Preoperative Statins and Acute Kidney Injury After Cardiac Surgery: Utilization of a Consensus Definition of Acute Kidney Injury

2011 ◽  
Vol 45 (1) ◽  
pp. 23-30 ◽  
Author(s):  
Scott Bolesta ◽  
Lindsey M Uhrin ◽  
John R Guzek
Keyword(s):  
Acute Kidney Injury ◽  
Cardiac Surgery ◽  
Kidney Injury ◽  
Consensus Definition ◽  
Definition Of

scholarly journals Evidence-based development of a nephrotoxic medication list to screen for acute kidney injury risk in hospitalized children

2019 ◽  
Vol 76 (22) ◽  
pp. 1869-1874 ◽  
Author(s):  
Elizabeth Goswami ◽  
Richard K Ogden ◽  
William E Bennett ◽  
Stuart L Goldstein ◽  
Richard Hackbarth ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Quality Improvement ◽  
Injury Risk ◽  
Kidney Injury ◽  
Quality Improvement Initiative ◽  
Evidence Based ◽  
Hospitalized Children ◽  
Consensus Definition ◽  
Medication Exposure ◽  
Definition Of

Abstract Purpose Medications are commonly associated with acute kidney injury (AKI). However, in both clinical practice and research, consideration of specific medications as nephrotoxic varies widely. The Nephrotoxic Injury Negated by Just-in-time Action quality improvement collaborative was formed to focus on prevention or reduction of nephrotoxic medication-associated AKI in noncritically ill hospitalized children. However, there were discrepancies among institutions as to which medications should be considered nephrotoxic. The collaborative convened a Nephrotoxic Medication (NTMx) Subcommittee to develop a consensus for the classification of nephrotoxic medications. Summary The NTMx Subcommittee initially included pediatric nephrologists, a pharmacist, and a pediatric intensivist. The committee reviewed NTMx lists from the collaborative and identified changes from the initial NTMx list. The NTMx Subcommittee conducted a literature review of the disputed medications and assigned an evidence grade based on the reported association with nephrotoxicity and the quality of the data. The association between medication exposure and AKI was also determined using administrative data from the Pediatric Health Information Systems database. The NTMx Subcommittee then came to a majority consensus regarding which medications should be included on the list. The subcommittee’s recommendations were presented to the larger collaborative for approval, and consensus was achieved. The list continues to be reviewed and updated annually. Conclusion Formation of a multicenter quality-improvement initiative exposed current limitations as to which medications are considered nephrotoxic in clinical and research settings and presented an opportunity to approach this problem using an evidence-based process. A consensus definition of nephrotoxic-medication exposure was achieved.

scholarly journals Association of Definition of Acute Kidney Injury by Cystatin C Rise With Biomarkers and Clinical Outcomes in Children Undergoing Cardiac Surgery

2015 ◽  
Vol 169 (6) ◽  
pp. 583 ◽  
Author(s):  
Michael Zappitelli ◽  
Jason H. Greenberg ◽  
Steven G. Coca ◽  
Catherine D. Krawczeski ◽  
Simon Li ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Cardiac Surgery ◽  
Clinical Outcomes ◽  
Cystatin C ◽  
Kidney Injury ◽  
Definition Of

scholarly journals Cardiac surgery-associated acute kidney injury (CSA-AKI) in adults and pediatrics; prevention is the optimal management.

2021 ◽  
Author(s):  
Abdulaziz Alghamdi ◽  
Mohammed O. Aqeeli ◽  
Saud Muhaisin Altalhi Q ◽  
Fahad Khaled Alshammari M ◽  
Abdullah Mohammed Bajebair A ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Cardiac Surgery ◽  
Kidney Injury ◽  
Acute Kidney Injury Network ◽  
University Hospital ◽  
Optimal Management ◽  
Baseline Serum ◽  
King Abdulaziz University ◽  
Definition Of

Background Cardiac surgery-associated acute kidney injury (CSA-AKI) is an important and serious complication that affects morbidity and mortality. We studied both pediatric and adults using the definition of the Acute Kidney Injury Network (AKIN). Methods This is an observational retrospective cohort study done at King Abdulaziz University Hospital in Jeddah, Saudi Arabia approved by ethical committee. The exclusion criteria were baseline serum creatinine (SCr) ≥ 4 mg/dL or preexisting renal failure requiring dialysis, reoperation, death within 24 hours postoperatively, and operative mortality or missing data. 941 patients were included in the analysis using the statistical software  SPSS, version 15.0. Results 28.68% in the adult group and 20.07% in the pediatric group developed CSA-AKI. Adult risk factors included age group of 60-69 years, cardiopulmonary bypass (CPB), number of grafts and hypertension. In the pediatric group, CPB, aortic cross-clamping (ACX) and the lower preoperative SCr are the main risk factors Conclusion Conventional conservative management and preoperative Identification of predictor risk factors are essential for prevention of CSA-AKI which constitute the main strategy for optimal management.

scholarly journals Impact of a new definition of acute kidney injury based on creatinine kinetics in cardiac surgery patients: a comparison with the RIFLE classification

2014 ◽  
Vol 20 (3) ◽  
pp. 338-344 ◽  
Author(s):  
Jose M. Garrido ◽  
Angel M. Candela-Toha ◽  
Diego Parise-Roux ◽  
Mayte Tenorio ◽  
Victor Abraira ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Cardiac Surgery ◽  
Kidney Injury ◽  
Rifle Classification ◽  
Creatinine Kinetics ◽  
Definition Of

scholarly journals New Consensus Definition of Acute Kidney Injury Accurately Predicts 30-Day Mortality in Patients With Cirrhosis and Infection

2013 ◽  
Vol 145 (6) ◽  
pp. 1280-1288.e1 ◽  
Author(s):  
Florence Wong ◽  
Jacqueline G. O'Leary ◽  
K. Rajender Reddy ◽  
Heather Patton ◽  
Patrick S. Kamath ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Kidney Injury ◽  
Consensus Definition ◽  
Definition Of

Preoperative Low Serum Albumin Levels Increase the Requirement of Renal Replacement Therapy after Cardiac Surgery

2016 ◽  
Vol 19 (3) ◽  
pp. 123 ◽  
Author(s):  
Orhan Findik ◽  
Ufuk Aydin ◽  
Ozgur Baris ◽  
Hakan Parlar ◽  
Gokcen Atilboz Alagoz ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Regression Analysis ◽  
Cardiac Surgery ◽  
Renal Replacement Therapy ◽  
Serum Albumin ◽  
Replacement Therapy ◽  
Kidney Injury ◽  
Preoperative Serum ◽  
Group I ◽  
Group Ii

<strong>Background:</strong> Acute kidney injury is a common complication of cardiac surgery that increases morbidity and mortality. The aim of the present study is to analyze the association of preoperative serum albumin levels with acute kidney injury and the requirement of renal replacement therapy after isolated coronary artery bypass graft surgery (CABG).<br /><strong>Methods:</strong> We retrospectively reviewed the prospectively collected data of 530 adult patients who underwent isolated CABG surgery with normal renal function. The perioperative clinical data of the patients included demographic data, laboratory data, length of stay, in-hospital complications and mortality. The patient population was divided into two groups: group I patients with preoperative serum albumin levels &lt;3.5 mg/dL; and group II pateints with preoperative serum albumin levels ≥3.5 mg/dL.<br /><strong>Results:</strong> There were 413 patients in group I and 117 patients in group II. Postoperative acute kidney injury (AKI) occured in 33 patients (28.2%) in group I and in 79 patients (19.1%) in group II. Renal replacement therapy was required in 17 patients (3.2%) (8 patients from group I; 9 patients from group II; P = .018). 30-day mortality occurred in 18 patients (3.4%) (10 patients from group I; 8 patients from group II; P = .037). Fourteen of these patients required renal replacement therapy. Logistic regression analysis revealing the presence of lower serum albumin levels preoperatively was shown to be associated with increased incidence of postoperative AKI (OR: 1.661; 95% CI: 1.037-2.661; <br />P = .035). Logistic regression analysis also revealed that DM (OR: 3.325; 95% CI: 2.162-5.114; P = .000) was another independent risk factor for AKI after isolated CABG. <br /><strong>Conclusion:</strong> Low preoperative serum albumin levels result in severe acute kidney injury and increase the rate of renal replacement therapy and mortality after isolated CABG.

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