Tag: AKI

Upvote Story 10
Pediatric critical care nephrology is a complex and highly specialized field, presenting challenges and management strategies that are often quite distinct from those seen in adult practice. Therefore, it is high time to address all the topics in the field of critical care nephrology in children in a unique book which is the first of its kind. This book covers the basics as well as... Read More | Comment
Upvote Story 13
Acute kidney injury (AKI) is a frequent postoperative complication with a substantial risk for both short and long-term adverse events, and its incidence is likely to rise because of increasing major surgical procedures. Studies investigating better strategies to prevent and treat AKI in this population are urgently needed.Postoperative AKI affects approximately one-fifth of patients after major surgery, but the incidence varies according to the type... Read More | Comment
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In this randomized, double-blind, placebo-controlled, dose-finding adaptive phase 2a/2b trial enrolling 301 adults, the optimal therapeutic dose of recombinant alkaline phosphatase was 1.6 mg/kg. Treatment with this dose for 3 days when added to standard care resulted in a median increase in endogenous creatinine clearance of 27.6 mL/min vs 14.7 mL/min for placebo in the first 7 days, a difference that was not statistically significant.... Read More | Comment
Upvote Story 5
Acute kidney injury (AKI) in the perioperative period is a common complication and is associated with increased morbidity and mortality. A standard definition and staging system for AKI has been developed, incorporating a reduction of the urine output and/or an increase of serum creatinine. Novel biomarkers may detect kidney damage in the absence of a change in function and can also predict the development of... Read More | Comment
Upvote Story 7
Among critically ill patients with Acute Kidney Injury (AKI), early Renal Replacement Therapy (RRT) compared with delayed initiation of RRT reduced mortality over the first 90 days. Further multicenter trials of this intervention are warranted. Among 231 patients (mean age, 67 years; men, 146 [63.2%]), all patients in the early group (n = 112) and 108 of 119 patients (90.8%) in the delayed group received RRT. The... Read More | Comment
Upvote Story 6
Urinary L-FABP and serum NT-proBNP levels on admission are independent predictors of acute kidney injury (AKI), and when used in combination, improve early prediction of AKI in patients hospitalized at medical cardiac intensive care units (CICUs). Urinary L-FABP levels correlated with serum NT-proBNP levels (r = 0.17, p  Read More | Comment
Upvote Story 10
Sepsis is one of the most frequent causes of acute kidney injury (AKI) in critically ill patients, with initial organ impairment often followed by dysfunction in other systems. Renal dysfunction may therefore represent one facet in the evolution towards multiple organ dysfunction syndrome (MODS) or, alternatively, may be indicative of system-wide endothelial damage caused by hyperinflammation and a positive fluid balance. Whilst numerous biomarkers have... Read More | Comment
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In patients with sepsis, recovery by hospital discharge is associated with long-term survival similar to patients without AKI. Of the 1742 patients who survived to hospital discharge, stage 2–3 AKI occurred in 262 (15%), of which 111 (42.4%) recovered. Compared to recovered patients, patients without recovery were older (75 ±14 vs 69 ±15 years, p Read More | Comment
Upvote Story 14
Acute kidney injury (AKI) is a common complication of critical illness and is associated with significant morbidity, mortality, and financial cost. Sepsis is the leading association of acute kidney injury in the intensive care unit and is implicated in more than half the cases. Our understanding of the pathogenesis of sepsis-associated acute kidney injury continues to evolve. Current evidence suggests that pathways involving inflammatory injury... Read More | Comment
Upvote Story 6
Physicians have an intense 70-year history of enthusiasm, skepticism, fear, and reconciliation with albumin products since their market introduction in the late 1940s. Despite its cumbersome production method and costs, albumin became popular soon after its debut. Advances in its production technique, producing purer formulations with less prekallikrein activators, turned it into a compound with few immediate adverse reactions that appeared to be safe. However,... Read More | Comment
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Decompressive laparotomy has been advised as potential treatment for abdominal compartment syndrome (ACS) when medical management fails; yet, the effect on parameters of organ function differs markedly in the published literature. In this study, we sought to investigate the effect of decompressive laparotomy on intra-abdominal pressure and organ function in critically ill adult and pediatric patients with ACS, specifically focusing on hemodynamic, respiratory, and kidney... Read More | Comment
Upvote Story 12
This comprehensive guide covers the causes, characteristics, and presentations of acute kidney injury (AKI), as well as prevention and treatment. The first part of the book features chapters on the epidemiology and diagnosis of AKI. This is followed by sections on pathophysiology, clinical syndromes and patient management. Authored by leading clinicians, epidemiologists, basic scientists, and clinical trialists, this book captures the latest evidence and best... Read More | Comment
Upvote Story 10
This review outlines key knowledge areas for critical care physicians and nephrologists caring for patients with cancer and associated kidney issues such as acute kidney injury (AKI) and electrolyte disorders. Specifically, understanding kidney-specific effects of new chemotherapeutic approaches is outlined, and provides an up-to-date compendium of these effects. Advances in chemotherapeutic regimens as well as in our understanding of cancer-associated kidney disease highlight the need... Read More | Comment
Upvote Story 8
Septic shock is defined as sepsis with hypotension refractory to fluid challenge and requiring vasopressor support combined with an increase in arterial lactate reflecting impaired cellular energy metabolism and dysoxia. Te use of vasoactive drugs to restore mean arterial pressure (MAP) is strongly recommended by the Surviving Sepsis Campaign and the Task Force of the European Society of Intensive Care Medicine (ESICM) on circulatory shock... Read More | Comment
Upvote Story 4
In patients with severe metabolic acidaemia, sodium bicarbonate had no effect on the primary composite outcome. However, sodium bicarbonate decreased the primary composite outcome and day 28 mortality in the a-priori defined stratum of patients with acute kidney injury. We did a multicentre, open-label, randomised controlled, phase 3 trial. Local investigators screened eligible patients from 26 intensive care units (ICUs) in France. We included adult... Read More | Comment