Tag: AKI
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
Diagnostic work-up and specific causes of acute kidney injury
Acute kidney injury (AKI) is common in critically ill patients and associated with grim short- and long-term outcome. Although in the vast majority of cases AKI is multifactorial, with sepsis, shock and nephrotoxicity accounting... read more
Blood pressure deficits in acute kidney injury: not all about the mean arterial pressure?
Acute kidney injury (AKI) is associated with increased morbidity and mortality. Although there are many causes of AKI, it is known that patients undergoing high-risk surgery are known to be at significant risk. Although much... read more
Implications of Prevalent Noncardiac Disease in the Cardiac ICU
Half of >1000 patients of admitted to the cardiac intensive care unit (ICU) at a major tertiary-care center over about 1 year also had acute respiratory failure, acute kidney injury, or sepsis. Those with lung or kidney... read more
Venous congestion: are we adding insult to kidney injury in sepsis?
In critical illness, septic shock is a contributing factor in nearly half of all cases of acute kidney injury (AKI). Traditional approaches to prevention of organ dysfunction in early sepsis have focused on prevention of... read more
Acute Kidney Injury is not Associated with IV Contrast Use in the ED
Intravenous (IV) iodinated contrast media is used routinely to improve the accuracy of computed tomography (CT) in the emergency department (ED). Prior studies have linked contrast media with the development of acute kidney... read more
Recovery after Acute Kidney Injury
Little is known about how acute kidney injury (AKI) resolves, and whether patterns of reversal of renal dysfunction differ among patients with respect to ultimate recovery. We have identified five distinct recovery phenotypes... read more
Use of Lab Tests in Detecting Kidney Disease
This systematic review summarizes evidence supporting the use of laboratory tests for glomerular filtration rate and albuminuria to detect and stage kidney disease in adults. Detection and staging of acute and chronic kidney... read more
Contrast-Induced Nephropathy: Confounding Causation
Comparing the methodological rigor of more recent CIN studies to those in the past, it seems clear that earlier studies purporting a causal relationship between AKI and contrast administration were only identifying an association... read more
