TY - JOUR. T1 - Acute kidney injury in pediatric acute decompensated heart failure. AU - Medar, Shivanand S.. AU - Hsu, Daphne T.. AU - Lamour, Jacqueline M.. AU - Aydin, Scott I.. PY - 2015/7/22. Y1 - 2015/7/22. N2 - Objective: Acute kidney injury in adult patients with acute decompensated heart failure is associated with increased mortality. There is limited literature in pediatric patients with acute decompensated heart failure and acute kidney injury. We aim to study acute kidney injury in the pediatric acute decompensated heart failure population and its association with specific outcomes. Design: Retrospective, case-control study. Setting: Cardiac ICU in a childrens tertiary care hospital. Patients: Index admissions of patients younger than 21 years with acute decompensated heart failure between January 2008 and December 2012. Interventions: None. Measurements and Main Results: Index admissions of patients younger than 21 years with acute decompensated heart failure between January 2008 ...

TY - JOUR. T1 - Delivered dose of continuous venovenous hemofiltration predicts outcome in septic patients with acute kidney injury: A retrospective study. AU - Nurmohamed, S.A.. AU - Koning, M.V.. AU - Vervloet, M.G.. AU - Groeneveld, A.B.J.. PY - 2011. Y1 - 2011. U2 - 10.1016/j.jcrc.2010.09.004. DO - 10.1016/j.jcrc.2010.09.004. M3 - Article. C2 - 21036524. VL - 26. SP - 213. EP - 220. JO - Journal of Critical Care. JF - Journal of Critical Care. SN - 0883-9441. IS - 2. ER - ...

Introduction: Acute kidney injury (AKI) is a common postoperative complication of cardiac surgery, which is associated with an increased risk of morbidity and mortality. This study investigated the frequency of postoperative AKI in low risk adult patients undergoing off-pump coronary artery bypass grafting (CABG).Materials & Methods: All consecutive adult patients of American Society of Anesthesiologists (ASA) class II and III, who were transferred to the post-operative cardiac surgery ICU after off-pump CABG and were low risk for AKI from October 2013 to September 2014 at Emam Reza Hospital, Mashhad, Iran were enrolled in this prospective cohort study at a teaching hospital. The patients were explored for AKI development, based on risk-injury-failure-loss- end stage kidney disease (RIFLE) and acute kidney injury network (AKIN) criteria, frequency of metabolic acidosis, hypernatremia, hyperchloremia, and length of stay in ICU.Results: According to the results of the present study, 479 patients with the

The management of perioperative patients with severe acute kidney injury (AKI), and its associated complications, is mostly supportive and includes renal replacement therapy (RRT). Available RRT modalities are intermittent hemodialysis (IHD), peritoneal dialysis (PD), continuous renal replacement therapy (CRRT), and hybrid therapies, known as prolonged intermittent renal replacement therapy (PIRRT). This chapter reviews the current evidence regarding the timing of initiation of RRT, the modality selection, and the critical elements of the RRT prescription for AKI in the postoperative period ...

Background Up to 50% of septic patients develop acute kidney injury (AKI). The pathomechanism of septic AKI is poorly understood. Therefore, we established an innovative rodent model to characterize sepsis-induced AKI by standardized colon ascendens stent peritonitis (sCASP). The model has a standardized focus of infection, an intensive care set up with monitoring of haemodynamics and oxygenation resulting in predictable impairment of renal function, AKI parameters as well as histopathology scoring. Methods Anaesthetized rats underwent the sCASP procedure, whereas sham animals were sham operated and control animals were just monitored invasively. Haemodynamic variables and blood gases were continuously measured. After 24 h, animals were reanesthetized; cardiac output (CO), inulin and PAH clearances were measured and later on kidneys were harvested; and creatinine, urea, cystatin C and neutrophil gelatinase-associated lipocalin (NGAL) were analysed. Additional sCASP-treated animals were investigated

Homeopathy for Acute Renal Failure or Acute Kidney Failure Treatment. Causes, signs, symptoms and management of acute kidney failure & homeopathic medicines.

Objective: To describe patients presenting with acute kidney injury after rhabdomyolysis at a tertiary renal care center in Pakistan. Patients and Methods: An observational cohort of patients identified as having acute kidney injury (AKI) with rhabdomyolysis, which was diagnosed by rise in creatinine phosphokinase (CK) and lactate dehydrogenase (LDH) more than 4 times the reference range whereas AKI was defined according to RIFLE criteria. On ultrasonography, all patients had normal size non obstructed kidneys, and no other co morbid. Results: Between January1990 to December 2014, 334 patients with rhabdomyolysis and AKI registered to this hospital. Mean age was 28.22 ± 11.22 years with M:F ratio of 3.33:1. Mean values of CK and LDH were 597,749.790 ± 180,461.360 and 4077.026 ± 5050.704 U/L with reference range of 26 - 174 U/L and 91 - 180 U/L respectively. We divided the study population into 4 groups over timeline. Rhabdomyolysis etiology was divided in 3 groups; 1) traumatic, 2) non-traumatic

TY - JOUR. T1 - Morphology of ischemic acute renal failure, normal function, and cyclosporine toxicity in cyclosporine-treated renal allograft recipients. AU - Solez, Kim. AU - Racusen, Lorraine C.. AU - Marcussen, Niels. AU - Slatnik, Irena. AU - Keown, Paul. AU - Burdick, James F.. AU - Olsen, Steen. PY - 1993/5. Y1 - 1993/5. N2 - To characterize morphologic changes in the early post-transplant period in cyclosporine-treated renal allograft recipients, we examined biopsies from three groups of cyclosporine-treated patients: normal function (N = 9), ischemic acute renal failure or acute tubular necrosis (N = 12), and cyclosporine toxicity (N = 7). Groups were compared with each other and with previously studied groups of azathioprine-treated patients and native kidney patients. The interstitial infiltrate commonly observed in normally functioning azathioprine-treated grafts was not observed in normally functioning cyclosporine-treated grafts, but two of nine such grafts had a significant ...

TY - JOUR. T1 - Effects of acute kidney injury and chronic kidney disease on long-term mortality after coronary artery bypass grafting. AU - Han, Seung Seok. AU - Shin, Nara. AU - Baek, Seon Ha. AU - Ahn, Shin Young. AU - Kim, Dong Ki. AU - Kim, Sejoong. AU - Chin, Ho Jun. AU - Chae, Dong Wan. AU - Na, Ki Young. PY - 2015/1/1. Y1 - 2015/1/1. N2 - Background Both acute kidney injury (AKI) and chronic kidney disease (CKD) are important issues in patients undergoing coronary artery bypass grafting (CABG), particularly with regard to mortality. However, their synergistic or discrete effects on long-term mortality remain unresolved. Methods A total of 1,899 patients undergoing CABG were retrospectively analyzed. The adjusted hazard ratios for all-cause mortality were calculated after stratifying the timeframes. To evaluate the synergistic effects between AKI and CKD, the relative excess risk due to interaction was applied. Results The presence of AKI, CKD, or both increased the hazard ratios for ...

The occurrences of hyperuricemia and acute kidney injury after antithymocyte globulin treatment are unusual in kidney transplant recipients. Here, we report a unique case of acute kidney injury with extreme hyperuricemia after antithymocyte globulin treatment in a kidney transplant recipient with underlying aplastic anemia. A 40-year-old woman with aplastic anemia who received a kidney transplant 5 years 6 months before presented to our emergency department with complaints of oliguria, generalized edema, and general weakness 6 days after receiving antithymocyte globulin treatment for acute T-cell-mediated rejection. Urinalysis revealed 100 uric acid crystal particles. The blood chemistry test results showed rapid increases in serum creatinine (from 2.86 mg/dL to 5.58 mg/dL) and uric acid levels (from 10.2 mg/dL to 32.7 mg/dL), which suggested acute uric acid nephropathy. Tumor lysis syndrome was suspected to be the cause of the acute uric acid nephropathy; hence, the patient was reevaluated for aplastic

TY - JOUR. T1 - Hyperferritinemia and acute kidney injury in pediatric patients receiving allogeneic hematopoietic cell transplantation. AU - Kurokawa, Mari. AU - Nishiyama, Kei. AU - Koga, Yuhki. AU - Eguchi, Katsuhide. AU - Imai, Takashi. AU - Oba, Utako. AU - Shiraishi, Akira. AU - Nagata, Hazumu. AU - Kaku, Noriyuki. AU - Ishimura, Masataka. AU - Honjo, Satoshi. AU - Ohga, Shouichi. N1 - Publisher Copyright: © 2020, IPNA. Copyright: Copyright 2020 Elsevier B.V., All rights reserved.. PY - 2020/10/1. Y1 - 2020/10/1. N2 - Background: Acute kidney injury (AKI) often occurs in pediatric patients who received allogeneic hematopoietic cell transplantation (HCT). We evaluated the risk and effect of HCT-related AKI in pediatric patients. Methods: We retrospectively studied the survival and renal outcome of 69 children 100 days and 1-year posttransplant in our institution in 2004-2016. Stage-3 AKI developed in 34 patients (49%) until 100 days posttransplant. Results: The 100-day overall survival ...

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.

The Global Continuous Renal Replacement Therapy (CRRT) Market is expected to reach USD 1.4 billion by 2025, according to a new report by Grand View Research, Inc. The magnitude of the global target diseases, such as kidney diseases, and diabetes, is immense, with millions of new cases registered every year. This in turn is anticipated to boost the usage of CRRT treatment procedure.. Increasing incidence of volume overload, uremia, and hyperkalemia is increasing the application of renal replacement therapy, thereby boosting the overall growth of the market. For individuals suffering from acute kidney injury and severe multi-organ dysfunction, CRRT can prove to be beneficial when started early to maintain metabolic and volume homeostasis. In addition, CRRT prevents further worsening and development of symptoms and signs of renal failure. Full Research Report on Global Continuous Renal Replacement Therapy Market Analysis ...

TY - JOUR. T1 - Acute kidney injury in a girl with ulcerative colitis and cytomegalovirus-induced focal segmental glomerular sclerosis. AU - Chirumamilla, Sankar R.. AU - He, Chun. AU - Racusen, Lorraine C.. AU - Scheimann, Ann O.. AU - Cuffari, Carmen. PY - 2013/2/1. Y1 - 2013/2/1. N2 - Background: Mesalamine or 5-aminosalicylic acid (5-ASA) has proven efficacy in treating patients with ulcerative colitis (UC). Although mesalamine is considered safe, it has been associated with acute interstitial nephritis and renal failure. Methods: Herein we present a case of a child with UC who developed acute renal failure on mesalamine therapy. Results: A 15-year-old African-American girl with well-controlled UC presented to the Johns Hopkins Hospital with a four-day history of high fever, malaise, generalized body aches, and productive non-bloody cough. Over the next three days, she developed acute renal failure with fluid retention, and elevated serum creatinine and blood urea nitrogen. A kidney biopsy ...

Erythropoietin (EPO) is a well-known hormone that is clinically used for the treatment of anemia. Very recently, an increasing body of evidence showed that EPO could still regulate bioactivities of macrophages. However, the details about the immunomodulatory effect of EPO on macrophages are not fully delineated, particularly in the setting of renal damages. Therefore, in the present study, we determined whether EPO could exert an impact on the dynamics of macrophages in a well-established model of rhabdomyolysis-induced acute kidney injury and explored the potential mechanisms. EPO was found to ameliorate kidney injuries by reducing macrophages recruitment and promoting phenotype switch toward M2 macrophages in vivo. It was also confirmed that EPO could directly suppress pro-inflammatory responses of M1 macrophages and promote M2 marker expression in vitro. Data indicated the possible involvement of Jak2/STAT3/STAT6 pathway in the augmentation of EPO on M2 polarization. These results improved the

Renal replacement therapy (RRT) is a fully established treatment for critically ill patients with acute kidney injury (AKI) but there are no scientifically established criteria when to initiate it. Our objectives were to describe the epidemiology of critically ill patients with AKI receiving RRT and to evaluate the relationship between biochemical, physiological and comorbid factors at time of RRT and ICU mortality. Retrospective analysis of demographic and physiologic data of 1,847 patients who received RRT for AKI in 22 ICUs in UK and Germany between 1989 - 1999. 54.1% of RRT patients died in ICU. ICU survivors were younger, had a lower APACHE II score and fewer failed organ systems on admission to ICU compared to non-survivors. Multivariate analysis showed that at time of initiation of RRT, independent risk factors for ICU mortality were mechanical ventilation [odds ratio (OR) 6.03], neurological failure (OR 2.48), liver failure (OR 2.44), gastrointestinal failure (OR 2.04), pre-existing chronic

TY - THES. T1 - Kidney transplantation from donors after cardiac death : studies on the pathophysiology and prevention of ischemic acute kidney injury and on the long-term outcome after transplantation. AU - Snoeijs, M.G.. PY - 2010/1/1. Y1 - 2010/1/1. N2 - Kidney transplantation is the best treatment for patients with terminal kidney insufficiency, but due to a shortage of donor kidneys many people are deprived from this optimal care. Organ donation after a cardiac arrest can make the number of kidney transplantations rise and shorten or even eliminate the waiting list for kidney transplantations. However, because these donor kidneys are damaged by ischemia in the period between the cardiac arrest and organ preservation, there is a reticence to accept these donor kidneys. For this reason this dissertation closely studies the entire transplantation process from donor to receiver to find clinically usable methods that can prevent this primary non-function of donor kidneys after a cardiac arrest. ...

There is an increasing incidence and prevalence of AKI globally [1, 7, 11] and severe AKI is associated with increased mortality up to greater than 50% [12-14]. In the absence of effective pharmacologic interventions for severe AKI, renal replacement therapy remains the main supportive management, and therefore is one of the critical aspects for improvement to achieve the goal of ISN AKF 0 by 25. However, up to now little is known about the need, availability, and maneuverability of RRT in the clinical practice in developing countries. Based on the nationwide survey of AKI in over 2 million adult hospitalizations, we were able to estimate the burden of RRT need and the real state of RRT performance in Mainland China [9].. Although there are some disagreements about the optimal timing for initiating RRT in AKI patients, there is no doubt that RRT should be performed in patients with life-threatening conditions including overt fluid imbalance, electrolyte abnormalities, acid-base disturbances, ...

Exposure to renin angiotensin aldosterone system blockade (i.e. RAASB) may have a protective effect in patients with hospital-acquired acute kidney injury (AKI), according to new research presented at the National Kidney Foundations 2015 Spring Clinical Meetings.

John R Prowle and Rinaldo Bellomo. We thank Dr MacLaren for his comments. We agree that such induction therapy is mandatory in situations of severe hyperkalemia (,8.0 mmol), especially when ongoing potassium release is taking place (for example, rhabdomyolysis). Although such reasoning and therapeutic adjustment seemed obvious to us, we agree that making them explicit is important.. We would also like to emphasize several important aspects of adjustments to unique cases. First, avoidance of often ineffective and delayed interventions in critically ill patients with severe acute kidney injury [3] and early CRRT as applied in the RENAL (Randomised Evaluation of Normal versus Augmented Level of Replacement Therapy) trial [4-6] are key to preventing such life-threatening events in the first place. In this regard, in the RENAL trial, only 6 out of 1,454 (0.4%) patients with baseline electrolyte values had a potassium level ,8 mmol/L. Second, faster solute removal can be achieved by the application ...

Acute kidney injury (AKI) is increasingly common around the world. Because of the low availability of effective therapies and resource limitations, early preventive and therapeutic measures are essential to decrease morbidity, mortality, and cost. Timely recognition and diagnosis of AKI requires a heightened degree of suspicion in the appropriate clinical and environmental context. In low- and middle-income countries (LMICs), early detection is impaired by limited resources and low awareness. In this article, we report the consensus recommendations of the 18th Acute Dialysis Quality Initiative meeting in Hyderabad, India, on how to improve recognition of AKI. We expect these recommendations will lead to an earlier and more accurate diagnosis of AKI, and improved research to promote a better understanding of the epidemiology, etiology, and histopathology of AKI in LMICs.

Abstact：objective To investigate acute kidney injury (AKI) in children with acute lymphoblastic leukemia (ALL) who received high dose methotrexate (MTX) chemotherapy and explore the corresponding treatment. Methods 180 children who received high dose MTX chemotherapy were observed with serum MTX concentration and serum creatinine. Patients with AKI of stage 3 or poor response to conventional treatment were performed on hemodialysis and assessed the treatment outcome. Results 9 patients (5%) have appeared AKI, including 7 cases of AKI of stage 3. However, there were not any significant correlation between age, gender, serum MTX concentration and AKI, respectively. Compared with normal serum MTX concentration, the patients with high serum MTX concentration easily were developed to AKI, the MTX and serum creatinine concentration had been significantly decreased in 9 patients after hemodialysis. Conclusion AKI has appeared in some children with ALL who receive high dose MTX chemotherapy, and this may due

Management of patients with acute kidney injury (AKI). As a small district general hospital we dont have a dedicated on site renal team therefore patients are at increased risk of delayed recognition and gaps in reliable timely and efficient care. To combat this I introduced an AKI strategy consisting of the NHS AKI algorithm, a concise care bundle with clear guidance and a response team who would be alerted to patients with AKI stage 2 and 3 alerts to enable them to be quickly reviewed. ...

Objectives: To measure plasma pro-apoptotic and pro-necrotic activity in severe acute kidney injury (AKI) patients within a randomized controlled trial of continuous veno-venous hemofiltration with high cut-off filters (CVVH-HCO) versus standard filters (CVVH-Std). Methods: We measured pro-apoptotic and pro-necrotic plasma activity by trypan blue exclusion cell viability assay, detection of DNA fragmentation, and by determination of caspase-3 activity and annexin V-based apoptosis and necrosis detection assay. Results: Compared to no apoptosis or necrosis after incubation with healthy plasma, 14-18% of cells showed apoptosis and 4-8% showed necrosis after incubation with plasma from AKI patients. When comparing different measures of pro-apoptotic or pro-necrotic activity, CVVH-HCO and CVVH-Std showed no differential effects on such activity, which remained high over the first 3 days of treatment. However, using annexin V-FITC, there was a significant drop in pro-apoptotic activity across the filter

Acute Kidney Injury in Patients With Cirrhosis and Hepatorenal Syndrome answers are found in the Washington Manual of Medical Therapeutics powered by Unbound Medicine. Available for iPhone, iPad, Android, and Web.

Acute Kidney Injury in Patients With Cirrhosis and Hepatorenal Syndrome answers are found in the Washington Manual of Medical Therapeutics powered by Unbound Medicine. Available for iPhone, iPad, Android, and Web.

Different forms of acute kidney injury (AKI) have been associated with endoplasmic reticulum (ER) stress; these include AKI caused by acetaminophen, antibiotics, cisplatin, and radiocontrast. Tunicamycin (TM) is a nucleoside antibiotic known to induce ER stress and is a commonly used inducer of AKI. 4-phenylbutyrate (4-PBA) is an FDA approved substance used in children who suffer from urea cycle disorders. 4-PBA acts as an ER stress inhibitor by aiding in protein folding at the molecular level and preventing misfolded protein aggregation. The main objective of this study was to determine if 4-PBA could protect from AKI induced by ER stress, as typified by the TM-model, and what mechanism(s) of 4-PBAs action were responsible for protection. C57BL/6 mice were treated with saline, TM or TM plus 4-PBA. 4-PBA partially protected the anatomic segment most susceptible to damage, the outer medullary stripe, from TM-induced AKI. In vitro work showed that 4-PBA protected human proximal tubular cells from

Abstract: Objective To evaluate the value of cystatin C(CysC)in early diagnosis and prognostic prediction of acute kidney injury(AKI)in patients with liver cirrhosis. Methods Serum levels of CysC and creatinine(SCr)were detected in 825 patients with liver cirrhosis,and the dynamic changes observed.Employing Child-Pugh grading of liver cirrhosis,the incidence of cirrhosis at different levels was analyzed.The relation ship between CysC,SCr and their abnormal rates,association of liver cirrhosis complicated with AKI with its prognosis was analyzed. Results The levels of CysC in the patients gradually elevated and the detection rate of abnormal CysC markedly increased along with heightened of Child-Pugh grading,the indifferences among each grade was significant(F=292.21,q=7.12-19.36,P,0.01;χ~2=24.96,P,0.01).The level of CysC was also elevated along with increased damage of liver function(F=345.56;q=12.48,16.35;P,0.01).The detection rate of abnormal SCr in grade C was higher than that in grades A ...

Acute kidney injury frequently accompanies sepsis. Endotoxin is known to reduce tissue levels of cAMP and low levels of cAMP have been associated with renal injury. We, therefore, hypothesized that endotoxin induced renal injury by activating phosphodiesterase 3 (PDE3) which metabolizes cAMP and that amrinone an inhibitor of PDE3 would prevent the renal injury. Animals were divided into three groups (n = 7/group): 1) Control (0.9% NaCl infusion without LPS); 2) LPS (0.9% NaCl infusion with LPS); 3) Amrinone+LPS (Amrinone infusion with LPS). Either lipopolysaccharide (LPS) or vehicle was injected via the jugular vein and the rats followed for 3 hours. We explored the expression of PDE3 isoenzymes and the concentrations of cAMP in the tissue. The PDE3B gene but not PDE3A was upregulated in the kidney of LPS group. Immunohistochemistry also showed that PDE3B was expressed in the distal tubule in the controls and LPS caused PDE3B expression in the proximal as well. However, PDE3A was not expressed in the

While enhanced recovery protocols (ERPs) reduce physiologic stress and improve outcomes in general, their effects on postoperative renal function have not been directly studied. Patients undergoing major colorectal surgery under ERP (February 2010 to March 2013) were compared with a traditional care control group (October 2004 October 2007) at a single institution. Multivariable regression models examined the association of ERP with postoperative creatinine changes and incidence of postoperative acute kidney dysfunction (based on the Risk, Injury, Failure, Loss, and End-stage renal disease criteria). Included were 1054 patients: 590 patients underwent surgery with ERP and 464 patients without ERP. Patient demographics were not significantly different. Higher rates of neoplastic and inflammatory bowel disease surgical indications were found in the ERP group (81 vs. 74%, p = 0.045). Patients in the ERP group had more comorbidities (ASA ≥ 3) (62 vs. 40%, p | 0.001). In unadjusted analysis, postoperative

GE Healthcare and Osprey Medical Inc. (ASX:OSP) ( Osprey) today announced a strategic alliance under which GE Healthcare will exclusively distribute Osprey s product portfolio in Europe, Russia, Middle East, Africa, Central Asia and Turkey. Osprey s DyeVert contrast minimization devices, complemented by GE Healthcare s range of iodinated x-ray contrast media, offer healthcare professionals a technology platform to address the rising problem of Acute Kidney Injury (AKI) following inter...

Peroxisome proliferator-activated receptor-alpha (PPAR alpha) activation attenuates cisplatin (CP)-mediated acute kidney injury by increasing fatty acid oxidation, but mechanisms leading to reduced renal triglyceride (TG) accumulation could also contribute. Here, we investigated the effects of PPAR alpha and CP on expression and enzyme activity of kidney lipoprotein lipase (LPL) as well as on expression of angiopoietin protein-like 4 (Angptl4), glycosylphosphatidylinositol-anchored-HDL-binding protein (GPIHBP1), and lipase maturation factor 1 (Lmf1), which are recognized as important proteins that modulate LPL activity. CP caused a 40% reduction in epididymal white adipose tissue (WAT) mass, with a reduction of LPL expression and activity. CP also reduced kidney LPL expression and activity. Angptl4 mRNA levels were increased by ninefold in liver and kidney tissue and by twofold in adipose tissue of CP-treated mice. Western blots of two-dimensional gel electrophoresis identified increased ...

Background Acute kidney injury (AKI) after coronary artery bypass grafting (CABG) is associated with a less favorable outcome. The aim of this study is to investigate the incidence, mortality and risk...

To the Editors: We read with great interest the review by Steen and colleagues (1) on the outcome of scleroderma renal crisis before and after the availability of angiotensin converting enzyme (ACE) inhibitors. Of the 55 patients in the study who had scleroderma renal crisis, the continuation or acceleration of renal insufficiency in 4 patients raised the question of captopril-related renal toxicity. The authors concluded that Captopril could not have caused renal deterioration in these patients because none of the 4 patients had peripheral blood or urine eosinophilia or improvement of renal failure after withdrawal of captopril.. We wish to ...

Clemens, M. (2016) Critical Care Medicine. 44(10). pp.e915-e922 Objective: To evaluate the association between acute respiratory distress syndrome and acute kidney injury with respect to their contributions to mortality in critically ill patients. Design: Retrospective analysis of consecutive adult burn patients requiring mechanical ventilation. Setting: A 16-bed burn ICU at tertiary military teaching hospital. Patients:…

Substances, such as medicines that are toxic to the kidneys. Many substances that are not toxic to the kidneys in a healthy person may become toxic in a person who has existing kidney problems or another condition that increases his or her risk of acute kidney injury, such as heart failure, diabetes, or multiple myeloma. Be safe with medicines. Read and follow all instructions on the label ...

Circulating endothelial microparticles: a promising biomarker of acute kidney injury after cardiac surgery with cardiopulmonary bypass

INDIANAPOLIS -- Scientists at Indiana University have identified a therapy that could help reverse damage from acute kidney injury and eliminate the need for dialysis treatment in the future.. Acute kidney injury commonly occurs after either cardiac surgery or prolonged vascular surgery procedures, said lead researcher Dr. Robert L. Bacallao, associate professor of medicine at IU School of Medicine. It can also occur with blood loss from trauma, so its a frequent problem for the military.. Its almost like a classic cable-TV problem, he said. If you have a good cable running through your neighborhood, but then the last 10 feet going to your house doesnt work, as far as youre concerned, you have bad cable. Thats what were seeing in acute kidney injury: Its that last little bit that seems to be affected, and this procedure repairs that.. The researchers found that in rat models, delivering hydrodynamic isotonic fluid to the left renal vein within 24 hours after acute kidney injury ...

Sodium bicarbonate supplements for treating acute kidney injury: Cochrane systematic review answers are found in the Cochrane Abstracts powered by Unbound Medicine. Available for iPhone, iPad, Android, and Web.

A prospective, observational study to determine the outcome of patients with acute kidney injury in pediatric intensive care unit

TY - JOUR. T1 - Association of early hypotension in pediatric sepsis with development of new or persistent acute kidney injury. AU - Fitzgerald, Julie C.. AU - Ross, Michelle E.. AU - Thomas, Neal J.. AU - Weiss, Scott L.. AU - Balamuth, Fran. AU - Chilutti, Marianne. AU - Grundmeier, Robert W.. AU - Anderson, Amanda Hyre. N1 - Funding Information: This study was supported by the Division of Critical Care Medicine Russell Raphaely, endowed chair of Critical Care Medicine at the Childrens Hospital of Philadelphia. Dr. Fitzgerald was supported by the National Institutes of Health [grant number R43-HD096961]. Dr. Weiss was supported by the National Institutes of Health [grant number K23-GM110496]. Dr. Balamuth was supported by the National Institutes of Health [grant number K23-HD082368]. Dr. Anderson is supported by the National Institutes of Health [grant numbers R01-DK104730 and R01-DK107566] and has received travel and consulting fees from Kyowa Hakko Kirin. Publisher Copyright: © 2020, IPNA. ...

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies. ...

Video articles in JoVE about acute kidney injury include Precise Cellular Ablation Approach for Modeling Acute Kidney Injury in Developing Zebrafish, Ischemia-reperfusion Model of Acute Kidney Injury and Post Injury Fibrosis in Mice, Nephrotoxin Microinjection in Zebrafish to Model Acute Kidney Injury, Standardized Colon Ascendens Stent Peritonitis in Rats - a Simple, Feasible Animal Model to Induce Septic Acute Kidney Injury, Intravenous Microinjections of Zebrafish Larvae to Study Acute Kidney Injury, Analysis of Nephron Composition and Function in the Adult Zebrafish Kidney, Renal Ischaemia Reperfusion Injury: A Mouse Model of Injury and Regeneration, Kidney Regeneration in Adult Zebrafish by Gentamicin Induced Injury, Isolation of Double Negative αβ T Cells from the Kidney, Techniques to Assess Kidney Function in Mouse Models of Glomerular Disease, Use of a Hanging-weight System for Isolated Renal Artery Occlusion, Phenotypic Characterization of Macrophages from Rat Kidney

Patient was hemodynamically and respiratory stable at all times, however he exhibited extremely elevated rhabdomyolysis and retention parameters (CK, 130,000 U/L, lactate dehydrogenase (LDH) 3672 U/L, glutamate oxalacetate transaminase (GOT) 651 U/L creatinine 9.4 mg/dl, urea 174 mg/dl) and an increased troponin T (142 pg / ml) and CRP (19.5 mg / dl), indicative of rhabdomyolysis from multifactorial genesis (trauma and intoxication ...

Bellomo R, Ronco C, Kellum JA, Mehta RL, Palevsky P; Acute Dialysis Quality Initiative workgroup. Acute renal failure - definition, outcome measures, animal models, fluid therapy and information technology needs: the Second International Consensus Conference of the Acute Dialysis Quality Initiative (ADQI) Group. Crit Care. 2004 Aug;8(4):R204-12. Epub 2004 May 24. [Medline] ...

Objective(s): Renal ischemia-reperfusion injury (IRI) as a severe condition of acute kidney injury (AKI) is the most common clinical problem with high mortality rates of 35-60% deaths in hospital. Mesenchymal stem cells (MSC) due to unique regenerative characteristics are ideal candidates for the treatment of the ischemic injuries. This work is focused on the administration of MSC to IRI-induced AKI Wistar rats and evaluating their significance in AKI treatment. Material and Methods: Animals underwent surgical procedure and AKI was induced by 40 min bilateral renal pedicle clamping. Immediately after reperfusion, 2×106 rat bone marrow derived MSCs were injected via intra-parenchymal or intra-aortic route. Results: Animals subjected to AKI after days 1 and 3 showed significant increase in the serum creatinine and blood urea nitrogen (BUN) concentration along with a declined glomerular filtration rate (GFR) when compared with non-ischemic animals. On the other hand, treated animals showed a significant

There are two types of kidney failure: acute kidney failure and chronic kidney failure.. Acute kidney failure which is also known as acute renal failure is a condition that happens suddenly(within a few days) causing the kidneys to lose their ability to perform their functions of eliminating excess salts, water, and harmful products in the blood. Chronic kidney failure is a gradual loss of the kidneys to function over time.. When a person has kidney disease, the symptoms begin to appear in stages. Kidney failure is the final stage of chronic kidney disease when the kidney Glomerular filtration rate (GFR) falls below 15. It is also known as an end-stage renal disease (ESRD) and at this stage, the kidney stops functioning properly. Kidneys filter the blood and eliminate the excess wastes from the blood that are directed to the bladder and are removed during urination.. When the kidneys are unable to perform their function sufficiently, toxins can accumulate in the body leading to complications. ...

Acute renal failure (ARF) is rarely an isolated process but is often a complication of underlying conditions such as sepsis, trauma, and multiple-organ failure in critically ill patients. As such, concomitant clinical conditions significantly affect patient outcome. Poor nutritional status is a major factor in increasing patients morbidity and mortality. Malnutrition in ARF patients is caused by hypercatabolism and hypermetabolism that parallel the severity of illness. When dialytic intervention is indicated, continuous renal replacement therapy (CRRT) is a commonly used alternative to intermittent hemodialysis because it is well tolerated by hemodynamically unstable patients. This paper reviews the metabolic and nutritional alterations associated with ARF and provides recommendations regarding the nutritional, fluid, electrolyte, micronutrient, and acid-base management of these patients. The basic principles of CRRT are addressed, along with their nutritional implications in critically ill ...

TY - JOUR. T1 - Neutrophil Gelatinase-Associated Lipocalin Is Not Associated with Tacrolimus-Induced Acute Kidney Injury in Liver Transplant Patients Who Received Mycophenolate Mofetil with Delayed Introduction of Tacrolimus. AU - Fukuda, Mio. AU - Suetsugu, Kimitaka. AU - Tajima, Soichiro. AU - Katsube, Yurie. AU - Watanabe, Hiroyuki. AU - Harada, Noboru. AU - Yoshizumi, Tomoharu. AU - Egashira, Nobuaki. AU - Mori, Masaki. AU - Masuda, Satohiro. PY - 2019/6/25. Y1 - 2019/6/25. N2 - Tacrolimus is widely used as an immunosuppressant in liver transplantation, and tacrolimus-induced acute kidney injury (AKI) is a serious complication. The urinary neutrophil gelatinase-associated lipocalin (NGAL) level has been linked to tacrolimus-induced AKI in patients starting tacrolimus treatment the morning after liver transplantation. Here we tested this association using a different immunosuppression protocol: Mycophenolate mofetil administration beginning on Postoperative Day 1 and tacrolimus administration ...

Keywords: Acute kidney injury, chronic kidney disease, end stage renal disease (ESRD), general anesthesia, hemodialysis, intraoperative hypotension, preventative nephrology.. Abstract: Background/Objective: Intraoperative hypotension (IOH) invariably follows the induction of general anesthesia during surgical operations. The current prevailing and predominant consensus is that IOH has immense clinical benefits such as reduced bleeding, less need for blood transfusions, and shorter surgery times. Simultaneously, it is assumed that IOH is devoid of adverse renal, hepatic and neurological consequences. Emerging new evidence and our experiences suggest a strong link between IOH and postoperative acute kidney injury (AKI). Method/Case Reports: We report on three case presentations to illustrate the impact of IOH on postoperative AKI. Conclusion: Our recent experiences suggest and show a link between IOH and postoperative AKI. Sun et al. (2015) recently demonstrated that postoperative AKI was ...

Nephropathia epidemica (NE) is a mild form of hemorrhagic fever with renal syndrome (HFRS) that is caused by the Puumala virus. Periodic outbreaks have been described in endemic areas, with a substantial number of previously healthy individuals developing acute kidney injury (AKI). There is a considerable diversity in the clinical course of the disease, and few patients require renal replacement therapy. We tested whether urinary neutrophil gelatinase associated lipocalin (uNGAL), urine albumin/creatinine ratio (uACR), urine protein/creatinine ratio (uPCR), urine dipstick protein, C-reactive protein, procalcitonin, leukocyte and platelet count, determined on admission to the hospital, can predict the severity of AKI. Sixty-one patients were analyzed during admission in the emergency department. The variables most strongly associated with peak plasma creatinine concentration were uNGAL (β = 0.70, p |0.0001), uPCR (β = 0.64, p = 0.001), uACR (β = 0.61, p = 0.002), and dipstick proteinuria (β = 0.34, p

Abstract Elderly is the main age group affected by acute kidney injury (AKI). There are no studies that investigated the predictive properties of urinary (u) NGAL as an AKI marker in septic elderly population. This study aimed to evaluate the efficacy of uNGAL as predictor of AKI diagnosis and prognosis in elderly septic patients admitted to ICUs. We prospectively studied elderly patients with sepsis admitted to ICUs from October 2014 to November 2015. Assessment of renal function was performed daily by serum creatinine and urine output. The level of uNGAL was performed within the first 48 hours of the diagnosis of sepsis (NGAL1) and between 48 and 96 hours (NGAL2). The results were presented using descriptive statistics and area under the receiver operating characteristic curve (AUC-ROC) and p value was 5%. Seventy-five patients were included, 47 (62.7%) developed AKI. At logistic regression, chronic kidney disease and low mean blood pressure at admission were identified as factors associated ...

Diagnosis of acute kidney injury (AKI) relies on a late marker, namely serum creatinine (SCr). New biomarkers are considered for early and sensitive detection of CIN. In particular, uNGAL has been used for early detection of AKI in the emergency department, after cardiopulmonary bypass or following CM administration.. This study will be conducted to assess the possible value of urinary Neutrophil Gelatinase-Associated Lipocalin (uNGAL) as an early detector of contrast-induced nephropathy (CIN) in a large sized cohort of patients undergoing percutaneous coronary procedures (PCP) and whether or not uNGAL correlates with the volume of contrast medium (CM) used. ...

Acute kidney injury (AKI) is a devastating potential consequence of renal ischaemia and reperfusion (I-R) subsequent to severe intra-operative hypotension and fluid resuscitation. Acute tubular epithelial damage is a common early histological abnormality in this syndrome. The high mortality rate associated with AKI in dogs is attributed in part to the limitations of current diagnostic techniques that can only detect AKI in the late stages when damage is irreversible. Early detection of renal tubular injury could improve outcome and might be possible by measuring urinary neutrophil gelatinase-associated lipocalin concentration (uNGAL) in at-risk dogs.. The objectives of this study were to establish a clinically relevant canine model of renal I-R injury, and use this model to determine changes in uNGAL within three hours of initiation of injury.. A pilot study was performed to establish the severity and duration of hypotension caused by haemorrhage, and duration of reperfusion, that produced ...

TY - JOUR. T1 - Assessing continuous renal replacement therapy as a rescue strategy in cardiorenal syndrome 1. AU - Prins, Kurt W.. AU - Wille, Keith M.. AU - Tallaj, Jose A.. AU - Tolwani, Ashita J.. PY - 2015/12/18. Y1 - 2015/12/18. N2 - Background Patients with acute decompensated heart failure (ADHF) and cardiorenal syndrome (CRS) 1 have poor outcomes. Ultrafiltration (UF) is used to mechanically remove salt and water in ADHF patients with diuretic resistance. However, little is known about the outcomes of ADHF patients on inotropes and/or vasopressors who require continuous renal replacement therapy (CRRT) for both UF and solute clearance in severe acute kidney injury. Methods We retrospectively analyzed 37 consecutive critically ill patients who were admitted for ADHF from 2005-13 and were on inotropes and/or vasopressors at the time of CRRT initiation. The primary outcome was in-hospital mortality. Results In-hospital mortality rate was 62%. Median survival was 15.5 days after CRRT ...

TY - JOUR. T1 - Rhabdomyolysis with acute kidney injury in deceased donors is not a contraindication for kidney donation. AU - Joshi, Shivam. AU - Ayyathurai, Rajinikanth. AU - Eldefrawy, Ahmed. AU - Aminsharifi, Jason. AU - Ekwenna, Obi. AU - Sageshima, Junichiro. AU - Chen, Linda. AU - Burke, George. AU - Ciancio, Gaetano. PY - 2012/8/1. Y1 - 2012/8/1. N2 - Purpose Deceased patients with acute kidney injury (AKI) from rhabdomyolysis can be considered as potential kidney donors. Methods: We performed a retrospective chart review from January 2005 to January 2011 of three donors with AKI from rhabdomyolysis and the four recipients of the donated kidneys. Three donors had AKI from rhabdomyolysis as evidenced by elevated serum creatinine levels, myoglobinuria, and plasma creatinine kinase levels greater than five times the upper limit of normal. All grafts were maintained on pulsatile machine perfusion (MP) prior to transplantation. In one of the patients, serial venous perfusate myoglobin levels ...

A case of acute renal failure due to Hydroxyethyl Starch,Hydroxyethyl Starch (HES) commonly is widely used as plasma volume expander. They are often used preoperatively and in cases of hypovolemia.

Objective: The aim of this study was to investigate whether acute kidney injury (AKI) after coronary artery bypass grafting can be attributed to intraoperative hypotension during cardiopulmonary bypass (IOH-CPB). Design: Retrospective analysis. Setting: Tertiary-care hospital. Participants: Patients undergoing on-pump coronary artery bypass grafting from June 2011 to January 2014. Interventions: ... read more None. Measurements and Main Results: IOH-CPB was defined as blood pressure below several absolute and relative mean arterial pressure (MAP) thresholds and as the area under the curve for absolute MAP thresholds. AKI was defined as an absolute increase in serum creatinine of≥26 μmol/L within 48 hours or an increase to 150% or more within 7 days of surgery. Poisson regression with robust standard errors both before and after adjustment for confounders was used. Of the 1,891 patients included, 386 (20%) developed AKI. In univariable analysis, all IOH-CPB thresholds defined as a MAP of 50 ...

Different molecular forms of urinary neutrophil gelatinase-associated lipocalin (NGAL) have recently been discovered. We aimed to explore the nature, source and discriminatory value of urinary NGAL in

TY - JOUR. T1 - Ghrelin protects mice against endotoxemia-induced acute kidney injury. AU - Wang, Wei. AU - Bansal, Shweta. AU - Falk, Sandor. AU - Ljubanovic, Danica. AU - Schrier, Robert. PY - 2009/10/1. Y1 - 2009/10/1. N2 - Acute kidney injury (AKI) in septic patients drastically increases the mortality to 50-80%. Sepsis is characterized by hemodynamic perturbations as well as overwhelming induction of proinflammatory cytokines. Since ghrelin has been shown to have anti-inflammatory properties, we hypothesized that ghrelin may afford renal protection during endotoxemia-induced AKI. Studies were conducted in a normotensive endotoxemia-induced AKI model in mice by intraperitoneal injection of 3.5 mg/kg LPS. Serum ghrelin levels were increased during endotoxemia accompanied by increased ghrelin receptor (GHSR-1a) protein expression in the kidney. Ghrelin administration (1.0 mg/kg sc 6 h and 30 min before and 14 h after LPS) significantly decreased serum cytokine levels (TNF-α, IL-1β, and IL-6) ...

TY - JOUR. T1 - Acute Kidney Injury in Pregnancy. AU - Jim, Belinda. AU - Garovic, Vesna D. PY - 2017/7/1. Y1 - 2017/7/1. N2 - Summary: Pregnancy-related acute kidney injury (AKI) has declined in incidence in the last three decades, although it remains an important cause of maternal and fetal morbidity and mortality. Pregnancy-related causes of AKI such as preeclampsia, acute fatty liver of pregnancy, HELLP (Hemolysis, Elevated Liver function tests, Low Platelets) syndrome, and the thrombotic microangiopathies (thrombotic thrombocytopenic purpura, atypical hemolytic-uremic syndrome [HUS]) exhibit overlapping features and often present as diagnostic dilemmas. Differentiating among these conditions may be difficult or impossible based on clinical criteria only. In difficult and rare cases, a renal biopsy may need to be considered for the exact diagnosis and to facilitate appropriate treatment, but the risks and benefits need to be carefully weighed. The use of eculizumab for the treatment of ...

One-hundred and eighty-one patients (66.1%) were men; mean age was 68.2 ± 12.2 years. Valve replacement was performed in 123, coronary artery bypass graft (CABG) in 81, valve surgery + CABG in 48, cardiac transplant in five, aorta aneurism surgery in nine, and other procedures in eight patients. ICU and hospital stays were 6.7 ± 8.1 and 15.7 ± 13.9 days, respectively. Renal replacement therapy (RRT) was required in 16 patients (5.8%) within 48 hours of ICU stay and in 28 patients (10.2%) within 43weeks. Mortality at 28 days was 2.9%. Eighty-six patients (31.4%) were diagnosed with AKI within 48 hours of surgery. Area under the ROC curve of POST uNGAL for AKI diagnosis was 0.72 (0.66 to 0.79) (P 0.0001) at an optimal cutoff value of 1803 μg/l, with 78.7% specificity, 64% sensitivity and 74.1% accuracy. uNGAL advanced diagnosis of AKI in 44 patients (51.2%), whereas diagnosis was achieved at the same time as AKI criteria in 11 patients; AKI criteria outperformed uNGAL in only 36% of cases. ...

AKI occurs frequently in the hospital setting and affects morbidity, mortality, and resource use, regardless of country, etiology, setting, or definition. In current practice, AKI is identified by a large, persistent increase in serum creatinine levels. However, physicians want to diagnose AKI as early as possible, and the serum creatinine increase happens days after AKI occurs. Early changes in serum creatinine are not particularly ...

According to the latest report published by Credence Research, Inc. Continuous Renal Replacement Therapy Market - Growth, Future Prospects and Competitive Analysis, 2017-2025, the global continuous renal replacement therapy market was valued at US$ 856.2 Mn in 2016, and is expected to reach US$ 1,653.8 Mn by 2025, expanding at a CAGR of 7.47% from 2017 to 2025.. Browse the full report Continuous Renal Replacement Therapy Market - Growth, Future Prospects and Competitive Analysis, 2017-2025 at http://www.credenceresearch.com/report/continuous-renal-replacement-therapy-market. Market Insights Acute dialysis-dependent renal failure is a common issue in ICU patients. Despite significant improvement in patient care in ICUs, the mortality arising from acute renal failure in ICU remains at over 50%. Over the past 20 years, significant improvement has taken place in the field of hemodialysis and the approach to the treatment of acute renal failure has underwent transformation. Use of novel, user ...

Porphyran is a sulfate galactan in the cell wall of Porphyra. Its acid hydrolysis product, oligo-porphyran (OP), was prepared and the structure studied by electrospray ionization time-of-flight mass spectrometry (ESI-TOF-MS). This oligosaccharide was mainly composed of monosulfate-oligo-galactan, disufate-oligo-galactan, trisulfate-oligo-galactan, trisulfate oligo-methyl-galactan, and 3,6-anhydrogalactose with the degree of polymerization ranging from 1 to 8. The effects of OP were investigated in the glycerol-induced acute renal failure (ARF) model. Compared with the normal group, rats from the glycerol-induced group exhibited collecting duct and medullary ascending limb dilation and casts. The OP-treated group exerted a protective effect against glycerol-induced changes. The results showed that the administration of OP markedly decreased mortality in female ARF rats. For male ARF rats, all of which survived, OP significantly decreased the blood urea nitrogen and serum creatinine levels. Ion levels in

Brown, M.R., Cianciolo, R.E., Nabity, M.B., Brown, C.A., Clubb, F.J. and Lees, G.E. (2013), Masitinib-Associated Minimal Change Disease with Acute Tubular Necrosis Resulting in Acute Kidney Injury in a Dog. Journal of Veterinary Internal Medicine, 27: 1622-1626. doi: 10.1111/jvim.12189 ...

敗血症（Sepsis）是造成急性腎損傷（Acute kidney injury, AKI）的主因，而AKI又為敗血症患者死因之一，研究認為NGAL（Neutrophil gelatinase-associated lipocalin）可作為預測AKI的生物標誌，但因NGAL又為感染及全身性發炎的生物標誌，可能受多重因素干擾。目前AKI患者可依RIFLE（Risk、Injury、Failure、Loss of kidney function及End-stage kidney disease）分級，若腎臟代替療法（Renal replacement therapy）於RIFLE-Failure（F）期之前進行，可提升治療結果，但AKI患者接受腎臟代替療法時機仍未有共識，因此發表於《Journal of the Formosan Medical Association》的最新文章評估血漿中NGAL及細胞激素是否可作為預測RIFLE-F及啟動腎臟代替療法的生物標誌。試驗中，30位健康受試者及85位患者接受採血，分析肌酸酐（creatinine, ...

Neutrophil gelatinase-associated lipocalin (NGAL) is a small 25-kDa protein released from kidney tubular cells after harmful stimuli. 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. However, recent studies also suggest a possible role for NGAL in chronic kidney disease (CKD). For this reason we evaluated serum (sNGAL) and urinary NGAL (uNGAL) in a cohort of CKD patients in order to verify the relationship with the severity of renal impairment. In CKD patients sNGAL, uNGAL and the fractional excretion of this protein were notably increased as compared to controls. Furthermore both sNGAL and uNGAL were correlated with serum creatinine and, inversely, with residual glomerular filtration rate (GFR): this last relationship was found to be even closer than that found between GFR and serum ...

Metformin is recommended as the treatment of choice in patients with type 2 diabetes mellitus because of its efficacy, general tolerability and low cost.. Recent guidelines have extended the use of metformin to patients with Chronic Kidney Disease (CKD) up to stage III. However, in the recent literature, cases of MALA (metformin-associated lactic acidosis) are increasingly reported. MALA is the most dangerous side effect of the drug, with an incidence rate of 2-9 cases per 100000 person-years of exposure.. We report on two patients with accidental metformin overdose, severe lactic acidosis and acute kidney injury. In both cases, the usual dose of metformin was inappropriate with respect to the level of kidney dysfunction (CKD stage III). As both patients met the criteria for renal replacement therapy in metformin poisoning, they were treated effectively with sustained low-efficiency dialysis until normalization of serum lactate and bicarbonate values. Clinical status and kidney function improved ...

B TALBOT1,2, J OTHMAN2, RCF CHAN2, M KRISHNASWAMY2, K ARCHER2, V CHEN2,3, S SEN2. 1The George Institute, Sydney, NSW; 2Concord Repatriation General Hospital, Sydney, NSW; 3The University of Sydney, Sydney, NSW.. Background:. Thrombotic microangiopathy (TMA) describes a pathological process of microvascular thrombosis, consumptive thrombocytopenia and microangiopathic haemolytic anaemia leading to end-organ ischaemia and infarction. Patients may present with acute renal failure and/or cerebral dysfunction. TMA is a feature of several clinical disorders and rarely can be associated with malignancy.. Case Report: A 71 year old gentleman presented with flank pain, fevers and deteriorating renal function. He was known to have unilateral hydronephrosis and a poorly defined hilar soft tissue density in the left kidney.. On arrival he was septic and haemodynamically unstable. Investigations revealed microcytic anaemia, acute kidney injury and raised inflammatory markers. Significant fragmentation was ...

TY - JOUR. T1 - Early renal function recovery and long-term graft survival in kidney transplantation. AU - Wan, Susan S.. AU - Cantarovich, Marcelo. AU - Mucsi, I.. AU - Baran, Dana. AU - Paraskevas, Steven. AU - Tchervenkov, Jean. PY - 2016/5/1. Y1 - 2016/5/1. N2 - Following kidney transplantation (KTx), renal function improves gradually until a baseline eGFR is achieved. Whether or not a recipient achieves the best-predicted eGFR after KTx may have important implications for immediate patient management, as well as for long-term graft survival. The aim of this cohort study was to calculate the renal function recovery (RFR) based on recipient and donor eGFR and to evaluate the association between RFR and long-term death-censored graft failure (DCGF). We studied 790 KTx recipients between January 1990 and August 2014. The last donor SCr prior to organ procurement was used to estimate donor GFR. Recipient eGFR was calculated using the average of the best three SCr values observed during the first ...

TY - JOUR. T1 - Neutrophil gelatinase-associated lipocalin regulates gut microbiota of mice. AU - Mori, Katsuya. AU - Suzuki, Takeshi. AU - Minamishima, Shizuka. AU - Igarashi, Toru. AU - Inoue, Kei. AU - Nishimura, Daisuke. AU - Seki, Hiroyuki. AU - Yamada, Takashige. AU - Kosugi, Shizuko. AU - Katori, Nobuyuki. AU - Hashiguchi, Saori. AU - Morisaki, Hiroshi. PY - 2016/1/1. Y1 - 2016/1/1. N2 - Background and Aim: Because neutrophil gelatinase-associated lipocalin (NGAL) is known to provide significant bacteriostatic effects during infectious conditions, we tested the hypothesis that this protein is up-regulated and secreted into the intraluminal cavity of the gut under critically ill conditions and is thus responsible for the regulation of bacterial overgrowth. Methods: With our institutional approval, male C57BL/6J mouse (6-7weeks) were enrolled and applied for lipopolysaccharide or peritonitis model compared with naïve control. We assessed NGAL protein concentrations in intestinal lumen and ...

The use of hyperoncotic albumin (HA) for shock resuscitation is controversial given concerns about its cost, effectiveness, and potential for nephrotoxicity. We evaluated the association between early exposure to hyperoncotic albumin (within the first 48 h of onset of shock) and acute organ dysfunction in post-surgical patients with shock. This retrospective, cohort study included 11,512 perioperative patients with shock from 2009 to 2012. Shock was defined as requirement for vasopressors to maintain adequate mean arterial pressure and/or elevated lactate (| 2.2 mmol/L). Subsets of 3600 were selected after propensity score and exact matching on demographics, comorbidities, and treatment variables (| 30). There was a preponderance of cardiac surgery patients. Proportional odds logistic regression, multivariable logistic regression or Cox proportional hazard regression models measured association between hyperoncotic albumin and acute kidney injury (AKI), hepatic injury, ICU days, and mortality.

TY - JOUR. T1 - miRNA profiling of urinary exosomes to assess the progression of acute kidney injury. AU - Sonoda, Hiroko. AU - Lee, Byung Rho. AU - Park, Ki Hoon. AU - Nihalani, Deepak. AU - Yoon, Je Hyun. AU - Ikeda, Masahiro. AU - Kwon, Sang Ho. N1 - Funding Information: This work was supported by a Carl Gottschalk career development award (American Society of Nephrology) and a Pilot Discovery grant (Center for Genomic Medicine, MUSC) to S.-H. K. The sequencing analysis was supported in part by Genomics Shared Resource, Hollings Cancer Center, Medical University of South Carolina (P30CA138313) and MUSC bioinformatics core, Center for Genomic Medicine. This work was supported by the American Society of Nephrology [the Carl Gottschalk Award to S.-H. K.; the Center for Genomic Medicine, SCTR [the Pilot Discovery grant to S.-H. K.]; Augusta University [startup package to S.-H. K.] and the JSPS KAKENHI [15H04594, 16K15047, 18H02348 to M.I., 15K18784, 18K05996 to H.S.]. Publisher Copyright: © ...

Acute renal failure developed in three patients within a few days of starting ciprofloxacin hydrochloride therapy. An allergic interstitial nephritis was suggested by fever and eosinophiluria in one patient and by erythema multiforme in another. A kidney biopsy specimen confirmed this diagnosis in one patient. Renal function improved shortly after withdrawal of the drug in all three patients. Literature survey revealed an additional three patients with a similar complication. Allergic manifestations, such as fever or rash, were a feature in most reported cases. In view of this potential complication, renal function should be closely monitored in patients receiving ciprofloxacin therapy, especially if other potentially nephrotoxic drugs are prescribed concomitantly ...

Continuous Renal Replacement Therapy (CRRT) is the standard of care for management of critically ill patients with acute renal failure. Part of the Pittsburgh Critical Care series, Continuous Renal Replacement Therapy provides concise, evidence-based, bedside guidance about this treatment modality, offering quick reference answers to clinicians questions about treatments and situations encountered in daily practice.

TY - JOUR. T1 - Nucleosome levels and toll-like receptor expression during high cut-off haemofiltration: A pilot assessment. AU - Atan, Rafidah. AU - May, Clive N. AU - Bailey, Simon R. AU - Tanudji, Marcel. AU - Visvanathan, Kumar. AU - Skinner, Narelle A. AU - Bellomo, Rinaldo. AU - Goehl, Hermann. AU - Storr, Markus. PY - 2015. Y1 - 2015. N2 - Objectives: To measure plasma nucleosome levels and expression of toll-like receptors (TLRs) in a pilot cohort of patients with severe acute kidney injury (AKI) within a randomised controlled trial of continuous venovenous haemofiltration with high cut-off filters (CVVH-HCO) v standard filters (CVVH-std). Methods: We measured plasma nucleosome levels using the Cell Death Detection ELISA PLUS (10X) assay kit. We analysed plasma levels for correlation with disease severity and compared the effects of CVVH-HCO and CVVH-std on plasma nucleosome levels over the first 72 hours. We studied cell surface TLR expression on CD14-positive monocytes in a subcohort ...

INTRODUCTION: Gout is characterized by recurrent episodes of acute inflammation of joint structures, called gout flares, and flares are commonly treated with nonsteroidal anti-inflammatory drugs (NSAIDs). The objective of the study was to evaluate risk factors associated with acute kidney injury (AKI) attributed to NSAIDs in a cohort of patients who were exposed to NSAIDs to treat gout flares prior to urate-lowering therapy. METHODS: Retrospective analysis of a nested cohort of 983 gout patients in whom general variables (age, gender, renal function, ethanol intake, hypertension, hyperlipidemia, diabetes, vascular events, diuretic use) and also variables related to gout and severity of gout (serum urate levels, number for flares per year, presence of tophi, joint distribution, X-ray involvement, previous urate-lowering therapy) were available for analysis ...

BACKGROUND: Acute kidney injury (AKI) occurs frequently after liver transplant surgery and is associated with significant morbidity and mortality. While the impact of intraoperative hypotension (IOH) on postoperative AKI has been well demonstrated in patients undergoi...

Sepsis-Associated Acute Kidney Injury: Is COVID-19 different? Kidney Int. 2020 Sep 10.. View in PubMed. MELD-GRAIL-Na: Glomerular Filtration Rate and Mortality on Liver-Transplant Waiting List Hepatology. 2020 May; 71(5):1766-1774. . View in PubMed. Reply to: Lack of evidence for a continuum between hepatorenal syndrome and acute tubular necrosis J Hepatol. 2020 Mar; 72(3):582-583. . View in PubMed. Community Health Care Quality Standards to Prevent Acute Kidney Injury and Its ConsequencesAm J Med. 2020 05; 133(5):552-560. e3. . View in PubMed. Outcomes of Liver Transplantation in Patients on Renal Replacement Therapy: Considerations for Simultaneous Liver Kidney Transplantation Versus Safety Net Transplant Direct. 2019 Oct; 5(10):e490. . View in PubMed. News in pathophysiology, definition and classification of hepatorenal syndrome: A step beyond the International Club of Ascites (ICA) consensus document J Hepatol. 2019 10; 71(4):811-822. . View in PubMed. Acute kidney injury in cirrhosis: ...

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. 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). First, high urinary or serum NGAL concentrations shortly after transplantation are a predictor of delayed graft function and are associated with reduced graft function at one year. Secondly, among KTRs with previously stable graft function who then suffer acute graft dysfunction, a high urinary NGAL predicts graft loss at one year. If further refined, diagnostic tests based on NGAL levels may provide future useful clinical tools.

TY - JOUR. T1 - Aprotinin for coronary artery bypass grafting. T2 - Effect on postoperative renal function. AU - Lemmer, John H.. AU - Stanford, William. AU - Bonney, Sharon L.. AU - Chomka, Eva V.. AU - Karp, Robert B.. AU - Laub, Glenn W.. AU - Rumberger, John A.. AU - Schaff, Hartzell V. PY - 1995. Y1 - 1995. N2 - Two hundred sixteen patients undergoing coronary artery bypass graft procedures were randomized to receive either high-dose aprotinin or placebo. Clinically important postoperative renal insufficiency was infrequent, with a single patient (0.9%) from each group requiring dialysis. Although increases in the serum creatinine level occurred postoperatively in more patients who received aprotinin (20/108) than in those given placebo (13/108), the difference between the two group was not statistically significant (p = 0.186), and the increases were generally small and transient. Likewise, there was no difference between the groups in terms of the incidence of abnormal serum electrolyte ...

Introduction. Gentamicin is commonly used aminoglycoside antibiotic for the treatment of various bacterial infections. The recommended routes of administration of gentamicin are intravenous, intramuscular, intraperitoneal or topical as it is not sufficiently absorbed by the intestinal tract.1,2 However, potential clinical use of gentamicin is limited due to gentamicin-induced toxicity, even at doses slightly higher than recommended doses. Gentamicin can cause tissue injury such as nephrotoxicity, ototoxicity3,4 and liver toxicity,5 possibly through generation of free oxygen radicals. Nephrotoxicity of gentamicin arises due to its accumulation in renal cortical tubular epithelial cells.2 Although the pathogenesis of gentamicin-induced acute kidney injury (AKI) has been the focus of a large number of studies, the underlying mechanisms are not yet fully elucidated. Recent studies suggest that gentamicin nephrotoxicity is a complex and multifaceted process in which gentamicin triggers cellular ...

Read Comparison of iohexol and iodixanol induced nephrotoxicity, mitochondrial damage and mitophagy in a new contrast-induced acute kidney injury rat model, Archives of Toxicology on DeepDyve, the largest online rental service for scholarly research with thousands of academic publications available at your fingertips.

This PhD sought to exploit the acute effects of exercise upon the kidneys to make tenable links to pathological states such as acute kidney injury (AKI) and chronic kidney disease (CKD). It is surprising that such associations with their potential clinical implications have received limited attention so far despite the ever-increasing number of healthy individuals participating in vigorous and physiologically challenging activities. The work herein has shown how experimental in-vivo exercise models may be used to simulate a stressed kidney with features that resemble diseased states. Summarising the key findings briefly, the first study (chapter 2) demonstrated that maximal-intensity exercise in the form of an 800 metre sprint resulted in increased urinary concentrations of an AKI biomarker (neutrophil gelatinase-associated lipocalin / NGAL), suggesting mild kidney stress or a concentrating effect. However, plasma NGAL concentrations decreased and urinary rises were independent of ...

Lipocalin-2, human recombinant protein, Neutrophil gelatinase-associated lipocalin, NGAL, p25, 25 kDa alpha-2-microglobulin-related subunit validated in (PBV10492r-10), Abgent

McLean , M H , Thomson , A J , Murray , G I , Fyfe , N , Hold , G L & El-Omar , E M 2013 , Expression of neutrophil gelatinase-associated lipocalin in colorectal neoplastic progression : a marker of malignant potential? , British Journal of Cancer , vol. 108 , no. 12 , pp. 2537-2541 . https://doi.org/10.1038/bjc. ...

Bilateral ureteral obstruction in children is a rare condition arising from several medical or surgical pictures. It needs to be promptly suspected in order to attempt a quick renal function recovery. In this paper we concentrated on uncommon causes

A patient with scleroderma renal crisis is described. At presentation he had severe hypertension, deteriorating renal function, microangiopathic haemolytic anaemia, and elevated levels of renin, aldosterone and noradrenaline. Enalapril controlled blood pressure, stabilized renal function, lowered aldosterone and noradrenaline levels, and improved peripheral circulation. It appears that converting-enzyme inhibitors can favourably alter the outlook of this otherwise fatal disorder.. ...

This study was designed to elucidate the expression of renal tissue cytokines by receiving concomitant ECMO and CRRT in the healthy swine model. Our results showed that it might remove ECMO-induced cytokines, maintain the role of immune equilibrium, reduce the extent of ECMO-related SIRS, thereby leading to improve ECMO-related acute renal dysfunction.. CRRT was applied to acute renal failure patients have been widely recognized. CRRT matched with human kidney by continuously, slowly and convection running. Its mainly advantage is that it could stabilize the hemodynamic, improve azotemia, electrolytes and water-salt metabolism, keep on cleaning cycle of all sorts of cytokines and improve nutrition [10-13].. Previous animal experiments and clinical studies have shown that blood components are continually exposed to non-biological artificial surface from cardiopulmonary bypass pipe and changes of the non-physiological hemorheology during ECMO running. This leads to the complement system, the ...

BACKGROUND: Several biomarkers are becoming available for the early detection of acute kidney injury (AKI), but few have been directly compared.. OBJECTIVE: To compare urinary kidney injury molecule-1 (KIM-1), neutrophil gelatinase-associated lipocalin (NGAL), and N-acetyl glucosaminidase (NAG) against serum creatinine and renal histological score in the initiation, maintenance, and recovery phases of cisplatin (CP)-induced AKI.. METHODS: Sprague-Dawley rats (300-350 g) were injected once through their tail veins with CP (CP group) at 5.5 mg/kg or with same volume of normal saline vehicle (Control group). Rats were euthanized at 2, 4, 6, 12, and 24 hours, and on days 2, 3, 6, and 10 (n = 12 in the CP group and n = 6 in the Control group at each time point), and urine, blood, and kidney samples were analyzed.. RESULTS: A significant increase in serum creatinine was noted by day 3 in the CP group versus Control group [1.46 (0.12) vs 0.28 (0.03) mg/dL; mean (SE); P , 0.05]. The renal histology ...