Tag: AKI

Upvote Story 5
Two CT scans performed during blunt trauma encounters demonstrated mixed benefit and were associated with an increased hospital LOS. Additionally, IV contrast was associated with lower rates of AKI. Of 5787 patient encounters, 5335 (93.4%) received IV contrast and 75 (1.3%) received two CT scans. Lower rates of AKI were associated with IV contrast (2.5 vs 12.5%). Receiving two CT scans was associated with increased... Read More | Comment
Upvote Story 4
We read with great interest the recent letter to Critical Care by Marik and Hooper. Vitamin C is increasingly recognized as a crucial compound to alleviate morbidity in critically ill patients. Vitamin C concentrations, however, are usually far below normal and even close to “scurvy levels” in this population. Vitamin C also is substantially cleared by continuous renal replacement therapy (CRRT). Significant vitamin C deficiency... Read More | Comment
Upvote Story 15
Critically ill patients with subarachnoid hemorrhage show a strong association between hyperchloremia and acute kidney injury as well as acute kidney injury and mortality. Of 1,267 patients included in this cohort, 16.7% developed acute kidney injury, as defined by Kidney Disease Improving Global Outcome criteria (changes in creatinine only). Compared to patients without acute kidney injury, patients with acute kidney injury had a higher prevalence... Read More | Comment
Upvote Story 11
Is hyperoncotic albumin administration an unrecognized resuscitation risk factor? 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. Early exposure to hyperoncotic albumin in postoperative shock... Read More | Comment
Upvote Story 6
Only half of patients who are hemodynamically unstable will respond to a fluid bolus. There are no historical or physical examination findings that can help us decide whether a patient is a fluid responder, but we must treat hypotension, as we do know that a mean arterial pressure (MAP) less than 60 mmHg increases the risk of death and acute kidney injury (AKI). Empirical fluid... Read More | Comment
Upvote Story 5
Plasma endostatin shows a useful value for predicting failure to recover from acute kidney injury (AKI). The predictive ability can be greatly improved when endostatin is combined with the Sequential Organ Failure Assessment (SOFA) score and AKI classification. Seventy-six of 198 (38.4%) patients failed to recover from AKI onset, with 41 in the derivation cohort and 35 in the validation cohort. Compared with NGAL and... Read More | Comment
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
Upvote Story 10
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
Upvote Story 6
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