scholarly journals COVID-19 and acute kidney injury: Point-of-care ultrasound in the assessment of volume status

2020 ◽  
Vol 0 (0) ◽  
pp. 0
Author(s):  
Subhrashis Guha Niyogi ◽  
KrishnaPrasad Gourav ◽  
Sunder Negi ◽  
Vikas Suri ◽  
GoverdhanDutt Puri
Keyword(s):  
Acute Kidney Injury ◽  
Point Of Care ◽  
Kidney Injury ◽  
Volume Status ◽  
Point Of Care Ultrasound

Point-of-Care Echocardiography Unveils Misclassification of Acute Kidney Injury as Hepatorenal Syndrome

2019 ◽  
Vol 50 (3) ◽  
pp. 204-211 ◽  
Author(s):  
Juan Carlos Q. Velez ◽  
Bradley Petkovich ◽  
Nithin Karakala ◽  
J. Terrill Huggins
Keyword(s):  
Acute Kidney Injury ◽  
Kidney Function ◽  
Volume Expansion ◽  
Hepatorenal Syndrome ◽  
Point Of Care ◽  
Kidney Injury ◽  
Volume Status ◽  
Early Improvement ◽  
Abdominal Hypertension ◽  
The Mean

Introduction: Fulfillment of the diagnostic criteria for ­hepatorenal syndrome type 1 (HRS-1) requires prior failure of 2 days of intravenous volume expansion and/or diuretic withdrawal. However, no parameter of volume status is used to guide the need for volume expansion in patients with suspected HRS-1. We hypothesized that point-of-care echocardiography (POCE) may better characterize the volume status in patients with acute kidney injury (AKI) and cirrhosis to ascertain or disprove the diagnosis of HRS-1. Methods: A pilot observational study was conducted to determine the clinical utility of POCE-based examination of inferior vena cava diameter (IVCD) and collapsibility index (IVCCI) to assess intravascular volume status in patients with cirrhosis and AKI who had been deemed adequately volume-repleted and thereby assigned a clinical diagnosis of HRS-1. Early improvement in kidney function was defined as ≥20% decrease in serum creatinine (sCr) at 48–72 h. Results: A total of 53 patients were included. The mean sCr at the time of volume assessment was 3.2 ± 1.5 mg/dL, and the mean Model for End-Stage Liver Disease score was 29 ± 8. Fifteen (23%) patients had an IVCD <1.3 cm and IVCCI >40% and were reclassified as fluid-depleted, 11 (21%) had an IVCD >2 cm and IVCCI <40% and were reclassified as fluid-expanded, and 8 (15%) had and IVCD <1.3 cm and IVCCI <40% and were reclassified as having intra-abdominal hypertension (IAH). Twelve (23%) patients exhibited early improvement in kidney function following a POCE-guided therapeutic maneuver, that is, volume expansion, diuresis, or paracentesis for those deemed fluid-depleted, fluid-expanded or having IAH, respectively. Conclusion: POCE-based assessment of volume status in cirrhotic individuals with AKI reveals marked heterogeneity. Unguided volume expansion in these patients may lead to premature or delayed diagnosis of HRS-1.

scholarly journals Point of care ultrasound in acute kidney injury – rapid and reliable imaging at the point of admission

2020 ◽  
Vol 20 (Suppl 2) ◽  
pp. s91-s91
Author(s):  
Samiksha Nepal ◽  
Nicholas Smallwood ◽  
Martin Dachsel
Keyword(s):  
Acute Kidney Injury ◽  
Point Of Care ◽  
Kidney Injury ◽  
Point Of Care Ultrasound

scholarly journals POCUS Evaluation in Acute Kidney Injury

POCUS Journal ◽  
2021 ◽  
Vol 6 (2) ◽  
pp. 67-69
Author(s):  
Vanessa Hoytfox ◽  
Brittney Ward ◽  
Emily Cox ◽  
Kang Zhang
Keyword(s):  
Acute Kidney Injury ◽  
Point Of Care ◽  
Fluid Collection ◽  
Complicated Urinary Tract Infection ◽  
Kidney Injury ◽  
Clinical History ◽  
Clinical Problem ◽  
Point Of Care Ultrasound ◽  
Renal Sinus ◽  
General Internal

Acute kidney injury is a common clinical problem encountered in general internal medicine. The evaluation of acute kidney injury is mainly driven by the patient’s clinical history, physical exam and basic urinary/laboratory investigation. Point of care ultrasound (POCUS) may be a useful tool to help clinicians to narrow and/or prioritize differential diagnosis in patients presenting with acute kidney injury. Here we present a case of a 67-year old male presenting with dysuria, fevers, and flank pain along with elevation in serum creatinine who was admitted for acute kidney injury secondary to complicated urinary tract infection. Subsequent renal POCUS showed bilateral anechoic fluid collection within the renal sinus with dilated calyces suggestive of bilateral hydronephrosis most likely due to a new diagnosis of benign prostatic hyperplasia. This case demonstrates the use of POCUS added valuable diagnostic information and therapeutic management for this patient presenting with acute kidney injury.

scholarly journals The Role of Point-of-Care Ultrasound Monitoring in Cardiac Surgical Patients With Acute Kidney Injury

2019 ◽  
Vol 33 (10) ◽  
pp. 2781-2796 ◽  
Author(s):  
William Beaubien-Souligny ◽  
André Denault ◽  
Pierre Robillard ◽  
Georges Desjardins
Keyword(s):  
Acute Kidney Injury ◽  
Point Of Care ◽  
Kidney Injury ◽  
Surgical Patients ◽  
Point Of Care Ultrasound ◽  
Ultrasound Monitoring

scholarly journals Intensive care unit physician-delivered point of care renal tract ultrasound in acute kidney injury is feasible

2018 ◽  
Vol 19 (4) ◽  
pp. 313-318 ◽  
Author(s):  
Prashant Parulekar ◽  
Ed Neil-Gallacher ◽  
Alex Harrison
Keyword(s):  
Intensive Care Unit ◽  
Acute Kidney Injury ◽  
Intensive Care ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Point Of Care ◽  
Kidney Injury ◽  
Diagnostic Quality ◽  
The Core ◽  
Low Incidence

Acute kidney injury is common in critically ill patients, with ultrasound recommended to exclude renal tract obstruction. Intensive care unit clinicians are skilled in acquiring and interpreting ultrasound examinations. Intensive Care Medicine Trainees wish to learn renal tract ultrasound. We sought to demonstrate that intensive care unit clinicians can competently perform renal tract ultrasound on critically ill patients. Thirty patients with acute kidney injury were scanned by two intensive care unit physicians using a standard intensive care unit ultrasound machine. The archived images were reviewed by a Radiologist for adequacy and diagnostic quality. In 28 of 30 patients both kidneys were identified. Adequate archived images of both kidneys each in two planes were possible in 23 of 30 patients. The commonest reason for failure was dressings and drains from abdominal surgery. Only one patient had hydronephrosis. Our results suggest that intensive care unit clinicians can provide focussed renal tract ultrasound. The low incidence of hydronephrosis has implications for delivering the Core Ultrasound in Intensive Care competencies.

scholarly journals Diagnostic relevance of neutrophil gelatinase-associated lipocalin in early detection of acute kidney injury

2020 ◽  
Vol 7 (2) ◽  
pp. 88-92
Author(s):  
Madhusudhan Mahadevaiah ◽  
Murali Mohan Nidasale Thimmaiah ◽  
Venu Sashank Yerramsetty ◽  
Jeevan Kumar ◽  
Ranjith Kumar
Keyword(s):  
Acute Kidney Injury ◽  
Diagnostic Accuracy ◽  
Point Of Care ◽  
Area Under The Curve ◽  
Kidney Injury ◽  
Neutrophil Gelatinase Associated Lipocalin ◽  
Plasma Ngal ◽  
Point Of Care Test ◽  
Reliable Marker ◽  
Neutrophil Gelatinase

Objective: To evaluate the predictive and diagnostic accuracy of neutrophil gelatinase-associated lipocalin (NGAL) in acute kidney injury (AKI) and also to predict the renal replacement therapy (RRT) using NGAL as a marker. Methods: This prospective study was conducted among the patients admitted to intensive care units. Plasma samples were collected 24 hours after admission and NGAL was measured using Triage® NGAL test, a specific point of care test which is based on the mechanism of fluorescence immunoassay. The diagnostic accuracy of plasma NGAL (pNGAL) to predict AKI in critically ill patients of ICU was assessed by applying receiver operator curve (ROC) analysis and calculating the area under the curve (AUC). Results: In this study, 100 patients with the mean age of 49.56±19.2 years were included for the period of 18 months. The blood samples were withdrawn from the patients 24 and 44 hours after admission. Totally, 55% (n=55) of ICU patients were diagnosed with AKI. Plasma NGAL level was significantly increased in AKI patients as compared to non-AKI patients (742.65±734.72 vs. 255.62±440.09 μg/L; P<0.01). The sensitivity and specificity of NGAL for diagnosing AKI was 83.6% and 88.9%, respectively. The overall diagnostic accuracy was 86%. Diagnostic accuracy of NGAL for requirement of RRT was 51%. Conclusion: Plasma NGAL is a reliable marker for patients with AKI in ICU, in case the cause of kidney injury is not known. In addition, NGAL also predicts the RRT need based on AKI severity.

Abstract 13032: Resolution of Congestion Before Coronary Angiography in Acute Heart Failure is Associated With Reduced Risk of Contrast-induced Acute Kidney Injury

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Jonghanne Park ◽  
Jin Joo Park ◽  
Young-Jin Cho ◽  
Yeon-Yee Yoon ◽  
Il-Young Oh ◽  
...  
Keyword(s):  
Heart Failure ◽  
Acute Kidney Injury ◽  
Body Weight ◽  
Coronary Angiography ◽  
Acute Heart Failure ◽  
Kidney Injury ◽  
Renal Perfusion ◽  
Volume Status ◽  
Absolute Deviation ◽  
Reduced Risk

Objectives: We investigated the risk factors for contrast-induced acute kidney injury (CIAKI) after coronary angiography (CAG) in patients with acute heart failure (AHF), especially with regard to the volume status. Background: Heart failure is a well-known risk factor for CIAKI after CAG. In HF patients, renal perfusion decreases with systemic congestion. Thus, the standard prevention strategy with isotonic solution infusion may be inappropriate while decongestion may be beneficiary in AHF patients undergoing CAG. Deviation from dry body weight suggests imbalanced volume status. Methods: A total of 199 AHF patients who underwent CAG were eligible for the analysis. Absolute deviation of body weight (

scholarly journals Point‐of‐care creatinine measurements to predict acute kidney injury

2020 ◽  
Vol 64 (6) ◽  
pp. 766-773
Author(s):  
Suvi T. Vaara ◽  
Neil Glassford ◽  
Glenn M. Eastwood ◽  
Emmanuel Canet ◽  
Johan Mårtensson ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Point Of Care ◽  
Kidney Injury
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