolemic shock (1 case). Three patients died with respiratory and hemodynamic disturbances while in the ICU, one of them during the polyuric phase. Twenty-four patients were discharged from the hospital with no clinical or laboratory evidence of renal failure. Two patients developed bilateral cortical necrosis of the kidney. One of them died in the general ward after interruption of dialysis and the other was discharged from the hospital with chronic renal failure. It was not possible to perform a kidney transplantation. The importance of the ICU in the recovery of such
Acute Renal Failure (ARF) (Acute Kidney Injury)- Pipeline Insights, 2015, provides the in-depth analysis of the pipeline assets across the Acute Renal Failure (ARF) (Acute Kidney Injury). The main objective of this report to track competitor pipeline molecules, related research activities, technology, collaborations, in-licensing and out-licensing deals.
We identified candidate biomarkers for the prediction of the development of severe AKI, and the prognostic potential of the most promising candidate, angiotensinogen, was verified in a larger set of patients who developed AKI after cardiac surgery. We found that uAnCR was elevated in patients who developed more severe AKI after sample collection. Elevated uAnCR was associated with worsening of AKI, independent of changes in SCr and Cleveland Clinic score, and it was also associated with several secondary outcomes. The prognostic predictive power of uAnCR was improved when only patients who were classified as AKIN stage 1 at the time of sample collection were used in the analysis, indicating that angiotensinogen could be used to predict adverse outcomes among patients who have not yet developed severe AKI as measured by serum creatinine.. Our data suggest that angiotensinogen could be used at the time of diagnosis with AKI to assess the risk of adverse outcomes. This risk assessment could lead to ...
article{8506963, abstract = {Purpose of review : Acute kidney injury (AKI) occurs in up to 30\% after cardiac surgery and is associated with adverse outcome. Currently, cardiac surgery-associated acute kidney injury (CSA-AKI) is diagnosed by Kidney Disease: Improving Global Outcomes criteria based on creatinine and urine output. To detect and treat AKI earlier, various biomarkers have been evaluated. This review addresses the current position of the two damage biomarkers neutrophil gelatinase-associated lipocalin (NGAL) and [TIMP-2] [IGFBP7] in clinical practice. Recent findings : We present an updated review on the use of blood and urinary NGAL in CSA-AKI. NGAL is a good predictor, and performs better in children than adults. There is a large variation in predictive ability, possibly caused by diversity of AKI definitions used, different time of measurement of NGAL, and lack of specificity of NGAL assays. Similarly, there are conflicting data on the predictive ability of urinary [TIMP-2] ...
OBJECTIVE to assess prevalence of acute kidney injury (AKI) among patients with acute decompensated heart failure (ADHF) and its impact on prognosis in a hospitalized patient. MATERIAL AND METHODS a sample of patients hospitalized with signs of ADHF. RESULTS Prevalence of AKI in this sample was 23.1%. There was no significant difference between patients with and without AKI by age, gender, and hemodynamic parameters. Portion of subjects with systolic blood pressure below 125 mm Hg among patients with AKI did not exceed one third. Development of AKI was associated with 3-fold elevation of risk of injury of the liver. Hospital mortality in patients with AKI was 7 times higher than in patients without AKI. CONCLUSION These results resemble those obtained in foreign studies on AKI prevalence among patients with ADHF except hospital mortality which turned out to be twice higher. Acute liver injury highly prevalent among patients with AKI worsened their prognosis. Risk of lethal outcome in patients with
Researchers from Canada showed that using serum creatinine (SCr) values obtained at the time of hospital admission is a reliable method for assessment of acute kidney injury (AKI).. In the study "Diagnosis and outcomes of acute kidney injury using surrogate and imputation methods for missing preadmission creatinine values," published in BMC Nephrology, the authors aimed to find a surrogate method to determine SCr baseline levels that can allow more accurate assessment of AKI diagnosis and outcomes.. Diagnoses and predictions of AKI disease outcomes rely on the calculation of the glomerular filtration rate (GFR). Such determination requires patients pre-admission SCr values. However, these parameters are frequently missing and are a common obstacle to evaluate this condition.. In the study, the authors evaluated four alternative methods to determine SCr values and compared them to the standard and most reliable method, which is blood measurement before hospital admission. They used an estimation ...
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NephroCheck is an assay to assess the risk of developing acute kidney injury. The laboratory test was developed by Astute Medical, in San Diego, California, in collaboration with clinical investigators. It was notable for being the first test of its kind for determining whether certain critically ill hospitalized patients were at risk of developing moderate to severe acute kidney injury (AKI) in the next 12 hours. Early knowledge that a patient is likely to develop AKI may prompt closer patient monitoring and help prevent permanent kidney damage or death. A randomized control trial led by Alexander Zarbock, M.D., at University Hospital Muenster, Germany has indicated that using Astute Medicals NephroCheck Test to identify patients at high risk for acute kidney injury (AKI) after open-heart surgery and providing them treatment recommended by globally-recognized care guidelines significantly improved outcomes by reducing the occurrence of moderate to severe AKI more than 33 percent. Nephrocheck ...
Discusses acute kidney injury (which used to be called acute renal failure), which means your kidneys suddenly stop working normally. Includes prerenal acute kidney injury. Covers causes like kidney or liver disease. Includes symptoms like little urine (oliguria) when you urinate. Covers dialysis.
SAN DIEGO, Sept. 5, 2017 /PRNewswire/ -- Astute Medical, Inc., developer of biomarkers for better healthcare, said a newly published trial showing improved patient outcomes, shorter hospital stays, and cost savings associated with a 66 percent reduction in moderate and severe acute kidney injury (AKI) following noncardiac surgery further validates the case for early AKI risk assessment in combination with guided therapy. The randomized trial, published online in Annals of Surgery,[1] utilized Astutes NephroCheck Test to identify patients at high risk of developing AKI, triggering the implementation of preventative intervention. Patients in the intervention group spent fewer days in the intensive care unit (ICU) (approximately one day) and hospital (approximately five days) yielding net savings of more than $2,000 per patient ...
Complications of Acute kidney failure including hidden complications, secondary medical conditions, symptoms, or other types of Acute kidney failure complication.
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Most cases of acute kidney injury occur in people who are already in the hospital for other reasons. In these people, acute kidney injury is usually diagnosed when routine tests show a sudden increase increatinineandblood urea nitrogen (BUN)levels. A buildup of these waste products in the blood points to a loss of kidney function. Your doctor will compare these levels to previous tests to find out if kidney disease is acute or chronic.. Anultrasoundof the kidneys also may help determine whether kidney problems are acute or chronic. Normal-sized kidneys may be present in either condition, but when both kidneys are smaller than normal, chronic kidney disease is usually the problem.. ...
Most cases of acute kidney injury occur in people who are already in the hospital for other reasons. In these people, acute kidney injury is usually diagnosed when routine tests show a sudden increase increatinineandblood urea nitrogen (BUN)levels. A buildup of these waste products in the blood points to a loss of kidney function. Your doctor will compare these levels to previous tests to find out if kidney disease is acute or chronic.. Anultrasoundof the kidneys also may help determine whether kidney problems are acute or chronic. Normal-sized kidneys may be present in either condition, but when both kidneys are smaller than normal, chronic kidney disease is usually the problem.. ...
Organ procurement teams are sometimes leery of accepting kidneys from deceased donors with acute kidney injury (AKI), fearing they will harm the recipients. However, a national study chaired by a Johns Hopkins kidney specialist suggests these fears may be unfounded. In medical chart reviews of 2,430 kidneys transplanted from 1,298 donors-585 (24 percent) of them with AKI-researchers say they found no significant differences in rates of organ rejection among kidneys from deceased donors with or without AKI. They also report they found no evidence that factors such as the amount of time an organ is chilled and left without blood supply before transplantation had any impact on recipient outcomes for those who received AKI kidneys. View more at https://www.hopkinsmedicine.org/news/newsroom Questions Answered: 0:01 What were the most important findings of the research? 3:17 Why is this research important to the field of medicine? 5:40 How could using deceased donor acute kidney injury kidneys for ...
Physicians treating hospitalized patients for conditions unrelated to the kidneys should pay close attention to common blood and urine tests for kidney function in order to prevent incidental injury to the organs that help cleanse the body of toxins, new Johns Hopkins Bloomberg School of Public Health-led research suggests.. The findings, published this month in two studies in the American Journal of Kidney Diseases, suggest that while being older, male, African-American or having diabetes are risk factors for developing acute kidney injury, the strongest risk factor is even mildly abnormal results on tests of kidney function.. Acute kidney injury - a sudden loss of kidney function, which can develop as quickly as a few hours or over the span of a few days - occurs in up to 10 percent of hospitalized patients and up to 22 percent of intensive care unit patients worldwide. And its incidence has increased over the past two decades. Researchers say that this type of injury, which can lead to ...
In 2008, the NIDDK initiated the Assessment, Serial Evaluation, and Subsequent Sequelae of Acute Kidney Injury (ASSESS-AKI) Study which is prospectively enrolli...
In 2008, the NIDDK initiated the Assessment, Serial Evaluation, and Subsequent Sequelae of Acute Kidney Injury (ASSESS-AKI) Study which is prospectively enrolli...
Introduction: Patients with acute kidney injury (AKI) in developing countries are described in a profile of young age, with less comorbidities, with unifactorial, and with a lower mortality compared to patients in developed countries. Objective: To assess mortality in patients with acute kidney injury undergoing hemodialysis (HD) and its associated factors in a developing country setting. Methods: Retrospective study. Demographic, clinical, and mortality variables were collected from patients who presented AKI and underwent HD between January 2014 and December 2015 at a national reference hospital in Lima, Peru. Risk ratios (RR) and 95% confidence intervals (95%CI) were estimated through Poisson regressions. Results: Data from 72 patients with AKI that underwent HD were analyzed, 66.7% of them were , 64 years old, and 40.2% of all patients died undergoing HD. Crude analysis showed higher mortality among those who used vasopressors, but lower mortality among those with creatinine values , 8.9 mg/ ...
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Some blood pressure medications are known risk factors for acute kidney injury (AKI) - a sudden deterioration in kidney function. Cambridge scientists have found an association between the increased prescriptions for ACE inhibitors (and similar drugs) and increased hospital admissions for acute kidney injury.. On behalf of Blood Pressure UK, Dr Rebecca Sucking, Consultant Nephrologist says:. "ACE-I and ARBs are life-saving medications which not only reduce blood pressure, but also reduce the progression of kidney disease, heart failure and diabetes. However, AKI has been shown to be a recognised, but avoidable, side effect for some seriously ill people on these medications. It is imperative that prescribing GPs advise their patients on how to take their medication safety, and not to ignore any serious side effects they may have. "Patients are put on to ACE-I or ARBs because they are otherwise at an increased risk of strokes and heart attacks, both of which can be fatal. It is likely that ...
A paper in the Mayo Clinic Proceedings, Acute Kidney Injury Predicts Outcomes of Non-Critically Ill Patients, examines the effect of Acute Kidney Injury (AKI) on the clinical out comes almost 6000 patients at a community teaching hospital affiliated with Yale. AKI was deined as an increase in serum creatinine of at least 0.3mg/dL over 48…
This webcast includes printable course notes. The aim of this 30 minute online tutorial for veterinary nurses, is to revisit the anatomy and physiology of the kidney and to understand the signs and symptoms which may be observed when our patients develop an acute kidney injury. This tutorial covers the classification of AKI, how we diagnose the condition and the treatment options that are available. The nursing considerations whilst caring for the AKI patient are discussed in detail. Acute Kidney Injury.
Acute kidney injury is quite a common adverse effect that associates with coronary angiography and percutaneous coronary interventions. Vitamin E may decrease the risk of acute kidney injury by up to 62 percent according to a meta-analysis of three randomized trials published in the American Journal of Kidney Diseases.
Kidney disorders. QPI-1002/I5NP. Graft dysfunction kidney transplant. p53 Kidney disorders. QPI-1002/I5NP. Kidney injury acute ... Kidney disorders. QPI-1002/I5NP. Acute kidney injury. p53 ... kidney disorders, LDL lowering, and antiviral.[51] The ...
... recovery from acute kidney injury (AKI), or performing a kidney transplant can slow or hold the progression of NSF. A few cases ... and those with acute kidney injury, even if kidney function subsequently returned to normal following GBCA administration.[13][ ... Bhaskaran A, Kashyap P, Kelly B, Ghera P (January 2010). "Nephrogenic systemic fibrosis following acute kidney injury and ... "Gadolinium-induced nephrogenic systemic fibrosis in a patient with an acute and transient kidney injury". The British Journal ...
... in-depth review of excipients and acute kidney injury risk". American Journal of Nephrology. 38 (4): 275-84. doi:10.1159/ ... Whether isolated acute sensory loss can be regarded as a form of Guillain-Barré syndrome is a matter of dispute; this is a rare ... Acute motor and sensory axonal neuropathy (AMSAN) Severe muscle weakness similar to AMAN but with sensory loss - Axonal ... Acute motor axonal neuropathy (AMAN) Isolated muscle weakness without sensory symptoms in less than 10%; cranial nerve ...
Kidney injury, acute renal failure I Completed Quark Pharmaceuticals NCT00554359 Delayed graft function, complications of ... siRNA is controlled by the innate immune system, which can be divided into the acute inflammatory responses and antiviral ... RNAi uptake and regulation is monitored by the kidneys.[166] ... kidney transplant I, II Recruiting Quark Pharmaceuticals ...
Acute kidney disease is now termed acute kidney injury and is marked by the sudden reduction in kidney function over seven days ... The most common form of kidney disease in cancer patients is Acute Kidney Injury (AKI) which can usually be due to volume ... Several chemotherapeutic agents, for example Cisplatin, are associated with acute and chronic kidney injuries.[20] Newer agents ... the complete loss of kidney function. Kidney failure is known as the end-stage of kidney disease, where dialysis or a kidney ...
Acute renal failure aka Acute Kidney Injury. *Burns. *Management of postoperative open heart surgical patients ...
... in the absence of acute kidney injury, and 59% if kidney impairment occurs. Most people who have sustained kidney impairment ... Rhabdomyolysis accounts for 7-10% of all cases of acute kidney injury in the U.S. Crush injuries are common in major disasters ... Rhabdomyolysis complicated by acute kidney impairment in patients with traumatic injury may have a mortality rate of 20%. ... Of those with rhabdomyolysis, 10-50% develop acute kidney injury. The risk is higher in people with a history of illicit drug ...
Acute kidney injury[edit]. Main article: Acute kidney injury. Acute kidney injury (AKI), previously called acute renal failure ... Acute kidney injury[edit]. Acute kidney injury (previously known as acute renal failure) - or AKI - usually occurs when the ... Acute-on-chronic kidney failure[edit]. Acute kidney injuries can be present on top of chronic kidney disease, a condition ... Kidney failure can be divided into two categories: acute kidney injury or chronic kidney disease. The type of renal failure is ...
And neither prevents acute kidney injury. How to prevent perioperative myocardial injury remains under active investigation, ... "Perioperative aspirin and clonidine and risk of acute kidney injury: a randomized clinical trial". JAMA. 312: 2254-64. doi: ... What causes acute surgical pain to become persistent remains unclear. However, it seems likely to result from some combination ... Wang L, Bauer M, Curry R, Larsson A, Sessler DI, Eisenach JC (October 2014). "Intrathecal ketorolac does not improve acute or ...
Drug toxicity includes acute kidney injury. Although used clinically since the 1930s, if not earlier, the mechanism of action ... 2012). "New fibrate use and acute renal outcomes in elderly adults: a population-based study". Ann Intern Med. 156 (8): 560-9. ...
"Acute kidney injury in late pregnancy in developing countries". Renal Failure. 32 (3): 309-313. doi:10.3109/08860221003606265. ... of all cases of acute kidney failure in adults and more than 20% of cases of acute kidney failure during late pregnancy.[15][16 ... diffuse bilateral renal cortical necrosis (BRCN), diffuse cortical necrosis, acute cortical necrosis, acute kidney failure with ... Renal cortical necrosis (RCN) is a rare cause of acute kidney failure. The condition is "usually caused by significantly ...
Acute Kidney Injury Work Group. "KDIGO Clinical Practice Guideline for Acute Kidney Injury" (PDF). Archived (PDF) from the ... Chalikias, G; Drosos, I; Tziakas, DN (October 2016). "Prevention of Contrast-Induced Acute Kidney Injury: an Update". ... "Comparative Effectiveness of 12 Treatment Strategies for Preventing Contrast-Induced Acute Kidney Injury: A Systematic Review ... Kidney diseaseEdit. Some reviews found that prior administration of acetylcysteine decreases radiocontrast induced kidney ...
... to prevent contrast-induced acute kidney injury and to slow progression of chronic kidney disease. Dosing trials began in June ... "AKIGUARD (Acute Kidney Injury GUARding Device) trial". Journal of Cardiovascular Medicine. 17 (7): 530-537. doi:10.2459/jcm. ... "Acute Kidney Injury With the RenalGuard System in Patients Undergoing Transcatheter Aortic Valve Replacement". JACC: ... Sadat U, Usman A, Gillard JH, Boyle JR (2013). "Does ascorbic acid protect against contrast-induced acute kidney injury in ...
"Calcium-channel blocker-clarithromycin drug interactions and acute kidney injury". JAMA. 310 (23): 2544-2553. doi:10.1001/jama. ... Liver and kidneyEdit. Clarithromycin has been known to cause jaundice, cirrhosis, and kidney problems, including renal failure. ... Concurrent therapy with calcium channel blocker may increase risk of low blood pressure, kidney failure, and death, compared to ... It should not be used with colchicine in people with kidney or liver impairment.[8] ...
Fanos, V; Antonucci, R; Zaffanello, M (2010). "Ibuprofen and acute kidney injury in the newborn". Turk. J. Pediatr. 52 (3): 231 ... It increases the risk of heart failure, kidney failure, and liver failure. At low doses, it does not appear to increase the ... A patient who survives the acute intoxication usually experiences no late sequelae. A study of pregnant women suggests those ... McElwee, NE; Veltri, JC; Bradford, DC; Rollins, DE (June 1990). "A prospective, population-based study of acute ibuprofen ...
... acute kidney injury, and mortality". J Am Soc Nephrol. 21: 845-51. doi:10.1681/ASN.2009070682. PMC 2865737 . PMID 20395373. CS1 ... Bell et al., in 2013, surveyed 91 acute hospital sites in England to evaluate systems of consultant cover for acute medical ... Injury. 47: 1236-41. doi:10.1016/j.injury.2016.02.021. PMID 27084114. CS1 maint: Multiple names: authors list (link) Worni M, ... "The weekend effect alters the procurement and discard rates of deceased donor kidneys in the United States". Kidney Int. 90: ...
Humphreys, BD; Duffield, JS; Bonventre, JV (2006). "Renal stem cells in recovery from acute kidney injury". Minerva urologica e ... It is involved in the homeostasis and repair of the kidney, and holds therapeutic potential for treatment of kidney failure. ... "Intrinsic Epithelial Cells Repair the Kidney after Injury". Cell Stem Cell. 2 (3): 284-91. doi:10.1016/j.stem.2008.01.014. PMID ... "Mouse kidney progenitor cells accelerate renal regeneration and prolong survival after ischemic injury". Stem cells (Dayton, ...
"Risk Factors for Acute Kidney Injury in Severe Rhabdomyolsis." PLOSONE 10.1371 (2013). Web. 25 Jan 2014. Poortsmans, JR. ... Acute Exertional Rhabdomyolysis. Aug. 1995 Retrieved 22 Jan. 2014 Demos, M. A., E. L. Gitin, and L. J. Kagen. "Exercise ... In some cases ER can lead to acute renal failure and bring medical costs up due to the need for hemodialysis for recovery/ ... Vanderstraten, J. "Kidney function during exercise in healthy and diseased human. An Update." Sports Medicine 18.6 (1994): 419- ...
Rhabdomyolysis leading to acute kidney injury, and impaired renal handling of acid and base has been reported after bypass ... Adverse effects on the kidneys have been studied. Hyperoxaluria that can potentially lead to oxalate nephropathy and ... Rare complications include lymphatic injury and major wound dehiscence. The hospital stay for the procedure can require from ...
Rhabdomyolysis leading to acute kidney injury, and impaired renal handling of acid and base has been reported after bypass ... Adverse effects on the kidneys have been studied. Hyperoxaluria that can potentially lead to oxalate nephropathy and ...
"Calcium-channel blocker-clarithromycin drug interactions and acute kidney injury". JAMA. 310 (23): 2544-2553. doi:10.1001/jama. ... It should not be used with colchicine in people with kidney or liver impairment. Concomitant use with cholesterol medications ...
Dosing of Renal Replacement Therapy in Acute Kidney Injury: lessons learned from clinical trials. Am J Kidney Dis 2010; 55: 570 ... Renal Support in Acute Kidney Injury - How Much Is Enough? N Engl J Med 2009; 361(17):1699-1701. RENAL Replacement Therapy ... Palevsky PM,«Renal Support in Acute Kidney Injury - How Much Is Enough?» (2009)N Engl J Med 361(17):1699-1701. In this way, ... Intensity of renal support in critically ill patients with acute kidney injury. N Engl J Med 2008;359(1):7-20. Schiffl H Daily ...
March 2015). "Cutaneous and renal glomerular vasculopathy as a cause of acute kidney injury in dogs in the UK". Veterinary ... link) Walker, D (23 March 2015). Important information regarding dogs with acute kidney injury ('Alabama Rot'). Anderson Moores ... "Cutaneous and renal glomerular vasculopathy as a cause of acute kidney injury in dogs in the UK". Veterinary Record. 176 (15): ... "Important information regarding dogs with acute kidney injury ('Alabama Rot')". Anderson Moores. Retrieved 28 March 2015. ...
"Comparative Efficacy of Statins for Prevention of Contrast-Induced Acute Kidney Injury in Patients With Chronic Kidney Disease ... Very rarely, atorvastatin may cause rhabdomyolysis,[34] and it may be very serious leading to acute kidney injury due to ... Cho A, Lee YK, Sohn SY (March 2020). "Beneficial effect of statin on preventing contrast-induced acute kidney injury in ... November 2017). "Preoperative Statin Treatment for the Prevention of Acute Kidney Injury in Patients Undergoing Cardiac Surgery ...
H.R. 1254, 112th Congress, 1st Session (2011). Acute Kidney Injury Associated with Synthetic Cannabinoid Use, Multiple States, ... The acute toxicity and long term side effects associated with the use of AM-2201 are acute kidney failure, brain damage, ... Forbes Synthetic Marijuana May Cause Psychosis, Brain and Kidney Damage. Forbes report, Synthetic Marijuana Linked to Psychosis ... Brain, and Kidney Damage. 2013 Dante Durand; Leticia L. Delgado; Dhizarah Matus de la Parra-Pellot; Diana Nichols-Vinueza ( ...
CD4+ T cells are required for the maintenance, not programming, of memory CD8+ T cells after acute infection. Nature Immunology ... Alpha-lactose reverses liver injury via blockade of Tim-3-mediated CD8 apoptosis in sepsis. Clinical Immunology. July 2018, 192 ... Disappearance of T Cell-Mediated Rejection Despite Continued Antibody-Mediated Rejection in Late Kidney Transplant Recipients. ... Hepatitis B Virus-Specific CD8+ T Cells Maintain Functional Exhaustion after Antigen Reexposure in an Acute Activation Immune ...
T1 - Delivered dose of continuous venovenous hemofiltration predicts outcome in septic patients with acute kidney injury: A ... title = "Delivered dose of continuous venovenous hemofiltration predicts outcome in septic patients with acute kidney injury: A ... Delivered dose of continuous venovenous hemofiltration predicts outcome in septic patients with acute kidney injury: A ... Delivered dose of continuous venovenous hemofiltration predicts outcome in septic patients with acute kidney injury: A ...
Acute kidney injury (AKI) is a devastating potential consequence of renal ischaemia and reperfusion (I-R) subsequent to severe ... neutrophil gelatinase-associated lipocalin concentration for the diagnosis of ischaemia-reperfusion induced acute kidney injury ... neutrophil gelatinase-associated lipocalin concentration for the diagnosis of ischaemia-reperfusion induced acute kidney injury ... Pressure-guided acute haemorrhage followed by colloid resuscitation produced a clinically relevant model of I-R AKI in dogs. ...
Tacrolimus is widely used as an immunosuppressant in liver transplantation, and tacrolimus-induced acute kidney injury (AKI) is ... N2 - Tacrolimus is widely used as an immunosuppressant in liver transplantation, and tacrolimus-induced acute kidney injury ( ... AB - Tacrolimus is widely used as an immunosuppressant in liver transplantation, and tacrolimus-induced acute kidney injury ( ... Neutrophil Gelatinase-Associated Lipocalin Is Not Associated with Tacrolimus-Induced Acute Kidney Injury in Liver Transplant ...
AIN accounts for 5% to 18% of kidney biopsies performed in the setting of acute kidney injury (AKI). In developed countries ... 2. Management of AKI: see Acute Kidney Injury. 3. Glucocorticoids may be considered in patients with biopsy-proven drug-induced ... an increasingly common cause of acute kidney injury. NDT 2014 Oct 16 [Epub ahead of print]. PubMed PMID: 25324356 Jelakovic B, ... Acute Interstitial Nephritis Chapter: Acute Interstitial Nephritis. McMaster Section Editor(s): Christine M. Ribic, Karen C.Y. ...
... a case in which the pharmacokinetic characteristics of levetiracetam were evaluated in a patient with acute kidney injury on ... TC was more consistent with that seen in a patient with mild kidney disease, or a CrCl of 50-80 ml/min. ...
It represents one of the most promising future biomarkers in the diagnostic field of acute kidney injury (AKI), as the increase ... It represents one of the most promising future biomarkers in the diagnostic field of acute kidney injury (AKI), as the increase ... However, recent studies also suggest a possible role for NGAL in chronic kidney disease (CKD). For this reason we evaluated ... However, recent studies also suggest a possible role for NGAL in chronic kidney disease (CKD). For this reason we evaluated ...
... no evidence to support the routine serial measurement of blood or urinary NGAL to detect subclinical acute tubular injury, NGAL ... Secondly, among KTRs with previously stable graft function who then suffer acute graft dysfunction, a high urinary NGAL ... has the potential to provide useful information to those that care for kidney transplant recipients (KTRs). First, high urinary ... is a protein expressed by kidney tubular cells in response to ischemia, but may also be an early indicator of immunological ...
This review discusses the epidemiology and pathophysiology of surgery-associated acute kidney injury, highlighting the ... acute kidney injury; FDA, Food and Drug Administration; IGFBP7, insulin-like growth factor-binding protein 7; KDIGO, Kidney ... Update on Perioperative Acute Kidney Injury. Alexander Zarbock, MD; Jay L. Koyner, MD; Eric A. J. Hoste, MD; John A. Kellum, MD ... Abbreviations: AKI, acute kidney injury; eGFR, estimated glomerular filtration rate; RRT, renal replacement therapy. ...
Acute kidney injury: short-term and long-term effects Acute kidney injury (AKI) is the most common cause of organ dysfunction ... Acute Kidney Injury (AKI). Edited by Prof Michael Joannidis.. Acute kidney injury is probably the most frequent syndrome ... Acute kidney injury 2016: diagnosis and diagnostic workup Acute kidney injury (AKI) is common and is associated with serious ... Acute kidney injury following cardiac surgery: current understanding and future directions Acute kidney injury (AKI) ...
Sepsis associated acute kidney injury. BMJ 2019; 364 doi: https://doi.org/10.1136/bmj.k4891 (Published 09 January 2019) Cite ... Meta-analysis of frusemide to prevent or treat acute renal failure. Published: 21 July 2006; BMJ doi:10.1136/bmj.38902.605347. ... Meta-analysis of frusemide to prevent or treat acute renal failure. Published: 24 August 2006; BMJ 333 doi:10.1136/bmj. ...
The treatment of acute kidney injury (AKI) prior to institution of renal replacement therapy (RRT) has traditionally focused on ... Acute Kidney Injury Work Group: KDIGO clinical practice guideline for acute kidney injury. Kidney Int Suppl. 2012;2:1-138. ... Acute Kidney Injury Network: report of an initiative to improve outcomes in acute kidney injury. Crit Care. 2007;11(2):R31. ... Non-dialytic Management of Acute Kidney Injury. In: Waikar S., Murray P., Singh A. (eds) Core Concepts in Acute Kidney Injury. ...
Reviewed state-of-the-art knowledge of acute kidney injury (AKI) in neonates and determined the feasibility of studying this ... The purpose of this conference is to: (1) review the state-of-the-art knowledge of acute kidney injury (AKI) in neonates; and ( ... What Do We Know About Long-term Kidney Outcomes in Neonatal Survivors? Cherry Mammen, M.D.. 9:30 a.m.. What Do We Know About ... The National Institute of Diabetes and Digestive and Kidney Diseases. Health Information Center ...
Neonatal Acute Kidney Injury.. Selewski DT1, Charlton JR2, Jetton JG3, Guillet R4, Mhanna MJ5, Askenazi DJ6, Kent AL7. ... In recent years, there have been significant advancements in our understanding of acute kidney injury (AKI) and its impact on ... In an effort to begin to address these needs, the Neonatal Kidney Collaborative was formed in 2014 with the goal of better ... We put forth and describe the neonatal modified Kidney Diseases: Improving Global Outcomes AKI criteria and provide the ...
... Guest Editors: Jeremiah R. Brown, Peter A. McCullough, and Michael E. Matheny *Novel ... Functional Magnetic Resonance Imaging in Acute Kidney Injury: Present Status, Hai Ying Zhou, Tian Wu Chen, and Xiao Ming Zhang ... Hospital Mortality in the United States following Acute Kidney Injury, Jeremiah R. Brown, Michael E. Rezaee, Emily J. Marshall ... Clinical Characteristics and 30-Day Outcomes of Intermittent Hemodialysis for Acute Kidney Injury in an African Intensive Care ...
Learn more about how this affects kidney function. ... Pediatric acute kidney injury occurs when kidneys begin to fail ... Acute (sudden) kidney injury, formerly called acute renal failure, occurs when a kidney is damaged suddenly due to an illness ... Pediatric acute kidney injury refers to the sudden loss of kidney function due to an underlying illness. ... not because of a blow or injury to a kidney as the name might suggest. Its a sudden onset of kidney failure that can happen ...
Learn more about how this affects kidney function. ... Pediatric acute kidney injury occurs when kidneys begin to fail ... Pediatric Acute Kidney Injury. Pediatric acute kidney injury refers to the sudden loss of kidney function due to an underlying ... What is a Pediatric Acute Kidney Injury?. Acute (sudden) kidney injury, formerly called acute renal failure, occurs when a ... What are the causes of a Pediatric Acute Kidney Injury?. Causes of acute kidney injury include:. Slow blood flow caused by:. * ...
Acute kidney injury (AKI) is associated with significant short-term morbidity and mortality, which cannot solely be explained ... Acute kidney injury; Cytokines; Electrolytes; Immune system; Inflammatory mediators; Neutrophils; Short term; Uremic toxins ... Short-term Effects of Acute Kidney Injury.. Singbartl K1, Joannidis M2. ... Evidence suggests that reduced renal cytokine clearance as well as increased cytokine production by the acutely injured kidney ...
... detection and management of non-traumatic acute kidney injury (AKI) ... Assessment for acute kidney injury. Clinical assessment for acute kidney injury involves doing a blood test to check serum ... no clear acute component and 1 or more indications or risk factors for acute kidney injury are assessed for acute kidney injury ... no clear acute component and 1 or more indications or risk factors for acute kidney injury are assessed for acute kidney injury ...
"Interleukin-6 mediates lung injury following ischemic acute kidney injury or bilateral nephrectomy," Kidney International, vol ... C. L. Edelstein, "Biomarkers of acute kidney injury," Advances in Chronic Kidney Disease, vol. 15, no. 3, pp. 222-234, 2008. ... S. Bolisetty and A. Agarwal, "Neutrophils in acute kidney injury: not neutral any more," Kidney International, vol. 75, no. 7, ... ameliorates sepsis-induced acute kidney injury and mortality," Kidney International, vol. 73, no. 11, pp. 1266-1274, 2008. View ...
... detection and management of non-traumatic acute kidney injury (AKI) ... detecting and managing acute kidney injury in adults, young people and children. Acute kidney injury is sudden damage to the ... It does not cover managing acute kidney injury in pregnant women or in people with a kidney transplant. ... Quality statement 2: Identifying acute kidney injury in people with no obvious acute illness ...
Sixteen cases of acute kidney injury following exposure to SCs were identified in six states with illness onset during March 16 ... Acute Kidney Injury Associated with Synthetic Cannabinoid Use - Multiple States, 2012. In March 2012, the Wyoming Department of ... Results of toxicologic analysis of implicated products and/or clinical specimens from seven patients with acute kidney injury ... Chronic kidney disease after kidney injury: a systemic review and meta-analysis. Kid Int 2012;81:442-8. ...
Reuters Health) - Kidney specialists recommend follow-up care for most patients who have experienced acute kidney injury, but ... "Acute kidney injury refers to a sudden loss of kidney function that usually develops over the course of days in patients who ... "Kidney problems can resolve after an acute kidney injury; however, some - but not all - patients can develop long-term ... Reuters Health) - Kidney specialists recommend follow-up care for most patients who have experienced acute kidney injury, but ...
... which means your kidneys suddenly stop working normally. Includes prerenal acute kidney injury. Covers causes like kidney or ... which used to be called acute renal failure), ... What is acute kidney injury?. Acute kidney injury (which used ... What causes acute kidney injury?. Acute kidney injury has three main causes:. *A sudden, serious drop in blood flow to the ... Acute Kidney Injury Work Group (2012). KDIGO clinical practice guideline for acute kidney injury. Kidney International ...
... , Acute Renal Failure, Acute Renal Insufficiency, Renal Failure, Azotemia, Uremia, Acute Tubular Necrosis, ... Acute kidney injury, Acute Kidney Injury, Acute Renal Injuries, Renal Injury, Acute, Acute Kidney Injuries, Acute Renal Injury ... Acute Kidney Injury Acute Kidney Injury Causes Acute Kidney Injury Management Acute Kidney Injury Prognosis Acute Kidney Injury ... Acute Kidney Injury. Acute Kidney Injury Aka: Acute Kidney Injury, Acute Renal Failure, Acute Renal Insufficiency, Renal ...
... leading to chronic kidney disease. Better understanding of the cellular pathophysiological processes underlying kidney injury ... Ischemic kidney injury often occurs in the context of multiple organ failure and sepsis. Here, we review the major components ... and repair will hopefully result in the design of more targeted therapies to prevent the injury, hasten repair, and minimize ... of this dynamic process, which involves hemodynamic alterations, inflammation, and endothelial and epithelial cell injury, ...
  • It represents one of the most promising future biomarkers in the diagnostic field of acute kidney injury (AKI), as the increase in NGAL levels is a good predictor of a brief-term onset of AKI, notably anticipating the resulting increase in serum creatinine. (unime.it)
  • Neutrophil gelatinase-associated lipocalin (NGAL) is a protein expressed by kidney tubular cells in response to ischemia, but may also be an early indicator of immunological rejection, calcineurin inhibitor toxicity, obstructive nephropathy, subclinical tubulitis or infection. (ox.ac.uk)
  • Most frequently the (probable) diagnosis is made on the basis of clinical manifestations (sudden onset of symptoms of kidney injury in a patient with generalized infection or treated with drugs that may cause AIN , in particular when extrarenal allergic symptoms occur simultaneously) after other causes of AKI have been excluded. (empendium.com)
  • NGAL levels were measured via enzyme-linked immunosorbent assays, as were those of three additional urinary biomarkers for kidney diseases: Monocyte chemotactic protein-1 (MCP-1), liver-type fatty acid-binding protein (L-FABP), and human epididymis secretory protein 4 (HE4). (elsevier.com)
  • Although there is currently no evidence to support the routine serial measurement of blood or urinary NGAL to detect subclinical acute tubular injury, NGAL has the potential to provide useful information to those that care for kidney transplant recipients (KTRs). (ox.ac.uk)
  • Secondly, among KTRs with previously stable graft function who then suffer acute graft dysfunction, a high urinary NGAL predicts graft loss at one year. (ox.ac.uk)
  • Even though our patient was on pre-filter-replacement CVVH with fluid replacement rates of 1.5-2 L/hr (equivalent to a creatinine clearance (CrCl of approximately 23-29 ml/min)), TC was more consistent with that seen in a patient with mild kidney disease, or a CrCl of 50-80 ml/min. (ikprress.org)
  • Tacrolimus is widely used as an immunosuppressant in liver transplantation, and tacrolimus-induced acute kidney injury (AKI) is a serious complication. (elsevier.com)
  • Neutrophil gelatinase-associated lipocalin in kidney transplantation: A review. (ox.ac.uk)
  • Neutrophil gelatinase-associated lipocalin (NGAL) is a small 25-kDa protein released from kidney tubular cells after harmful stimuli. (unime.it)
  • In the acute phase, hydration is of primary concern in the treatment of rhabdomyolysis because it dilutes the blood and allows the myoglobin and its byproducts to pass more easily through the kidney. (fasterskier.com)
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