Tag: AKI
Intra-Abdominal Hypertension and Abdominal Compartment Syndrome
Intra-abdominal hypertension (IAH) and abdominal compartment syndrome are increasingly recognized in both medical and surgical critically ill patients and are predictive of death and the development of acute kidney injury.... read more
The 10 False Beliefs in Adult Critical Care Nephrology
Acute tubular necrosis (ATN), a histological pattern observed after ischemic insult, is considered the most frequent cause of any form of acute kidney injury (AKI) despite the absence of extensive histological data. This... read more
Kinetic Estimated Glomerular Filtration Rate in Critically Ill Patients
Both the Acute kidney injury (AKI) classification system and the nonsteady-state (kinetic) estimated glomerular filtration rate (KeGFR) are complementary to each other. Assessing both AKI stage and KeGFR can help to identify... read more
Better AKI Patient Survival Linked to Negative Fluid Balance
Optimal fluid management of critically ill patients with or at risk for acute kidney injury (AKI) is still uncertain. Now a new prospective study from India confirms that patients with negative fluid balance live longer.... read more
Outcomes after Angiography with Sodium Bicarbonate and Acetylcysteine
Intravenous sodium bicarbonate and oral acetylcysteine are widely used to prevent acute kidney injury (AKI) and associated adverse outcomes after angiography without definitive evidence of their efficacy. Among patients at... read more
Is Intravenous Administration of Iodixanol Associated with Increased Risk of AKI, Dialysis, or Mortality?
Among patients at the highest perceived risk of post-contrast Acute Kidney Injury (AKI), intravenous administration of iodixanol for contrast material enhanced CT was not an independent risk factor for AKI, dialysis, or... read more
Are Biomarkers Ready for Prime Time?
Kyle Enfield, MD, speaks with John A. Kellum, MD, MCCM, about his talk presented at the 46th Critical Care Congress in Honolulu, Hawaii entitled, "Are Biomarkers Ready for Prime Time?" Dr. Kellum works as an Intensivist in... read more
Platelets and Multi-Organ Failure in Sepsis
Platelets have received increasing attention for their role in the pathophysiology of infectious disease, inflammation, and immunity. In sepsis, a low platelet count is a well-known biomarker for disease severity and more... read more
Severe AKI in Young ICU Patients Predicts Higher Mortality
Acute kidney injury (AKI) among critically ill children and young adults is common and is associated with higher mortality risk and other poor outcomes The condition also is associated with greater use of renal-replacement... read more
Can this patient be safely weaned from RRT?
The timing of initiation of renal replacement therapy (RRT) in the critically ill with acute kidney injury (AKI) has been widely studied and discussed in detail recently. However, there is limited information and few recommendations... read more
Acute Kidney Injury Is Risk Factor for Delirium and Coma
For critically ill adults, acute kidney injury is a risk factor for delirium and coma. Stage 2 acute kidney injury was associated with increased risk of delirium and coma (odds ratios, 1.55 and 2.04, respectively), as was... read more
Risk of AKI After Intravenous Contrast Media Administration
In the largest well-controlled study of acute kidney injury (AKI) following contrast administration in the ED to date, intravenous contrast was not associated with an increased frequency of acute kidney injury. Rates of acute... read more
Immunoglobulin G for patients with Necrotising Soft Tissue Infection
The aim of the INSTINCT trial was to assess the effect of intravenous polyspecific immunoglobulin G (IVIG) compared with placebo on self-reported physical function in intensive care unit (ICU) patients with necrotising soft... read more
Biomarkers in AKI: That’s All the Story?
We would like to add to the recent editorial by McMahon on biomarkers of acute kidney injury (AKI), with a specific focus on biomarkers in the clinical setting of cardiac surgery-associated AKI (CSA-AKI). We agree with McMahon... read more
Most pediatric ICU physicians don’t use current guidelines to diagnose acute kidney injury
A study by University at Buffalo researchers has shown that physicians in pediatric intensive care units are not using the newest guidelines to diagnose acute kidney injury (AKI) in critically ill children, a practice that... read more
The Association of Early Combined Lactate and Glucose Levels with Subsequent Renal and Liver Dysfunction
Abnormal combined lactate and glucose measurements may provide an early indication of organ dysfunction. In critically ill patients a 'normal' glucose with an elevated lactate should not be considered desirable, as this combination... read more
Optimal Timing of RRT in Patients with AKI in the Context of Sepsis
Among 620 patients enrolled in AKIKI, 494 (80%) had sepsis and 413 (67%) septic shock. This can help to suggest recommendations in septic patients with AKI. AKIKI showed no significant difference in mortality between early... read more
The Role of Oliguria and the Absence of Fluid Administration and Balance Information in Illness Severity Scores
Urinary examination has formed part of patient assessment since the earliest days of medicine. Current definitions of oliguria are essentially arbitrary, but duration and intensity of oliguria have been associated with an... read more
Impact of End-Stage Renal Disease and Acute Kidney Injury on ICU Outcomes in Patients With Sepsis
Patients with sepsis having AKI have a higher mortality rate than those with ESRD and non-KI. Hospital and ICU mortality rates for patients with ESRD were similar to non-KI patients. Late AKI compared to early AKI had a higher... read more
Prevention of AKI and protection of renal function in ICU
Acute kidney injury (AKI) in the intensive care unit is associated with significant mortality and morbidity. The results of recent randomised controlled trials have allowed the formulation of new recommendations and/or increase... read more
Exosomes in Critical Illness
Exosomes are small, cell-released vesicles (40–100 nm in size) with the potential to transfer proteins, lipids, small RNAs, messenger RNAs, or DNA between cells via interstitial fluids. Due to their role in tissue homeostasis,... read more
Generalizable Biomarkers in Critical Care
The sequencing of the human genome and the subsequent availability of inexpensive, robust methods for "omics" profiling (e.g., genome-wide association studies, gene expression microarrays, and metabolomics) have... read more
