Renal Function of Renal Transplantation Patients After Hospitalization in an Intensive Care Unit

2012 ◽  
Vol 44 (9) ◽  
pp. 2792-2794 ◽  
Author(s):  
J. Badin ◽  
H. Longuet ◽  
A. Guillon ◽  
C. Barbet ◽  
J.M. Halimi ◽  
...  
2013 ◽  
Vol 2013 ◽  
pp. 1-7
Author(s):  
Melanie Chan ◽  
Marlies Ostermann

Patients with end-stage renal disease (ESRD) experience higher rates of hospitalisation, cardiovascular events, and all-cause mortality and are more likely to require admission to the intensive care unit (ICU) than patients with normal renal function. Sepsis and cardiovascular diseases are the most common reasons for ICU admission. ICU mortality rates in patients requiring chronic hemodialysis are significantly higher than for patients without ESRD; however, dialysis patients have a better ICU outcome than those with acute kidney injury (AKI) requiring renal replacement therapy suggesting that factors other than loss of renal function contribute to their prognosis. Current evidence suggests, the longer-term outcomes after discharge from ICU may be favourable and that long-term dependence on dialysis should not prejudice against prompt referral or admission to ICU.


2012 ◽  
Vol 40 (3) ◽  
pp. 1166-1174 ◽  
Author(s):  
L Yavuz ◽  
G Aynali ◽  
A Aynali ◽  
A Alaca ◽  
S Kutuk ◽  
...  

OBJECTIVE: To determine the effect of immunoglobulin (Ig)M-enriched Ig therapy on mortality rate and renal function in sepsis-induced multiple organ dysfunction syndrome (MODS), using the Acute Physiology and Chronic Health Evaluation II (APACHE II) score. METHODS: Retrospective study of patients with sepsis-induced MODS treated with standard antibiotic plus supportive therapy (control group) or IgM-enriched Ig therapy adjuvant to control group therapy (IVIg group). Total length of stay in the intensive care unit (ICU), overall mortality rate and 28-day case fatality rate (CFR), as well as APACHE II scores and renal function parameters at day 1 and day 4 of therapy, were recorded. RESULTS: A total of 118 patients were included (control group, n = 62; IVIg group, n = 56). In both groups, day 4 APACHE II scores decreased significantly compared with day 1 scores; the effect of treatment on renal function was minimal. Length of ICU stay, overall mortality rate and 28-day CFR were significantly lower in the IVIg group compared with the control group. CONCLUSIONS: Adding IgM-enriched Ig therapy to standard therapy for MODS improved general clinical conditions and significantly reduced APACHE II scores, overall mortality rate and 28-day CFR, although effects on renal function were minimal.


2014 ◽  
Vol 2014 ◽  
pp. 1-8
Author(s):  
Francesca Bonassin Tempesta ◽  
Alain Rudiger ◽  
Marco Previsdomini ◽  
Marco Maggiorini

Background. The aim of this study was to investigate whether different haemofilter surface areas affect clotting and platelet consumption in critically ill patients undergoing continuous venovenous haemodiafiltration (CVVHDF).Methods. CVVHDF was performed in postdilution technique using a capillary haemofilter with two different membrane sizes, Ultraflux AV 1000S (n=17, surface 1.8 m2, volume 130 mL), and the smaller AV 600S (n=16, surface 1.4 m2, volume 100 mL), respectively. Anticoagulation was performed with heparin.Results. No significant differences were found when the two filters were compared. CVVHDF was performed for 33 (7–128) hours with the filter AV 1000S and 39 (7–97) hours with AV 600S (P=0.68). Two (1–4) filters were utilised in both groups over this observation period (P=0.94). Platelets dropped by 52,000 (0–212,000) in AV 1000S group and by 89,500 (0–258,000) in AV 600S group (P=0.64). Haemoglobin decreased by 1.2 (0–2.8) g/dL in AV 1000S group and by 1.65 (0–3.9) g/dL in AV 600S group (P=0.51), leading to the transfusion of 1 (0–4) unit of blood in 19 patients (10 patients with AV 1000S and 9 with AV 600S). Filter observation was abandoned due to death (12.1%), need for systemic anticoagulation (12.1%), repeated clotting (36.4%), and recovery of renal function (39.4%).Conclusion. Our study showed that a larger filter surface area did neither reduce the severity of thrombocytopenia and anaemia, nor decrease the frequency of clotting events.


1987 ◽  
Vol 9 (2) ◽  
pp. 154-160 ◽  
Author(s):  
B. Lacarelle ◽  
C. Granthil ◽  
J. C. Manelli ◽  
N. Brader ◽  
G. Francois ◽  
...  

2018 ◽  
Vol 64 (9) ◽  
pp. 1361-1369 ◽  
Author(s):  
Pietro Caironi ◽  
Roberto Latini ◽  
Joachim Struck ◽  
Oliver Hartmann ◽  
Andreas Bergmann ◽  
...  

Abstract BACKGROUND Acute kidney injury (AKI) occurs in many critically ill patients and is associated with high mortality. We examined whether proenkephalin could predict incident AKI and its improvement in septic patients. METHODS Plasma proenkephalin A 119–159 (penKid) was assayed in 956 patients with sepsis or septic shock enrolled in the multicenter Albumin Italian Outcome Sepsis (ALBIOS) trial to test its association with incident AKI, improvement of renal function, need for renal replacement therapy (RRT), and mortality. RESULTS Median [Q1–Q3] plasma penKid concentration on day 1 [84 (20–159) pmol/L[ was correlated with serum creatinine concentration (r = 0.74); it was higher in patients with chronic renal failure and rose progressively with the renal Sequential Organ Failure Assessment subscore. It predicted incident AKI within 48 h (adjusted odds ratio, 3.3; 95% CI, 2.1–5.1; P < 0.0001) or 1 week [adjusted hazard ratio, 2.1 (1.7–2.8); P < 0.0001] and future RRT during the intensive care unit stay [odds ratio, 4.0 (3.0–5.4)]. PenKid was also associated with improvements in renal function in patients with baseline serum creatinine >2 mg/dL, both within the next 48 h [adjusted odds ratio, 0.31 (0.18–0.54), P < 0.0001] and 1 week [0.23 (0.12–0.45)]. The time course of penKid concentrations predicted AKI and 90-day mortality. CONCLUSIONS Early measurement and the trajectory of penKid predict incident AKI, improvement of renal function, and the need for RRT in the acute phase after intensive care unit admission during sepsis or septic shock. PenKid measurement may be a valuable tool to test early therapies aimed at preventing the risk of AKI in sepsis.


2011 ◽  
Vol 51 (2) ◽  
pp. 89
Author(s):  
Feiby Julianto ◽  
Adrian Umboh ◽  
Suryadi Tatura

Background Sepsis is a commonly seen emergency case in the pediatric intensive care unit.1 Severe sepsis mortality rate in developed country andin developing country such as Indonesia are 9% and 50-70%, respectively. Furthennore, the mortality rate in septic shock is 80%.2 Several researches documented increasing rate of acute kidney injury (AKI) incidence correlated 'With sepsis. Clinical intervention identification may decrease AKI and sepsis incidence.Objective To identify the correlation between incidence of AKI in sepsis and in septic shock patients who was treated in pediatric intensive care unit (PICU).Methods A cross sectional study was perfonned in 37 patients diagnosed as sepsis according ACCP/SCCM criteria for children aged 1 month to 13 years. The study was conducted in Pediatric Department, Prof. Dr. R.D. Kandou hospital from April 2009 to June 2009.Results From 37 sepsis patients, 27 were boys and 10 were girls. In the sepsis group (n=27) 10 had AKI, and in the septic shock group (n= 10) had AKI. Phi correlation coefficient applied to statistically analyzed sepsis in correlation with AKI (creatinin serum and GFR). Significant Phi correlation coefficient was (r=0.117; P> 0.05)Conclusions The study concludes that there is no correlation of renal function impainnent Mth sepsis and septic shock.


1988 ◽  
Vol 16 (4) ◽  
pp. 389-395 ◽  
Author(s):  
P. Older ◽  
R. Smith

The extent of physiological disturbance in a preoperative population of 100 elderly patients scheduled for elective major surgery was measured. Haemodynamic, respiratory and renal function were evaluated preoperatively in the intensive care unit. Of these patients 13% had serious problems requiring either postponement of the operation (7%) or its cancellation (6%). Cardiac index was 2.2 l/min/m2 or less in 11% of patients; creatinine clearance 50 ml/min or less in 19% of patients; mean blood pressure was equal to or exceeded 120 mmHg in 15% of patients and intrapulmonary shunt equalled or exceeded 15% in 10% of patients. The mean duration of stay in the intensive care unit was four days, including the preoperative day. The logistics of preoperative admission were implemented without undue difficulty.


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