scholarly journals The Colistin-related nephrotoxicity and risk factors in the intensive care unit; a retrospective study

2021 ◽  
Vol 8 (1) ◽  
pp. 9-13
Author(s):  
Guler Doganay ◽  
Mustafa Ozgur Cirik ◽  
Ali Alagoz
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Significant Risk ◽  
Kidney Injury ◽  
Laboratory Evaluation ◽  
Multi Drug Resistance ◽  
Reactive Protein ◽  
Colistimethate Sodium ◽  
Nephrotoxic Drugs

Objective:  Colistimethate sodium (CMS) which is salvage therapy in the management of infections caused by multi-drug resistance (MDR) gram-negative pathogens is eliminated by the kidneys and cause nephrotoxicity. Many factors may also contribute to this nephrotoxic effect. In this study we aimed to determine the risks for the development of nephrotoxicity patients who received CMS in the intensive care unit (ICU). Materials and Methods: We evaluated retrospectively of the patients who have lung cancer or COPD, aged older than 18 years, and received intravenous CMS therapy at least 72 hours in ICU.  Patients’ age, comorbidities, C-reactive protein (CRP), procalcitonin, albumin, glomerular filtration rate (GFR),  creatinine values on the 1st and 7th days of CMS treatment, positive inotropes,  and nephrotoxic drugs  used concurrently with CMS therapy, and renal replacement therapy (RRT) were recorded. RIFLE score , lenght  of stay (LOS) in hospital and in  the ICU, and 28-day mortality were also recorded. Results: In this study, the GFR and creatinine level deteriorated significantly on the 7th day with CMS therapy patients who had preexisting lower GFR, hypoalbuminemia, and concomitant nephrotoxic drugs usage. The incidence of acute kidney injury was higher in malignant patients and 28-day mortality increased in patients with nephrotoxicity. Conclusion: The CMS therapy with preexisting lower GFR, hypoalbuminemia, and concomitant nephrotoxic drugs usage significant risk factors to develop nephrotoxicity.  It was also higher in malignant patients and increased 28-day mortality. Detailed clinical and laboratory evaluation of the patients is needed before CMS treatment.

scholarly journals Study of clinical profile, risk factors of acute kidney injury in children admitted in pediatric intensive care unit at tertiary health care centre

2020 ◽  
Vol 7 (8) ◽  
pp. 1665
Author(s):  
Harsha S. ◽  
Gonesh N. Mevundi
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Acute Kidney Injury ◽  
Intensive Care ◽  
General Hospital ◽  
Pediatric Intensive Care Unit ◽  
Significant Risk ◽  
Kidney Injury ◽  
Pediatric Intensive Care ◽  
Clinical Profile

Background: Acute kidney injury (AKI) is an important condition in hospitalized patients, associated with adverse short- and long-term outcomes. Objective of this study was to determine the clinical profile of acute kidney injury in pediatric ICU (Basaveshwar Teaching and General Hospital, Sangameshwar Hospital, Kalaburagi).Methods: This study was conducted in all patients within the age group of 1 month to 18 years admitted in the PICU (pediatric intensive care unit) at Basaveshwar teaching and General hospital and Sangameshwar hospital attached to Mahadevappa Rampure medical college during a period from December 2015 to May 2017.Results: Incidence of AKI was 6.9% in pediatric intensive care unit. The median age of boys and girls were 4.56±3.84 and 4.49±4.01 respectively. Hypotension and need for ventilation were significant risk factors for AKI (p<0.001). The median admission serum creatinine value in AKI patients was 2.91±2.48 mg/dL. In the present study, the median duration of PICU and Hospital stay was 9.98±7.27 in AKI group compared to7.41±5.62 days in non-AKI group (p<0.001).Conclusions: It was concluded that Incidence of AKI was 6.9% in pediatric intensive care unit. The mean and SD of age of boys and girls were 4.56±3.84 and 4.49±4.01 respectively. Hypotension and need for ventilation were significant risk factors for AKI.

Analysis of diagnostic criteria for ventilator-associated pneumonia: a cohort study

2021 ◽  
Vol 74 (6) ◽  
Author(s):  
Caroline Gonçalves Pustiglione Campos ◽  
Aline Pacheco ◽  
Maria Dagmar da Rocha Gaspar ◽  
Guilherme Arcaro ◽  
Péricles Martim Reche ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Mechanical Ventilation ◽  
Cohort Study ◽  
Intensive Care ◽  
Diagnostic Criteria ◽  
Statistical Tests ◽  
Significant Risk ◽  
Diagnostic Methods ◽  
Ventilator Associated Pneumonia

ABSTRACT Objectives: to analyze the diagnostic criteria for ventilator-associated pneumonia recommended by the Brazilian Health Regulatory Agency and the National Healthcare Safety Network/Centers for Disease Control and Prevention, as well as its risk factors. Methods: retrospective cohort study carried out in an intensive care unit throughout 12 months, in 2017. Analyses included chi-square, simple linear regression, and Kappa statistical tests and were conducted using Stata 12 software. Results: the sample was 543 patients who were in the intensive care unit and under mechanical ventilation, of whom 330 (60.9%) were men and 213 (39.1%) were women. Variables such as gender, age, time under mechanical ventilation, and oral hygiene proved to be significant risk factors for the development of ventilator-associated pneumonia. Conclusions: patients submitted to mechanical ventilation need to be constantly evaluated so the used diagnostic methods can be accurate and applied in an objective and standardized way in Brazilian hospitals.

scholarly journals Acute kidney injury in pediatric intensive care unit: Incidence, risk factors, and outcome

2016 ◽  
Vol 20 (9) ◽  
pp. 526-529 ◽  
Author(s):  
Sheetal Gupta ◽  
Ghanshyam Sengar ◽  
Praveen K. Meti ◽  
Anil Lahoti ◽  
Mukesh Beniwal ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Acute Kidney Injury ◽  
Intensive Care ◽  
Pediatric Intensive Care Unit ◽  
Kidney Injury ◽  
Pediatric Intensive Care ◽  
Incidence Risk

scholarly journals Risk factors for acute kidney injury in a pediatric intensive care unit: a retrospective cohort study

Medwave ◽  
2017 ◽  
Vol 17 (03) ◽  
pp. e6940-e6940 ◽  
Author(s):  
Lina María Serna-Higuita ◽  
John Fredy Nieto-Ríos ◽  
Jorge Eduardo Contreras-Saldarriaga ◽  
Juan Felipe Escobar-Cataño ◽  
Luz Adriana Gómez-Ramírez ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Acute Kidney Injury ◽  
Cohort Study ◽  
Intensive Care ◽  
Pediatric Intensive Care Unit ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Kidney Injury ◽  
Pediatric Intensive Care

scholarly journals Vancomycin-induced nephrotoxicity in non-intensive care unit pediatric patients

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Shinhyeung Kwak ◽  
Jeong Yeon Kim ◽  
Heeyeon Cho
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Pediatric Patients ◽  
Trough Level ◽  
Medical Center ◽  
Kidney Injury ◽  
Maximum Serum ◽  
Serum Trough ◽  
Youden’S Index

AbstractPrevious data suggested several risk factors for vancomycin-induced nephrotoxicity (VIN), including higher daily dose, long-term use, underlying renal disease, intensive care unit (ICU) admission, and concomitant use of nephrotoxic medications. We conducted this study to investigate the prevalence and risk factors of VIN and to estimate the cut-off serum trough level for predicting acute kidney injury (AKI) in non-ICU pediatric patients. This was a retrospective, observational, single-center study at Samsung Medical Center tertiary hospital, located in Seoul, South Korea. We reviewed the medical records of non-ICU pediatric patients, under 19 years of age with no evidence of previous renal insufficiency, who received vancomycin for more than 48 h between January 2009 and December 2018. The clinical characteristics were compared between patients with AKI and those without to identify the risk factors associated with VIN, and the cut-off value of serum trough level to predict the occurrence of VIN was calculated by the Youden’s index. Among 476 cases, 22 patients (4.62%) developed AKI. The Youden’s index indicated that a maximum serum trough level of vancomycin above 24.35 μg/mL predicted VIN. In multivariate analysis, longer hospital stay, concomitant use of piperacillin-tazobactam and serum trough level of vancomycin above 24.35 μg/mL were associated independently with VIN. Our findings suggest that concomitant use of nephrotoxic medication and higher serum trough level of vancomycin might be associated with the risk of VIN. This study suggests that measuring serum trough level of vancomycin can help clinicians prevent VIN in pediatric patients.

scholarly journals Risk Factors For Kidney Damage In COVID-19 Patients Admitted To The Intensive Care Unit

2021 ◽  
Vol 10 (2) ◽  
Author(s):  
Diana K. Sarkisian ◽  
Natalia V. Chebotareva ◽  
Valerie McDonnell ◽  
Armen V. Oganesyan ◽  
Tatyana N. Krasnova ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Kidney Injury ◽  
Kidney Damage ◽  
Elderly Age ◽  
Total Blood ◽  
Independent Risk Factors

Background — Acute kidney injury (AKI) reaches 29% in the intensive care unit (ICU). Our study aimed to determine the prevalence, features, and the main AKI factors in critically ill patients with coronavirus disease 2019 (COVID-19). Material and Methods — The study included 37 patients with COVID-19. We analyzed the total blood count test results, biochemical profile panel, coagulation tests, and urine samples. We finally estimated the markers of kidney damage and mortality. Result — All patients in ICU had proteinuria, and 80.5% of patients had hematuria. AKI was observed in 45.9% of patients. Independent risk factors were age more than 60 years, increased C-reactive protein (CRP) level, and decreased platelet count. Conclusion — Kidney damage was observed in most critically ill patients with COVID-19. The independent risk factors for AKI in critically ill patients were elderly age, a cytokine response with a high CRP level.

scholarly journals Analysis of the Risk Factors Associated with Hearing Loss of Infants Admitted to a Neonatal Intensive Care Unit: A 13-Year Experience in a University Hospital in Korea

2020 ◽  
Vol 17 (21) ◽  
pp. 8082
Author(s):  
Kyu Young Choi ◽  
Bum Sang Lee ◽  
Hyo Geun Choi ◽  
Su-Kyoung Park
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Hearing Loss ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Significant Risk ◽  
University Hospital ◽  
Control Group ◽  
Brainstem Response

Early detection of hearing loss in neonates is important for normal language development, especially for infants admitted to the neonatal intensive care unit (NICU) because the infants in NICU have a higher incidence of hearing loss than healthy infants. However, the risk factors of hearing loss in infants admitted to the NICU have not been fully acknowledged, especially in Korea, although they may vary according to the circumstances of each country and hospital. In this study, the risk factors of hearing loss in NICU infants were analyzed by using the newborn hearing screening (NHS) and the diagnostic auditory brainstem response (ABR) test results from a 13-year period. A retrospective chart review was performed using a list of NICU infants who had performed NHS from 2004 to 2017 (n = 2404) in a university hospital in Korea. For the hearing loss group, the hearing threshold was defined as 35 dB nHL or more in the ABR test performed in infants with a ‘refer’ result in the NHS. A four multiple number of infants who had passed the NHS test and matched the age and gender of the hearing loss group were taken as the control group. Various patient factors and treatment factors were taken as hearing loss related variables and were analyzed and compared. From the 2404 infants involved, the prevalence of hearing loss was 1.8% (n = 43). A comparison between the hearing loss group (n = 43) and the control group (n = 172) revealed that history of sepsis, peak total bilirubin, duration of vancomycin use, days of phototherapy, and exposure to loop-inhibiting diuretics were significantly different, and can be verified as significant risk factors for hearing loss in NICU infants.

scholarly journals Incidence, Risk Factors, and Outcome of Acute Kidney Injury in the Intensive Care Unit: A Single-Center Study from Jordan

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Ashraf O. Oweis ◽  
Sameeha A. Alshelleh ◽  
Suleiman M. Momany ◽  
Shaher M. Samrah ◽  
Basheer Y. Khassawneh ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Acute Kidney Injury ◽  
Intensive Care ◽  
Kidney Injury ◽  
Tertiary Hospital ◽  
Acute Kidney Injury Network ◽  
Apache Ii Score ◽  
Mortality And Morbidity ◽  
Incidence Risk

Background. Acute kidney injury (AKI) is a common serious problem affecting critically ill patients in intensive care unit (ICU). It increases their morbidity, mortality, length of ICU stay, and long-term risk of chronic kidney disease (CKD). Methods. A retrospective study was carried out in a tertiary hospital in Jordan. Medical records of patients admitted to the medical ICU between 2013 and 2015 were reviewed. We aimed to identify the incidence, risk factors, and outcomes of AKI. Acute kidney injury network (AKIN) classification was used to define and stage AKI. Results. 2530 patients were admitted to medical ICU, and the incidence of AKI was 31.6%, mainly in stage 1 (59.4%). In multivariate analysis, increasing age (odds ratio (OR) = 1.2 (95% CI 1.1–1.3), P = 0.0001) and higher APACHE II score (OR = 1.5 (95% CI 1.2–1.7), P = 0.001) were predictors of AKI, with 20.4% of patients started on hemodialysis. At the time of discharge, 58% of patients with AKI died compared to 51.3% of patients without AKI (P = 0.05). 88% of patients with AKIN 3 died by the time of discharge compared to patients with AKIN 2 and 1 (75.3% and 61.2% respectively, P = 0.001). Conclusion. AKI is common in ICU patients, and it increases mortality and morbidity. Close attention for earlier detection and addressing risk factors for AKI is needed to decrease incidence, complications, and mortality.

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