Electrolytes-Enriched Hemodiafiltration Solutions for Continuous Renal Replacement Therapy in Acute Kidney Injury: A Crossover Study

2016 ◽  
Vol 42 (1) ◽  
pp. 18-26 ◽  
Author(s):  
Noemie Besnard ◽  
Marianne Serveaux ◽  
Sonia Machado ◽  
Delphine Daubin ◽  
Vincent Brunot ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Metabolic Disorders ◽  
Kidney Injury ◽  
Serum Biochemistry ◽  
Total Serum ◽  
Normal Range ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Total Serum Calcium ◽  
Glucose Supplementation

Aims: To evaluate the capability of an electrolytes-enriched solution to prevent metabolic disorders during continuous veno-venous hemodiafiltration (CVVHDF). Methods: Serum biochemistry and clinical tolerance were compared during CVVHDF treatments with an electrolyte-enriched (Phoxilium) or standard solutions in 10 acute renal failure patients. Results: As compared to standard fluids, serum potassium and phosphate levels were maintained in the normal range with Phoxilium without any supplementation but total serum calcium levels were significantly lower. Bicarbonatemia was slightly higher (24-26 vs. 21.5-24.5 mmol/l, p < 0.05) with conventional solutions and was associated with a significant increased level of pH (>7.44). Despite the absence of glucose in the Phoxilium solution, blood glucose levels and glucose supplementation were similar between treatments. Clinical tolerance and efficiency of CVVHDF sessions were comparable. Conclusion: Phoxilium effectively prevented hypophosphatemia and hypokalemia during CVVHDF. It was, however, associated with a slight metabolic acidosis and hypocalcemia compared with conventional solutions.

scholarly journals Risk factors for acute kidney injury and mortality in high risk patients undergoing cardiac surgery

PLoS ONE ◽  
2021 ◽  
Vol 16 (5) ◽  
pp. e0252209
Author(s):  
Giuseppe Filiberto Serraino ◽  
Michele Provenzano ◽  
Federica Jiritano ◽  
Ashour Michael ◽  
Nicola Ielapi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Cardiac Surgery ◽  
Blood Glucose ◽  
Kidney Injury ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Risk Patients

Background Acute Kidney Injury (AKI) represents a clinical condition with poor prognosis. The incidence of AKI in hospitalized patients was about 22–57%. Patients undergoing cardiac surgery (CS) are particularly exposed to AKI because of the related oxidative stress, inflammation and ischemia-reperfusion damage. Hence, the risk profile of patients undergoing CS who develop AKI and who are consequently at increased mortality risk deserves further investigation. Methods We designed a retrospective study examining consecutive patients undergoing any type of open-heart surgery from January to December 2018. Patients with a history of AKI were excluded. AKI was diagnosed according to KDIGO criteria. Univariate associations between clinical variables and AKI were tested using logistic regression analysis. Variable thresholds maximizing the association with AKI were measured with the Youden index. Multivariable logistic regression analysis was performed to assess predictors of AKI through backward selection. Mortality risk factors were assessed through the Cox proportional hazard model. Results We studied 158 patients (mean age 51.2±9.7 years) of which 74.7% were males. Types of procedures performed were: isolated coronary artery bypass (CABG, 50.6%), valve (28.5%), aortic (3.2%) and combined (17.7%) surgery. Overall, incidence of AKI was 34.2%. At multivariable analysis, young age (p = 0.016), low blood glucose levels (p = 0.028), estimated Glomerular Filtration Rate (p = 0.007), pH (p = 0.008), type of intervention (p = 0.031), prolonged extracorporeal circulation (ECC, p = 0.028) and cross-clamp (p = 0.021) times were associated with AKI. The threshold for detecting AKI were 91 and 51 minutes for ECC and cross-clamp times, respectively. At survival analysis, the presence of AKI, prolonged ECC and cross-clamp times, and low blood glucose levels forecasted mortality. Conclusions AKI is common among CS patients and associates with shortened life-expectancy. Several pre-operative and intra-operative predictors are associated with AKI and future mortality. Future studies, aiming at improving prognosis in high-risk patients, by a stricter control of these factors, are awaited.

scholarly journals Clinical features and risk factors of acute kidney injury in children with acute paraquat intoxication

2019 ◽  
Vol 47 (9) ◽  
pp. 4194-4203
Author(s):  
Yue Song ◽  
Chaofeng Li ◽  
Fenglan Luo ◽  
Yuhong Tao
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Blood Glucose ◽  
Kidney Injury ◽  
Elevated Blood ◽  
Glucose Levels ◽  
Oral Ulcers ◽  
Blood Glucose Levels ◽  
Independent Risk Factors ◽  
Stage 1

Objective This study aimed to investigate the clinical features and risk factors of acute kidney injury (AKI) in children with acute paraquat intoxication. Methods A retrospective study of 110 hospitalized children with acute paraquat intoxication in West China Second University Hospital, Sichuan University was conducted from January 2010 to May 2017. The Kaplan–Meier method was used to compare the survival rates of children with different AKI stages. Multivariate logistic regression was applied to analyse the risk factors for paraquat-induced AKI. Results AKI occurred in 42 of 110 (38.2%) children. We observed AKI stage 1 in two (4.8%) children, AKI stage 2 in 11 (26.2%), and AKI stage 3 in 29 (69.0%). The survival rate of children in AKI stage 3 (34.5%) was significantly lower than that in children in AKI stage 2 (63.6%) and AKI stage 1 (100%). Multivariate analysis showed that oral ulcers and elevated blood glucose levels were significant independent risk factors for paraquat-induced AKI in children (odds ratio = 4.223 and 5.545, respectively). Conclusions The incidence and mortality rates of paraquat-induced AKI in children are high. Oral ulcers and elevated blood glucose levels are independent risk factors affecting the occurrence of paraquat-induced AKI in children.

Abstract P315: Vascular AT1 Angiotensin Receptors Do Not Contribute to Albuminuria or Hyperfiltration in Diabetes

Hypertension ◽  
2016 ◽  
Vol 68 (suppl_1) ◽  
Author(s):  
Matthew A Sparks ◽  
Stacy Johnson ◽  
Rishav Adhikari ◽  
Edward Diaz ◽  
Aaron Kupin ◽  
...  
Keyword(s):  
Kidney Injury ◽  
Renin Angiotensin System ◽  
Diabetic Control ◽  
Angiotensin Receptors ◽  
Mrna Levels ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Significant Difference ◽  
Akita Mice ◽  
The Impact

Blockade of the renin angiotensin system (RAS) reduces albuminuria, attenuates hyperfiltration, and slows the progression of diabetic nephropathy (DN) by preventing vasoconstriction and subsequent increases in glomerular hydrostatic pressure. Since RAS blockade disrupts Ang II signaling in all tissues, the specific contribution of vascular actions of AT1 receptors in DN has been difficult to delineate. Therefore, we generated 129 SvEv mice with cell-specific loss of AT1A from VSMCs (SMKOs) using Cre-loxp . To eliminate AT1R from VSMCs, we crossed the SMKO mice with AT1BR -/- mice, lacking the minor AT1B isoform. To study the impact of vascular AT1R in DN, we crossed the AT1B- null SMKOs with mice having the Ins2 C96Y AKITA mutation, which develop DM1 early. To enhance kidney injury, mice underwent uninephrectomy (UNX) at 11wks. Blood glucose levels were elevated (~500mg/dL) and similar at 10, 16 and 24wks between the two groups. Prior to UNX, albuminuria was similar between Control AKITA and AT1B- null SMKO AKITA (62±10 Control AKITA versus 107±27 μg/24hrs SMKO AKITA, P=NS). Albuminuria increased with age in both Control Akita and AT1B- null SMKO AKITA but without significant differences between the groups at 16wks (307±106 vs 313±117 μg/24hrs; P=NS) or 24wks (494±236 versus 730±217 μg/24hrs; P=NS), despite a trend toward higher albuminuria in AT1B- null SMKO AKITAs. There was no significant difference in GFR (using FITC-inulin) between non-diabetic Control and AT1B- null SMKO (15.6±1.2 vs 14.8±0.8 μl/min/g BW), and hyperfiltration was observed in both Control AKITA (23.7±2.4 μl/min/g BW; P=0.003) and AT1B- null SMKO AKITA mice (20.7±1.7 μl/min/g BW; P=0.01) relative to their non-diabetic comparators. However, there was no significant difference in GFR between ControlAKITA and AT1B- null SMKO AKITA (P=NS). Finally we measured mRNA levels of putative kidney injury markers by RTqPCR and found no differences in levels of Col1A1 , NGAL , or TGFB1 mRNA between Control AKITA and AT1B null SMKO AKITA. Our studies indicate that the absence of vascular AT1R responses is not sufficient to reduce albuminuria and prevent hyperfiltration in a mouse model of DN. This suggests that blockade of AT1R in other cell lineages may contribute to beneficial actions of ARBs in DN.

scholarly journals Iron overload is related to elevated blood glucose levels in obese children and aggravates high glucose-induced endothelial cell dysfunction in vitro

2020 ◽  
Vol 8 (1) ◽  
pp. e001426
Author(s):  
Wei Wu ◽  
Jinna Yuan ◽  
Yu Shen ◽  
Yunxian Yu ◽  
Xuefeng Chen ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Iron Overload ◽  
High Glucose ◽  
Metabolic Disorders ◽  
Control Group ◽  
Endothelial Cell Dysfunction ◽  
Obese Children ◽  
Glucose Levels ◽  
Cell Dysfunction ◽  
Blood Glucose Levels

IntroductionThis study was performed to investigate the role of iron overload in the early stage of hyperglycemia-induced vascular functional impairment.Research design and methodsA total of 196 obese children were enrolled, and data regarding ferritin levels, blood glucose levels, intima-media thickness of carotid arteries, liver function and fibrosis index, hemoglobin, blood pressure, blood lipids, and inflammation indicators were collected. Ferritin levels were compared with a control group, which consisted of 148 healthy non-obese children who were age-matched and gender-matched. Endothelial cells were cultured in high glucose medium and supplemented with ferric citrate with or without iron remover (deferoxamine), a reducing agent (N-acetyl-cysteine), or a nuclear factor-κB (NF-κB) inhibitor (BAY 11-7082). Apoptosis, oxidative stress, nitric oxide levels, and endothelin content were evaluated. DNA microarray analysis was performed to analyze the expression of genes in the NF-κB signaling pathway.ResultsObese children have significantly higher ferritin levels compared with the control group. Ferritin level was positively correlated with hemoglobin and was related to metabolic disorders, including impaired glucose tolerance, higher blood pressure, dyslipidemia, and impaired hepatic function. Endothelial cells treated with ferric citrate showed a significantly higher rate of apoptosis, higher levels of oxidative stress, and impaired vasomotor function under high glucose conditions. The above effects were rescued by treatment with an iron remover, reducing agent, or NF-κB inhibitor. Further, detection of phosphorylated-p65 distribution in cells confirmed activation of the NF-κB pathway. DNA microarrays and subsequent gene oncology enrichment analyses revealed the main processes activated in cells.ConclusionIncreased ferritin levels are related to impaired glucose tolerance and other metabolic disorders in obese children. At the cellular level, iron overload aggravated the endothelial cell dysfunction caused by high glucose.

scholarly journals Pre-Procedural Glucose Levels and the Risk for Contrast-Induced Acute Kidney Injury in Patients Undergoing Emergency Coronary Intervention

2012 ◽  
Vol 76 (8) ◽  
pp. 1848-1855 ◽  
Author(s):  
Hiroyuki Naruse ◽  
Junnichi Ishii ◽  
Tousei Hashimoto ◽  
Tomoko Kawai ◽  
Kousuke Hattori ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Kidney Injury ◽  
Coronary Intervention ◽  
Glucose Levels

Cardiovascular Risk in Patients With Fasting Blood Glucose Levels Within Normal Range

2010 ◽  
Vol 106 (11) ◽  
pp. 1602-1605 ◽  
Author(s):  
David Pereg ◽  
Avishay Elis ◽  
Yoram Neuman ◽  
Morris Mosseri ◽  
Michael Lishner ◽  
...  
Keyword(s):  
Cardiovascular Risk ◽  
Blood Glucose ◽  
Fasting Blood Glucose ◽  
Normal Range ◽  
Glucose Levels ◽  
Blood Glucose Levels

Normal Point of Care Glucose Values after Birth in the Well-Baby Nursery

2018 ◽  
Vol 36 (02) ◽  
pp. 219-224
Author(s):  
Floris Levy-Khademi ◽  
Assaf Perry ◽  
Gil Klinger ◽  
Tina Herscovici ◽  
Yair Kasirer ◽  
...  
Keyword(s):  
Blood Glucose ◽  
Medical Center ◽  
Point Of Care ◽  
Normal Range ◽  
Initial Value ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Study Population ◽  
Low Levels ◽  
Initial Blood

Objective Normal initial blood glucose values in healthy newborns are not well defined and are subject to controversy. Despite substantive research, there is no single initial value of glucose that can be used with certainty of safety in newborns, and thus various protocols and cutoffs have been proposed. Study Design We sought to characterize the normal values of blood glucose levels in a large cohort of neonates admitted to the well-baby nursery in Shaare Zedek Medical Center. The blood glucose levels were measured with a point of care (POC) glucometer (Accu-Chek Performa) within 180 minutes after birth. Results The study population included 3,912 newborns with a mean birth weight of 3,322 ± 439 g and a mean gestational age of 39.4 ± 1.3 weeks. Sampling was performed at a median age of 73 minutes (interquartile range [IQR], 55–92 minutes). Median glucose concentration was 58 (IQR, 51–67) mg/dL, and first, third, and fifth percentiles were 34, 39, and 41 mg/dL, respectively. Conclusion Our data describe the normal range of POC blood glucose levels in healthy neonates on admission to the nursery. Extreme low levels were rare.

scholarly journals Incidence of metabolic diseases of dairy cows in Puerto Rico and its relationship with production and reproduction behavior

1969 ◽  
Vol 92 (1-2) ◽  
pp. 39-52
Author(s):  
Julio C. Meléndez ◽  
José Pantoja ◽  
Angel A. Custodio ◽  
John Fernández Van Cleve ◽  
Raúl Macchiavelli ◽  
...  
Keyword(s):  
Blood Glucose ◽  
Body Condition ◽  
Metabolic Disorders ◽  
Metabolic Diseases ◽  
Body Condition Score ◽  
Normal Blood ◽  
Blood Calcium ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Condition Score

Data were obtained from 89 Holstein cows, distributed among seven commercial herds, to evaluate the incidence of metabolic disorders during the periparturient transition period. The herds were enrolled in the Dairy Herd Improvement Program (DHIP) and were routinely visited by veterinarians, who diagnosed any metabolic disorders. The cows were observed every two weeks to evaluate body condition score (1 to 5 scale), to discern clinical disorders and to obtain blood samples for chemical analyses. Clinical metabolic diseases were not diagnosed, but 34% of the cows showed sub-clinical hypocalcaemia (blood calcium less than 7.9 mg/dl) and 14% had blood glucose levels less than 39.9 mg/dl. Although not significant (P greater than 0.05), milk production was higher at the second and third milk weighings in the normal cows than in those with sub-clinical hypocalcaemia (27.5 and 25.6 vs. 25.1 and 23.6 kg, respectively). The interval between parturition and first service was shorter in cows with normal blood calcium levels than in those that suffered sub-clinical hypocalcaemia (74 vs. 91 days, P less than 0.05). Mean body condition score of the cows without sub-clinical hypocalcaemia or sub-normal blood glucose levels was higher than that of cows with these conditions (2.5 vs. 2.3 in both criteria, P less than 0.05). It is concluded that postpartum blood calcium concentrations affect the interval from parturition to first service and that the probability of occurrence of hypocalcaemia after parturition can be estimated from prepartum blood calcium concentrations.

scholarly journals Life-threatening hyperkalemia - an overlooked acute kidney injury with a serum creatinine rise in the 'normal' range

2012 ◽  
Vol 2012 (may07 1) ◽  
pp. bcr0120125691-bcr0120125691
Author(s):  
J. Latus ◽  
N. Braun ◽  
M. D. Alscher ◽  
M. Kimmel
Keyword(s):  
Acute Kidney Injury ◽  
Serum Creatinine ◽  
Kidney Injury ◽  
Normal Range ◽  
Life Threatening
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