scholarly journals The Involvement of Chronic Kidney Disease and Acute Kidney Injury in Disease Severity and Mortality in Patients with COVID-19: A Meta-Analysis

2020 ◽  
pp. 1-14
Author(s):  
Bin Wang ◽  
Qing Luo ◽  
Weiguang Zhang ◽  
Shuai Yu ◽  
Xiaowei Cheng ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Acute Kidney Injury ◽  
Kidney Disease ◽  
Disease Severity ◽  
Meta Analysis ◽  
Kidney Injury ◽  
Research Network ◽  
Cochrane Library ◽  
Severe Condition ◽  
Increased Risk

<b><i>Background:</i></b> A meta-analysis was performed to evaluate the association of chronic kidney disease (CKD) and acute kidney injury (AKI) with the clinical prognosis of patients with coronavirus disease 2019 (COVID-19). <b><i>Methods:</i></b> The PubMed, EMBASE, Cochrane Library, medRxiv, Social Science Research Network, and Research Square databases (from December 1, 2019 to May 15, 2020) were searched to identify studies that reported the associations of CKD/AKI and disease severity/mortality. Pooled odds ratios (ORs) and 95% confidence intervals (CIs) were calculated and meta-regression was performed. <b><i>Results:</i></b> In total, 42 studies enrolling 8,932 participants were included in this meta-analysis. The quality of most included studies was moderate to high. Compared with patients without previously diagnosed CKD, those with CKD had a significantly increased risk of progressing to a severe condition (OR 2.31, 95% CI 1.64–3.24) or death (OR 5.11, 95% CI 3.36–7.77). Similarly, compared with patients without AKI, those with AKI had a significantly increased risk of progressing to a severe condition (OR 11.88, 95% CI 9.29–15.19) or death (OR 30.46, 95% CI 18.33–50.59). Compared with patients with previously diagnosed CKD, those with AKI were more likely to progress to a severe condition (<i>p</i><sub>group</sub> &#x3c; 0.001, <i>I</i><sup>2</sup> = 98.3%) and even to death (<i>p</i><sub>group</sub> &#x3c; 0.001, <i>I</i><sup>2</sup> = 96.5%). Age had a significant impact on the association between CKD and disease severity (<i>p</i> = 0.001) but had no impact on the associations between AKI and disease severity (<i>p</i> = 0.80), between CKD and mortality (<i>p</i> = 0.51), or between AKI and mortality (<i>p</i> = 0.86). Four important complications (cardiac injury, shock, acute respiratory distress syndrome, and liver injury) did not significantly affect the associations between CKD/AKI and disease severity/mortality, indicating that CKD/AKI may be independent clinical prognostic indicators for patients with COVID-19. <b><i>Conclusions:</i></b> In COVID-19 patients, CKD/AKI was associated with worse outcomes compared with those without CKD/AKI. AKI was associated with higher risks of severity and mortality than CKD.

Comparative Efficacy of Statins for Prevention of Contrast-Induced Acute Kidney Injury in Patients With Chronic Kidney Disease: A Network Meta-Analysis

Angiology ◽  
2018 ◽  
Vol 70 (4) ◽  
pp. 305-316 ◽  
Author(s):  
Xinbin Zhou ◽  
Jin Dai ◽  
Xiaoming Xu ◽  
Zhijun Wang ◽  
Haibin Xu ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Acute Kidney Injury ◽  
Kidney Disease ◽  
Cardiac Catheterization ◽  
Meta Analysis ◽  
Kidney Injury ◽  
Cochrane Library ◽  
High Dose ◽  
Iodinated Contrast ◽  
Reduced Risk

Contrast-induced acute kidney injury (CI-AKI) is a common complication of iodinated contrast medium administration during cardiac catheterization. Statin treatment has been shown to be associated with reduced risk of CI-AKI; however, the results are inconsistent, especially for patients with chronic kidney disease (CKD). Thus, we conducted a network meta-analysis to evaluate the effects of statins in the prevention of CI-AKI. We systematically searched several databases (including, Embase, PubMed, the Cochrane Library, and ClinicalTrials.gov ) from inception to January 31, 2018. The primary outcome was occurrence of CI-AKI in patients with CKD undergoing cardiac catheterization. Both pairwise and network meta-analysis were performed. Finally, 21 randomized controlled trials with a total of 6385 patients were included. Results showed that statin loading before contrast administration was associated with a significantly reduced risk of CI-AKI in patients with CKD undergoing cardiac catheterization (odds ratio: 0.46; P < .05). Atorvastatin and rosuvastatin administered at high dose may be the most effective treatments to reduce incidence of CI-AKI, with no difference between these 2 agents.

scholarly journals Postoperative acute kidney injury in adult non-cardiac surgery: joint consensus report of the Acute Disease Quality Initiative and PeriOperative Quality Initiative

2021 ◽  
Author(s):  
John R. Prowle ◽  
Lui G. Forni ◽  
Max Bell ◽  
Michelle S. Chew ◽  
Mark Edwards ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Acute Kidney Injury ◽  
Cardiac Surgery ◽  
Kidney Disease ◽  
Kidney Injury ◽  
Adverse Outcomes ◽  
Baseline Risk ◽  
Major Surgery ◽  
Increased Risk

AbstractPostoperative acute kidney injury (PO-AKI) is a common complication of major surgery that is strongly associated with short-term surgical complications and long-term adverse outcomes, including increased risk of chronic kidney disease, cardiovascular events and death. Risk factors for PO-AKI include older age and comorbid diseases such as chronic kidney disease and diabetes mellitus. PO-AKI is best defined as AKI occurring within 7 days of an operative intervention using the Kidney Disease Improving Global Outcomes (KDIGO) definition of AKI; however, additional prognostic information may be gained from detailed clinical assessment and other diagnostic investigations in the form of a focused kidney health assessment (KHA). Prevention of PO-AKI is largely based on identification of high baseline risk, monitoring and reduction of nephrotoxic insults, whereas treatment involves the application of a bundle of interventions to avoid secondary kidney injury and mitigate the severity of AKI. As PO-AKI is strongly associated with long-term adverse outcomes, some form of follow-up KHA is essential; however, the form and location of this will be dictated by the nature and severity of the AKI. In this Consensus Statement, we provide graded recommendations for AKI after non-cardiac surgery and highlight priorities for future research.

scholarly journals Developing better mouse models to study cisplatin-induced kidney injury

2017 ◽  
Vol 313 (4) ◽  
pp. F835-F841 ◽  
Author(s):  
Cierra N. Sharp ◽  
Leah J. Siskind
Keyword(s):  
Chronic Kidney Disease ◽  
Acute Kidney Injury ◽  
Kidney Disease ◽  
Kidney Injury ◽  
Therapeutic Interventions ◽  
Low Doses ◽  
Dosing Regimen ◽  
Risk Of Mortality ◽  
Increased Risk ◽  
Novel Therapeutic

Cisplatin is a potent chemotherapeutic used for the treatment of many types of cancer. However, its dose-limiting side effect is nephrotoxicity leading to acute kidney injury (AKI). Patients who develop AKI have an increased risk of mortality and are more likely to develop chronic kidney disease (CKD). Unfortunately, there are no therapeutic interventions for the treatment of AKI. It has been suggested that the lack of therapies is due in part to the fact that the established mouse model used to study cisplatin-induced AKI does not recapitulate the cisplatin dosing regimen patients receive. In recent years, work has been done to develop more clinically relevant models of cisplatin-induced kidney injury, with much work focusing on incorporation of multiple low doses of cisplatin administered over a period of weeks. These models can be used to recapitulate the development of CKD after AKI and, by doing so, increase the likelihood of identifying novel therapeutic targets for the treatment of cisplatin-induced kidney injury.

scholarly journals Acute kidney injury is associated with severe and fatal outcomes in patients with Coronavirus disease 2019 (COVID-19) infection: a systematic review and meta-analysis of observational studies

2020 ◽  
Author(s):  
Mohammad Parohan ◽  
Sajad Yaghoubi ◽  
Mahmoud Djalali ◽  
Asal Seraji ◽  
Mohammad Hassan Javanbakht ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Disease Severity ◽  
Fixed Effects ◽  
Weighted Mean Difference ◽  
Meta Analysis ◽  
Kidney Injury ◽  
Cochrane Library ◽  
Pool Data ◽  
Fixed Effects Model ◽  
Death Cases

Coronavirus disease 2019 (COVID-19) is a pandemic impacting 213 countries and territories with more than 17,918,582 cases worldwide. Kidney dysfunction has been reported to occur in severe and death cases. This meta-analysis was done to summarize available studies on the association between acute kidney injury and severity of COVID-19 infection. Online databases including Web of Science, PubMed/Medline, Cochrane Library, Scopus and Google Scholar were searched to detect relevant articles up to 1 July 2020, using relevant keywords. To pool data, a random- or fixed-effects model was used based on the heterogeneity between studies. In total, 50 studies with 8,180 COVID-19 confirmed cases (severe cases=1,823 and death cases=775), were included in this meta-analysis. Higher serum levels of creatinine (weighted mean difference (WMD) for disease severity=5.47 μmol/L, 95% CI=2.89 to 8.05, P<0.001 and WMD for mortality=18.32 μmol/L, 95% CI=12.88 to 23.75, P<0.001), blood urea nitrogen (BUN) (WMD for disease severity=1.10 mmol/L, 95% CI=0.67 to 1.54, P<0.001 and WMD for mortality=3.56 mmol/L, 95% CI=2.65 to 4.48, P<0.001) and lower levels of estimated glomerular filtration rate (eGFR) (WMD for disease severity=-15.34 mL/min/1.73 m2, 95% CI=-18.46 to -12.22, P<0.001 and WMD for mortality=-22.74 mL/min/1.73 m2, 95% CI=-27.18 to -18.31, P<0.001) were associated with a significant increase in the severity and mortality of COVID-19 infection. Acute kidney injury, as assessed by kidney biomarkers (serum creatinine, BUN and eGFR), was associated with severe outcome and death from COVID-19 infection.

scholarly journals Acute Kidney Injury in Patients Receiving Systemic Treatment for Cancer: A Population-Based Cohort Study

2018 ◽  
Vol 111 (7) ◽  
pp. 727-736 ◽  
Author(s):  
Abhijat Kitchlu ◽  
Eric McArthur ◽  
Eitan Amir ◽  
Christopher M Booth ◽  
Rinku Sutradhar ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Acute Kidney Injury ◽  
Kidney Disease ◽  
Angiotensin Converting Enzyme ◽  
Systemic Therapy ◽  
Kidney Injury ◽  
Population Based ◽  
Converting Enzyme ◽  
Angiotensin Receptor ◽  
Increased Risk

Abstract Background Patients undergoing treatment for cancer are at increased risk of acute kidney injury (AKI). There are few data on AKI incidence and risk factors in the current era of cancer treatment. Methods We conducted a population-based study of all patients initiating systemic therapy (chemotherapy or targeted agents) for a new cancer diagnosis in Ontario, Canada (2007–2014). The primary outcome was hospitalization with AKI or acute dialysis. We estimated the cumulative incidence of AKI and fitted Fine and Gray models, adjusting for demographics, cancer characteristics, comorbidities, and coprescriptions. We modeled exposure to systemic therapy (the 90-day period following treatments) as a time-varying covariate. We also assessed temporal trends in annual AKI incidence. Results We identified 163 071 patients initiating systemic therapy of whom 10 880 experienced AKI. The rate of AKI was 27 per 1000 person-years, with overall cumulative incidence of 9.3% (95% CI = 9.1% to 9.6%). Malignancies with the highest 5-year AKI incidence were myeloma (26.0%, 95% CI = 24.4% to 27.7%), bladder (19.0%, 95% CI = 17.6% to 20.5%), and leukemia (15.4%, 95% CI = 14.3% to 16.5%). Advanced cancer stage, chronic kidney disease, and diabetes were associated with increased risk of AKI (adjusted hazard ratios [aHR] = 1.41, 95% CI = 1.28 to 1.54; 1.80, 95% CI = 1.67 to 1.93; and 1.43, 95% CI = 1.37 to 1.50, respectively). In patients aged 66 years or older with universal drug benefits, diuretic, and angiotensin-converting enzyme inhibitor/angiotensin receptor blocker coprescription was associated with higher AKI risk (aHR = 1.20, 95% CI = 1.14 to 1.28; 1.30, 95% CI = 1.23 to 1.38). AKI risk was further accentuated during the 90-day period following systemic therapy (aHR = 2.34, 95% CI = 2.24 to 2.45). The annual incidence of AKI increased from 18 to 52 per 1000 person-years between 2007 and 2014. Conclusion Cancer-related AKI is common and associated with advanced stage, chronic kidney disease, diabetes, and concomitant receipt of diuretics or angiotensin-converting enzyme inhibitors/angiotensin receptor blockers. Risk is heightened in the 90 days after systemic therapy. Preventive strategies are needed to address the increasing burden of AKI in this population.

scholarly journals Increased risk of death and de novo chronic kidney disease following reversible acute kidney injury

2012 ◽  
Vol 81 (5) ◽  
pp. 477-485 ◽  
Author(s):  
Ion D. Bucaloiu ◽  
H Lester Kirchner ◽  
Evan R. Norfolk ◽  
James E. Hartle ◽  
Robert M. Perkins
Keyword(s):  
Chronic Kidney Disease ◽  
Acute Kidney Injury ◽  
Kidney Disease ◽  
De Novo ◽  
Kidney Injury ◽  
Risk Of Death ◽  
Increased Risk
Sign in / Sign up

Export Citation Format

Share Document