scholarly journals Clarifying the relationship between metformin, acute kidney injury and lactic acidosis

2018 ◽  
Vol 14 (1) ◽  
pp. 70-70 ◽  
Author(s):  
Samira Bell ◽  
Enrique Soto-Pedre ◽  
Paul Connelly ◽  
Shona Livingstone ◽  
Ewan Pearson
Keyword(s):  
Acute Kidney Injury ◽  
Lactic Acidosis ◽  
Kidney Injury ◽  
The Relationship

Association between Procalcitonin and Acute Kidney Injury in Patients with Bacterial Septic Shock

2021 ◽  
pp. 1-10
Author(s):  
Guang Fu ◽  
Hai-chao Zhan ◽  
Hao-li Li ◽  
Jun-fu Lu ◽  
Yan-hong Chen ◽  
...  
Keyword(s):  
Septic Shock ◽  
Acute Kidney Injury ◽  
Logistic Regression ◽  
Piecewise Linear ◽  
Kidney Injury ◽  
Multiple Logistic Regression ◽  
Primary Analysis ◽  
Female Patients ◽  
Potential Biomarker ◽  
The Relationship

Objective: The objective of this study was to assess the relationship between serum procalcitonin (PCT) and acute kidney injury (AKI) induced by bacterial septic shock. Methods: A retrospective study was designed which included patients who were admitted to the ICU from January 2015 to October 2018. Multiple logistic regression and receiver operating characteristic (ROC) as well as smooth curve fitting analysis were used to assess the relationship between the PCT level and AKI. Results: Of the 1,631 patients screened, 157 patients were included in the primary analysis in which 84 (53.5%) patients were with AKI. Multiple logistic regression results showed that PCT (odds ratio [OR] = 1.017, 95% confidence interval [CI] 1.009–1.025, p < 0.001) was associated with AKI induced by septic shock. The ROC analysis showed that the cutoff point for PCT to predict AKI development was 14 ng/mL, with a sensitivity of 63% and specificity 67%. Specifically, in multivariate piecewise linear regression, the occurrence of AKI decreased with the elevation of PCT when PCT was between 25 ng/mL and 120 ng/mL (OR 0.963, 95% CI 0.929–0.999; p = 0.042). The AKI increased with the elevation of PCT when PCT was either <25 ng/mL (OR 1.077, 95% CI 1.022–1.136; p = 0.006) or >120 ng/mL (OR 1.042, 95% CI 1.009–1.076; p = 0.013). Moreover, the PCT level was significantly higher in the AKI group only in female patients aged ≤75 years (p = 0.001). Conclusions: Our data revealed a nonlinear relationship between PCT and AKI in septic shock patients, and PCT could be used as a potential biomarker of AKI in female patients younger than 75 years with bacterial septic shock.

Sustained low-efficiency dialysis for metformin-associated lactic acidosis in patients with acute kidney injury

2018 ◽  
Vol 32 (2) ◽  
pp. 297-306 ◽  
Author(s):  
Paolo Greco ◽  
Giuseppe Regolisti ◽  
Umberto Maggiore ◽  
Elena Ferioli ◽  
Filippo Fani ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Lactic Acidosis ◽  
Kidney Injury ◽  
Low Efficiency

Readmissions after Acute Kidney Injury during Left Ventricular Assist Device Implantation Hospitalization

2020 ◽  
Vol 51 (3) ◽  
pp. 172-181 ◽  
Author(s):  
Carl P. Walther ◽  
Wolfgang C. Winkelmayer ◽  
Anita Deswal ◽  
Jingbo Niu ◽  
Sankar D. Navaneethan
Keyword(s):  
Acute Kidney Injury ◽  
Left Ventricular Assist Device ◽  
Kidney Injury ◽  
Left Ventricular ◽  
Assist Device ◽  
Ventricular Assist ◽  
Left Ventricular Assist ◽  
Relationship Of ◽  
The Relationship ◽  
Readmission Risk

Background: Acute kidney injury (AKI) frequently complicates hospitalizations for left ventricular assist device (LVAD) implantation. Little is known about the relationship of AKI with subsequent readmissions, and we investigated the relationship of AKI during LVAD implantation hospitalization with all-cause and cause-specific 30-day readmissions. Methods: We used a United States (US) nationwide all-payer administrative database, identifying patients who underwent implantable LVAD placement 2010–2015. Patients were classified into 3 mutually exclusive groups based on presence and severity of AKI during the LVAD placement hospitalization: no AKI, AKI, and AKI requiring dialysis (AKI-D). Outcomes were all-cause and cause-specific 30-day readmissions. Results: Within 30 days after discharge 25.4% of patients were readmitted. Of those without AKI, 23.9% were readmitted, compared to 25.5% of those with AKI and 42.2% of those with AKI-D. Compared to no AKI (adjusted for demographics, index hospitalization and chronic comorbidity factors, and year), odds of 30-day readmission were 2.18 (95% CI 1.37–3.49) times higher for those with AKI-D, whereas those with AKI not requiring dialysis had similar 30-day readmission risk (OR 1.03 [95% CI 0.89–1.20]). Those with AKI-D had higher risk of 30-day readmission for infection (OR 2.02 [95% CI 1.13–3.61]), gastrointestinal (GI) bleed (2.32 [95% CI 1.24–4.34]), and kidney disease (13.9 [95% CI 4.0–48]). There was no increased risk for stroke readmission with AKI or AKI-D. Conclusion: AKI-D was associated with highest ­30-day readmission risk, possibly related to negatively synergistic effects of LVAD, kidney dysfunction, and dialysis related factors on infection and GI bleeding risks. AKI alone was not associated with increased readmission risk.

scholarly journals Acute Kidney Injury due to Anticoagulant-Related Nephropathy : A Suggestion for Therapy

2020 ◽  
Vol 2020 ◽  
pp. 1-5 ◽  
Author(s):  
Letizia Zeni ◽  
Chiara Manenti ◽  
Simona Fisogni ◽  
Vincenzo Terlizzi ◽  
Federica Verzeletti ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Oral Anticoagulants ◽  
Direct Oral Anticoagulants ◽  
Kidney Injury ◽  
Cast Nephropathy ◽  
Anca Associated Vasculitis ◽  
A Prospective Study ◽  
The Relationship ◽  
Gross Haematuria ◽  
Strong Suspicion

The relationship between kidneys and anticoagulation is complex, especially after introduction of the direct oral anticoagulants (DOAC). It is recently growing evidence of an anticoagulant-related nephropathy (ARN), a form of acute kidney injury caused by excessive anticoagulation. The pathogenesis of kidney damage in this setting is multifactorial, and nowadays, there is no established treatment. We describe a case of ARN, admitted to our Nephrology Unit with a strong suspicion of ANCA-associated vasculitis due to gross haematuria and haemoptysis; the patient was being given dabigatran. Renal biopsy excluded ANCA-associated vasculitis and diagnosed a red blood cell cast nephropathy superimposed to an underlying IgA nephropathy. Several mechanisms are possibly responsible for kidney injury in ARN: tubular obstruction, cytotoxicity of heme-containing molecules and free iron, and activation of proinflammatory/profibrotic cytokines. Therefore, the patient was given a multilevel strategy of treatment. A combination of reversal of coagulopathy (i.e., withdrawal of dabigatran and infusion of its specific antidote) along with administration of fluids, sodium bicarbonate, steroids, and mannitol resulted in conservative management of AKI and fast recovery of renal function. This observation could suggest a prospective study aiming to find the best therapy of ARN.

Metformin-related lactic acidosis with acute kidney injury: results of a French observational multicenter study

2019 ◽  
Vol 58 (5) ◽  
pp. 375-382 ◽  
Author(s):  
Anthony Corchia ◽  
Alain Wynckel ◽  
Julien Journet ◽  
Julie Moussi Frances ◽  
Nihel Skandrani ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Lactic Acidosis ◽  
Multicenter Study ◽  
Kidney Injury

scholarly journals Regarding the Relationship Between 48-Hour Fluid Balance and Acute Kidney Injury

2020 ◽  
Vol 230 (5) ◽  
pp. 837-838
Author(s):  
Gabrielle E. Hatton ◽  
John A. Harvin ◽  
Charles E. Wade ◽  
Lillian S. Kao
Keyword(s):  
Acute Kidney Injury ◽  
Fluid Balance ◽  
Kidney Injury ◽  
The Relationship
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