scholarly journals Prevalence, Characteristics, Risk Factors, and Outcomes of Invasively Ventilated COVID-19 Patients with Acute Kidney Injury and Renal Replacement Therapy

2020 ◽  
pp. 1-8 ◽  
Author(s):  
Evgeny V. Fominskiy ◽  
Anna Mara Scandroglio ◽  
Giacomo Monti ◽  
Maria Grazia Calabrò ◽  
Giovanni Landoni ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Kidney Injury

scholarly journals Early mortality risk factors at the beginning of continuous renal replacement therapy for acute kidney injury

2018 ◽  
Vol 5 (1) ◽  
pp. 1407485 ◽  
Author(s):  
Camilo Alberto Gonzalez ◽  
Jessica Liliana Pinto ◽  
Viviana Orozco ◽  
Kateir Contreras ◽  
Paola Garcia ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Renal Replacement Therapy ◽  
Continuous Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Mortality Risk ◽  
Kidney Injury ◽  
Early Mortality

scholarly journals SO020NEPHROLOGY INTERVENTION IN PATIENTS AWAITING CARDIAC SURGERY: A RANDOMISED CONTROLLED TRIAL

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Sergi Codina ◽  
Ana Coloma ◽  
Fabrizio Sbraga ◽  
Enric Boza ◽  
Jose Maria Vazquez-Reveron ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Cardiac Surgery ◽  
Renal Replacement Therapy ◽  
Kidney Disease ◽  
Replacement Therapy ◽  
Controlled Trial ◽  
Kidney Injury ◽  
Categorical Variables

Abstract Background and Aims Acute kidney injury (AKI) is a frequent complication after cardiac surgery. Its incidence ranges from 19 to 44% depending on the study and which definition is used. There are some well-known risk factors associated with AKI, including baseline patient characteristics (age and comorbidities), need of perioperative blood transfusion or presence of previous chronic kidney disease. We wanted to evaluate if a nephrologist management and control of potential risk factors of renal disease can be used to prevent AKI, thereby minimizing the risk of need RRT, reducing costs and improving survival in these patients. It will be the first study focused on this intervention. The aim of this study is to assess if a nephrology intervention before cardiac surgery can reduce the postoperative incidence of AKI. Method Unicentric prospective randomized controlled trial of 298 participants from 2015 to 2019. The inclusion criteria was patients undergoing scheduled cardiac surgery of > 18 years old. The exclusion criteria was a requirement for renal replacement therapy before surgery. Clinical Research Ethics Committee of Bellvitge has approved the study before initiation. All patients have given written informed consent. We have done an intention-to-treat analysis, continuous variables have been compared between groups using Student's t test and categorical variables using X2. Results Nephrology intervention before surgery, included a preoperative study done minimum 1 month before the surgery to optimize the patient’ s overall condition by optimization of hydration state, remove or minimize dose of drugs that potentially deteriorate kidney function and correct metabolic disorders. No differences in the characteristics of the patients between groups was found (Table 1). The number of patients with AKI were 49 without differences between groups (0.112), with most of them presenting a stage 1 AKI, only 3 patients present a stage 3 AKI, but none of them required renal replacement therapy (Table 2). We found 1.3% of mortality (1 participant in the intervention group and 3 in control group). Data at 1 year follow-up (n= 144) showed low incidence of kidney disease (creatinine in intervention arm 91.87±30.79μmol/L and in control arm 87.08±23.58, p=0.292) without differences in albuminuria. Conclusion In summary, we did not find any difference in acute kidney injury and death when a nephrology intervention is done to cardiac surgery patients, probably it would be necessary to increase the sample size to make conclusions. The results at 1 year follow-up showed no kidney disease in these patients.

scholarly journals Acute Kidney Injury and Renal Replacement Therapy in Critically Ill COVID-19 Patients: Risk Factors and Outcomes: A Single-Center Experience in Brazil

2020 ◽  
pp. 1-11
Author(s):  
Marisa Petrucelli Doher ◽  
Fabrício Rodrigues Torres de Carvalho ◽  
Patrícia Faria Scherer ◽  
Thaís Nemoto Matsui ◽  
Adriano Luiz Ammirati ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Critically Ill ◽  
Invasive Mechanical Ventilation ◽  
Group Versus ◽  
Kidney Injury ◽  
Multivariable Logistic Regression Analysis ◽  
Additional Risk Factor

<b><i>Background:</i></b> Critically ill patients with COVID-19 may develop multiple organ dysfunction syndrome, including acute kidney injury (AKI). We report the incidence, risk factors, associations, and outcomes of AKI and renal replacement therapy (RRT) in critically ill COVID-19 patients. <b><i>Methods:</i></b> We performed a retrospective cohort study of adult patients with COVID-19 diagnosis admitted to the intensive care unit (ICU) between March 2020 and May 2020. Multivariable logistic regression analysis was applied to identify risk factors for the development of AKI and use of RRT. The primary outcome was 60-day mortality after ICU admission. <b><i>Results:</i></b> 101 (50.2%) patients developed AKI (72% on the first day of invasive mechanical ventilation [IMV]), and thirty-four (17%) required RRT. Risk factors for AKI included higher baseline Cr (OR 2.50 [1.33–4.69], <i>p</i> = 0.005), diuretic use (OR 4.14 [1.27–13.49], <i>p</i> = 0.019), and IMV (OR 7.60 [1.37–42.05], <i>p</i> = 0.020). A higher C-reactive protein level was an additional risk factor for RRT (OR 2.12 [1.16–4.33], <i>p</i> = 0.023). Overall 60-day mortality was 14.4% {23.8% (<i>n</i> = 24) in the AKI group versus 5% (<i>n</i> = 5) in the non-AKI group (HR 2.79 [1.04–7.49], <i>p</i> = 0.040); and 35.3% (<i>n</i> = 12) in the RRT group versus 10.2% (<i>n</i> = 17) in the non-RRT group, respectively (HR 2.21 [1.01–4.85], <i>p</i> = 0.047)}. <b><i>Conclusions:</i></b> AKI was common among critically ill COVID-19 patients and occurred early in association with IMV. One in 6 AKI patients received RRT and 1 in 3 patients treated with RRT died in hospital. These findings provide important prognostic information for clinicians caring for these patients.

scholarly journals Acute Kidney Injury After Cardiac Surgery - Risk Factors for Renal Replacement Therapy

2017 ◽  
Vol 2 (1) ◽  
Author(s):  
Lahdenperä N-I ◽  
Suojaranta-Ylinen RT ◽  
Nisula S ◽  
Schramko AA
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Cardiac Surgery ◽  
Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Kidney Injury

scholarly journals Incidence of acute kidney injury and use of renal replacement therapy in intensive care unit patients in Indonesia

2020 ◽  
Author(s):  
Jonny Jonny ◽  
Moch Hasyim ◽  
Vedora Angelia ◽  
Ayu Nursantisuryani Jahya ◽  
Lydia Permata Hilman ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Renal Replacement Therapy ◽  
Kidney Disease ◽  
Replacement Therapy ◽  
Kidney Injury ◽  
Predictive Score ◽  
Apache Ii Score ◽  
Intermittent Hemodialysis ◽  
Factors Associated

Abstract Background : Currently, there is limited epidemiology data on acute kidney injury (AKI) in Indonesia.Therefore, we assessed the incidence of AKI and the utilization of renal replacement therapy (RRT) in Indonesia. Methods : Demographic and clinical data were collected from 952 ICU participants. The participants were categorized into AKI and non-AKI groups. The participants were further classified according to the 3 different stages of AKI as per the Kidney Disease Improving Global Outcome (KDIGO) criteria. Results : Overall incidenceof AKI was 43%. The participants were divided into three groups based on the AKI stages: 18.5% had stage 1, 33% had stage 2, and 48.5% had stage 3. Primary diagnosis of renal disease and high APACHE II score were the risk factors associated with AKI (OR = 4.53, 95% CI: 1.67-12.33, p=0.003 and OR = 1.14 per 1 unit increase, 95% CI: 1.09-1.20, p<0.001, respectively).Chronic kidney disease was the risk factor for severe AKI. Sepsis was the leading cause of AKI.Among the AKI participants, 24.6% required RRT. The most common RRT modalities were intermittent hemodialysis (71.7%), followed by slow low-efficiency dialysis (22.8%), continuous renal replacement therapy (4.3%), and peritoneal dialysis (1.1%). Conclusions : This study showed that AKI was a common problem in the Indonesian ICU. We strongly believe that identification of the risk factors associated with AKI will help us develop a predictive score for AKI so we can prevent and improve AKI outcome in the future.

scholarly journals Risk Factors for Acute Kidney Injury Requiring Renal Replacement Therapy after Orthotopic Heart Transplantation in Patients with Preserved Renal Function

2021 ◽  
Vol 10 (18) ◽  
pp. 4117
Author(s):  
René M‘Pembele ◽  
Sebastian Roth ◽  
Alexandra Stroda ◽  
Giovanna Lurati Buse ◽  
Stephan U. Sixt ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Renal Function ◽  
Renal Replacement Therapy ◽  
Heart Transplantation ◽  
Replacement Therapy ◽  
Plasma Levels ◽  
Kidney Injury ◽  
Orthotopic Heart Transplantation ◽  
Postoperative Aki

Acute kidney injury (AKI), requiring renal replacement therapy (RRT). is a serious complication after orthotopic heart transplantation (HTX). In patients with preexisting impaired renal function, postoperative AKI is unsurprising. However, even in patients with preserved renal function, AKI requiring RRT is frequent. Therefore, this study aimed to identify risk factors associated with postoperative AKI requiring RRT after HTX in this sub-cohort. This retrospective cohort study included patients ≥18 years of age with preserved renal function (defined as preoperative glomerular filtration rate ≥60 mL/min) who underwent HTX between 2010 and 2021. In total, 107 patients were included in the analysis (mean age 52 ± 12 years, 78.5% male, 45.8% AKI requiring RRT). Based on univariate logistic regression, use of extracorporeal membrane oxygenation, postoperative infection, levosimendan therapy, duration of norepinephrine (NE) therapy and maximum daily increase in tacrolimus plasma levels were chosen to be included into multivariate analysis. Duration of NE therapy and maximum daily increase in tacrolimus plasma levels remained as independent significant risk factors (NE: OR 1.01, 95%CI: 1.00–1.02, p = 0.005; increase in tacrolimus plasma level: OR 1.18, 95%CI: 1.01–1.37, p = 0.036). In conclusion, this study identified long NE therapy and maximum daily increase in tacrolimus plasma levels as risk factors for AKI requiring RRT in HTX patients with preserved renal function.

Acute kidney injury

2020 ◽  
pp. 105-114
Author(s):  
Reshma Bholah ◽  
Timothy E. Bunchman
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Acute Kidney Injury ◽  
Intensive Care ◽  
Prognostic Factors ◽  
Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Kidney Injury ◽  
Made In

Acute kidney injury (AKI) affects roughly one-quarter of children in the Intensive Care Unit and is associated with increased morbidity and mortality. Progress made in classifying paediatric AKI has allowed for better recognition of this entity. Consideration of degree of fluid overload and other risk factors for mortality should influence the choice to initiate renal replacement therapy. And while not all patients with AKI will require renal replacement therapy, the modality needs to be chosen carefully. This book chapter aims to describe AKI, provide a brief overview of the aetiology and diagnosis of this process, describe biomarkers under study for diagnosing AKI, compare the modalities of renal replacement therapy, and touch upon prognostic factors and recent advances in the field.

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