Tag: AKI
CEUS Value in Diagnosis of AKI in ICU patients
Ultrasound can assess renal perfusion, but its role in the evaluation of acute kidney injury (AKI) is still unclear. This prospective cohort study was to investigate the value of contrast-enhanced ultrasound (CEUS) in the... read more
Higher Protein Dosing in Critically Ill Patients with High Nutritional Risk
Delivery of higher doses of protein to mechanically ventilated critically ill patients did not improve the time-to-discharge-alive from hospital and might have worsened outcomes for patients with acute kidney injury (AKI)... read more
Bayesian Reanalysis of the Standard vs. Accelerated Initiation of RRT in AKI Trial
Timing of initiation of kidney-replacement therapy (KRT) in critically ill patients remains controversial. The Standard versus Accelerated Initiation of Renal-Replacement Therapy (RRT) in Acute Kidney Injury (STARRT-AKI)... read more
Acid-Base Disorders in the Critically III Patient
Acid-base disorders are common in the intensive care unit. By utilizing a systematic approach to their diagnosis, it is easy to identify both simple and mixed disturbances. These disorders are divided into four major categories:... read more
Association of Vancomycin Plus Piperacillin-tazobactam with Early Changes in Creatinine vs. Cystatin C
Although dozens of studies have associated vancomycin + piperacillin–tazobactam with increased acute kidney injury (AKI) risk, it is unclear whether the association represents true injury or a pseudotoxicity characterized... read more
Subphenotypes of AKI in Adults
Subphenotyping may help reduce heterogeneity under the umbrella term of acute kidney injury (AKI). Despite challenges remain, the identification of AKI subphenotypes has opened the potential of AKI research focused on better... read more
Is Continuous Intra-abdominal Pressure Ready For Prime Time?
Abdominal contents are primarily fluid in character so that pressure within this compartment follows Pascal's hydrostatic law. Intra-abdominal pressure (IAP) is the steady state pressure within the abdominal cavity and changes... read more
Sepsis-Associated AKI Risks in the PICU
In children with severe sepsis, the degree of hemodynamic support as measured by the VIS and the presence of fluid overload may identify patients at increased risk of developing severe acute kidney injury (AKI). Children... read more
Optimizing the Design and Analysis of Future AKI Trials
Acute kidney injury (AKI) is a complex clinical syndrome associated with an increased risk of morbidity and mortality, particularly in critically ill and perioperative patient populations. Most AKI clinical trials have... read more
Acute Kidney Injury Related to Intoxication From Synthetic Cannabis
Acute kidney injury (AKI) occurs infrequently in young patients and often raises concern for irreversible or deadly etiologies. However, AKI related to synthetic marijuana, colloquially known as K2, is an increasingly common... read more
Reducing Mortality in Acute Kidney Injury
This book describes the techniques, strategies, and drugs that have been demonstrated by at least one paper published in a peer-reviewed journal to significantly influence survival in patients with or at risk for acute kidney... read more
Multi-Organ Point-Of-Care Ultrasound in AKI
Acute kidney injury (AKI) is a clinical syndrome caused by a multitude of hemodynamic, toxic, and structural insults to the kidney, and portends worse patient outcomes. Despite careful history taking, physical examination,... read more
Balanced Crystalloids Probably Reduce Mortality in the Critically-Ill
As remarked by the authors of the recent PLUS trial, a systematic review and meta-analysis of randomized controlled trials comparing balanced resuscitation fluid to 0.9% saline was reported in the New England Journal of Medicine... read more
Balanced vs. Unbalanced Fluid in Critically Ill Children
Our systematic review found some evidence of improvement in blood pH and bicarbonate values in critically ill children after 4–12 hours of fluid bolus therapy with balanced fluid compared with the unbalanced fluid. However,... read more
Balanced Fluid Resuscitation for the Critically-Ill: the PLUS study mirrors the BaSICS
Intravenous fluid therapy is one of the most commonly-performed interventions in all of critical care medicine. Numerous trials over the last 20 years have attempted to identify the ideal fluid for those in the intensive... read more
Assessment of Patiromer Monotherapy for Hyperkalemia in an Acute Care Setting
In this cohort study of patients with acute, non–life-threatening hyperkalemia, a single dose of patiromer was associated with a significant decrease in serum potassium levels and a low incidence of hypokalemia. These... read more
The Ongoing Saga of Normal Saline vs. Balanced Fluids
I have discussed the ongoing battle between normal saline and ‘balanced fluids’ many times in the past. First, there was the SPLIT trial, a double blind cluster RCT of 2200 ICU patients that showed no difference between... read more
Prolonged Blood Storage and Risk of Posttransfusion AKI
In a population of patients without severely impaired baseline renal function receiving fewer than 10 erythrocyte units, duration of blood storage had no effect on the incidence of posttransfusion acute kidney injury (AKI). The... read more
Chlorthalidone Improves Blood Pressure Control in Advanced Chronic Kidney Disease with Hypertension
Among patients with advanced chronic kidney disease and poorly controlled hypertension, chlorthalidone therapy improved blood-pressure control at 12 weeks as compared with placebo. A total of 160 patients underwent randomization,... read more
Intraoperative Hypotension and AKI after Noncardiac Surgery in Infants and Children
In distinct contrast to adults, the authors did not find any association between intraoperative hypotension and postoperative renal injury. Avoiding short periods of hypotension should not be the clinician’s primary concern... read more
Obesity, Inflammatory and Thrombotic Markers, and Major Clinical Outcomes in Critically Ill Patients with COVID-19 in the US
In critically ill patients with COVID-19, higher BMI was not associated with death or thrombotic events but was associated with a greater risk of ARDS and AKI-RRT. The lack of an association between BMI and circulating... read more
