Arsalan Amin, Ravi K Ghanta, Qianzi Zhang, Rodrigo Zea-Vera, Todd K Rosengart, Ourania Preventza, Scott A LeMaire, Joseph S Coselli, Subhasis Chatterjee
BACKGROUND: Investigations into readmissions after surgical repair of acute Stanford Type A aortic dissection (TAAD) remain scarce. We analyzed potential risk factors for readmission after TAAD. METHODS: The 2013-2014 United States Nationwide Readmissions Database was queried for TAAD index hospitalizations and 90-day readmissions indicated by diagnostic and procedural codes. Multivariable analysis was completed to identify risk factors and the most common reasons for readmission...
July 28, 2021: Annals of Thoracic Surgery
Rajit K Basu, Erica C Bjornstad, Katja M Gist, Michelle Starr, Paras Khandhar, Rahul Chanchlani, Kelli A Krallman, Michael Zappitelli, David Askenazi, Stuart L Goldstein
BACKGROUND: We aimed to study the association of suspected versus confirmed infection with the novel SARS-CoV2 virus with the prevalence of acute kidney injury (AKI) in critically ill children. METHODS: Sequential point-prevalence study of children and young adults aged 7 days to 25 years admitted to intensive care units under investigation for SARS-CoV2 infection. AKI was staged in the first 14 days of enrollment using KDIGO creatinine-based staging. SARS-CoV2 positive (CONFIRMED) were compared to SUSPECTED (negative or unknown)...
July 30, 2021: Pediatric Research
Timo N Haschler, Harry Horsley, Monika Balys, Glenn Anderson, Jan-Willem Taanman, Robert J Unwin, Jill T Norman
Ischemia is a major cause of kidney damage. Proximal tubular epithelial cells (PTECs) are highly susceptible to ischemic insults that frequently cause acute kidney injury (AKI), a potentially life-threatening condition with high mortality. Accumulating evidence has identified altered mitochondrial function as a central pathologic feature of AKI. The mitochondrial NAD+ -dependent enzyme sirtuin 5 (SIRT5) is a key regulator of mitochondrial form and function, but its role in ischemic renal injury (IRI) is unknown...
July 30, 2021: Scientific Reports
Zhihuang Zheng, Chuanlei Li, Guangze Shao, Jinqing Li, Kexin Xu, Zhonghua Zhao, Zhigang Zhang, Jun Liu, Huijuan Wu
Acute kidney injury (AKI) is associated with significant morbidity and its chronic inflammation contributes to subsequent chronic kidney disease (CKD) development. Yes-associated protein (YAP), the major transcriptional coactivator of the Hippo pathway, has been shown associated with chronic inflammation, but its role and mechanism in AKI-CKD transition remain unclear. Here we aimed to investigate the role of YAP in AKI-induced chronic inflammation. Renal ischemia/reperfusion (I/R) was used to induce a mouse model of AKI-CKD transition...
July 30, 2021: Cell Death & Disease
Geminiganesan Sangeetha, Jaippreetha Jayaraj, Swathi Ganesan, Sreeapoorva Puttagunta
Complement-mediated kidney disease has been an evolving area in the field of nephrology. Atypical haemolytic uraemic syndrome (aHUS) is a rare thrombotic microangiopathy that affects multiple organs, particularly kidneys. The disease is characterised by a triad of haemolytic anaemia, thrombocytopenia and acute kidney injury (AKI). aHUS is most commonly caused by dysregulation of alternative complement pathway. In contrast to shiga toxin-associated haemolytic uraemic syndrome, diarrheal prodrome is usually absent in children with aHUS...
July 30, 2021: BMJ Case Reports
Takuya Hinoue, Isao Nahara, Tomoaki Yatabe, Yoshitaka Hara, Naohide Kuriyama, Tomoyuki Nakamura, Hidefumi Komura, Osamu Nishida
OBJECTIVES: Hyperchloremia is a potential risk factor for acute kidney injury (AKI) in critically ill patients. However, the relationship between hyperchloremia and postoperative AKI in adult patients undergoing cardiovascular surgery with cardiopulmonary bypass (CPB) remains unclear. The authors aimed to determine whether postoperative hyperchloremia was associated with postoperative AKI in these populations. OBJECTIVES: Retrospective, single-center study. SETTING: Tertiary care hospital...
July 8, 2021: Journal of Cardiothoracic and Vascular Anesthesia
Jia-Yih Feng, Yi-Tzu Lee, Sheng-Wei Pan, Kuang-Yao Yang, Yuh-Min Chen, David Hung-Tsang Yen, Szu-Yuan Li, Fu-Der Wang
BACKGROUND: Colistin is widely used in the treatment of nosocomial infections caused by carbapenem-resistant gram-negative bacilli (CR-GNB). Colistin-induced nephrotoxicity is one of the major adverse reactions during colistin treatment. Comparisons of colistin-induced nephrotoxicity between different formulations of colistin are rarely reported. METHODS: In this retrospective cohort study, we enrolled intensive care unit-admitted patients if they had culture isolates of CR-GNB and underwent intravenous treatment with colistin...
July 30, 2021: Antimicrobial Resistance and Infection Control
Nazareth N Rocha, Cynthia S Samary, Mariana A Antunes, Milena V Oliveira, Matheus R Hemerly, Patrine S Santos, Vera L Capelozzi, Fernanda F Cruz, John J Marini, Pedro L Silva, Paolo Pelosi, Patricia R M Rocco
BACKGROUND: We evaluated the effects of abrupt versus gradual PEEP decrease, combined with standard versus high-volume fluid administration, on cardiac function, as well as lung and kidney damage in an established model of mild-moderate acute respiratory distress syndrome (ARDS). METHODS: Wistar rats received endotoxin intratracheally. After 24 h, they were treated with Ringer's lactate at standard (10 mL/kg/h) or high (30 mL/kg/h) dose. For 30 min, all animals were mechanically ventilated with tidal volume = 6 mL/kg and PEEP = 9 cmH2 O (to keep alveoli open), then randomized to undergo abrupt or gradual (0...
July 30, 2021: Respiratory Research
Fahed Darmoch, Waqas Ullah, Yasser Al-Khadra, Yasar Sattar, Homam Moussa Pacha, Mohamed Zghouzi, Mohamad Soud, Rodrigo Bagur, Srihari S Naidu, Andrew M Goldsweig, Mamas Mamas, Emmanouil S Brilakis, M Chadi Alraies
BACKGROUND: Suboptimal stent delivery and deployment in calcified coronary lesions is associated with a poor clinical outcome. We investigated the rate of utilization and in-hospital outcomes of patients undergoing coronary intervention with and without atherectomy. METHODS: Using the National Inpatient Sample database, we identified patients undergoing percutaneous coronary intervention (PCI). Comparison between procedural and hospital outcomes between patients who underwent atherectomy and those who did not...
July 30, 2021: Expert Review of Cardiovascular Therapy
Dongren Sun, Hengshu Chen, Yeqing Xiao, Weiye Xu, Fan Liu, Shihang Luo, Fafa Tian
No abstract text is available yet for this article.
July 24, 2021: Clinical Imaging
Natalie A Silverton, Lars R Lofgren, Isaac E Hall, Gregory J Stoddard, Natalia P Melendez, Michael Van Tienderen, Spencer Shumway, Bradley J Stringer, Woon-Seok Kang, Carter Lybbert, Kai Kuck
BACKGROUND: Acute kidney injury (AKI) is a common complication of cardiac surgery. An intraoperative monitor of kidney perfusion is needed to identify patients at risk for AKI. The authors created a noninvasive urinary oximeter that provides continuous measurements of urinary oxygen partial pressure and instantaneous urine flow. They hypothesized that intraoperative urinary oxygen partial pressure measurements are feasible with this prototype device and that low urinary oxygen partial pressure during cardiac surgery is associated with the subsequent development of AKI...
July 30, 2021: Anesthesiology
Anika Singh, Ashwin Kamath
BACKGROUND: Remdesivir has been used for treating patients with moderate to severe coronavirus disease 2019 (COVID-19) although there is conflicting evidence regarding its usefulness. Data regarding its safety largely come from the clinical trials conducted to support its emergency use authorization (EUA). This study aimed to identify the adverse events of remdesivir with disproportionately high reporting using real-world data. RESEARCH DESIGN AND METHODS: The adverse event reports submitted to the United States Food and Drug Administration Adverse Event Reporting System (FAERS) by healthcare professionals for drugs that have received EUA or approved for the treatment of COVID-19 in the US were studied...
July 30, 2021: Expert Opinion on Drug Safety
Orsolya Horváth, Kata Kelen, Zoltán Prohászka, Ádám Hosszú, Attila J Szabó, George S Reusz
BACKGROUND: In atypical hemolytic-uremic syndrome (aHUS), various defects of the complement system have been reported to explain pathophysiology. Therapeutic options for complement inhibition are well-recognized; however, the links between various immune-derived diseases and aHUS are unclear, and their interference with treatment efficacy during long-term complement-blocking therapy is scarcely known. CASE-DIAGNOSIS/TREATMENT: We present a pediatric patient who developed aHUS with acute kidney injury in parallel with the onset of Crohn's disease (CD), and who required long-term complement-blocking therapy with eculizumab (ECU)...
July 30, 2021: Pediatric Nephrology
Tina Noutsos, Bart J Currie, Katherine Z Isoardi, Simon G A Brown, Geoffrey K Isbister
BACKGROUND: Snakebite-associated thrombotic microangiopathy (TMA) occurs in a subset of patients with venom-induced consumption coagulopathy (VICC) following snakebite. Acute kidney injury (AKI) is the commonest end-organ manifestation of TMA. The epidemiology, diagnostic features, outcomes, and effectiveness of interventions including therapeutic plasma-exchange (TPE), in snakebite-associated TMA are poorly understood. METHODS: We reviewed all patients with suspected or confirmed snakebite recruited to the Australian Snakebite Project (2004-2018 inclusive), a prospective cohort study, from 202 participating Australian hospitals across the country...
July 30, 2021: Clinical Toxicology
Zhenzhen Sang, Shimin Dong, Pu Zhang, Yunxia Wei
Previous studies have suggested that oxidative stress and autophagy results in acute kidney injury (AKI) during sepsis and microRNA (miR)‑214 serves a vital role in the protection of kidneys subjected to oxidative stress. The present study aimed to test whether the renoprotection of miR‑214 is related to autophagy in sepsis. The role of autophagy was investigated in a mouse model of cecal ligation and puncture (CLP). Reverse transcription‑quantitative polymerase chain reaction (RT‑qPCR) was used to analyze the expression of miR‑214...
October 2021: Molecular Medicine Reports
Meiwen Ding, Evelyn Tolbert, Mark Birkenbach, Reginald Gohh, Fatemeh Akhlaghi, Nisanne S Ghonem
BACKGROUND: Renal ischemia-reperfusion injury (IRI) is a major factor contributing to acute kidney injury and it is associated with a high morbidity and mortality if untreated. Renal IRI depletes cellular and tissue adenosine triphosphate (ATP), which compromises mitochondrial function, further exacerbating renal tubular injury. Currently, no treatment for IRI is available. This study investigates the protective role of treprostinil in improving mitochondria biogenesis and recovery during rat renal IRI...
July 15, 2021: Biomedicine & Pharmacotherapy
Jennifer P Ngo, Khin M Noe, Michael Z L Zhu, Andrew Martin, Meg Ollason, Andrew D Cochrane, Julian A Smith, Amanda G Thrift, Roger G Evans
BACKGROUND: Acute kidney injury (AKI) is common after cardiac surgery requiring cardiopulmonary bypass. Renal hypoxia may precede clinically detectable AKI. We compared the efficacy of two indices of renal hypoxia, (i) intraoperative urinary oxygen tension (UPO2 ) and (ii) the change in plasma erythropoietin (pEPO) during surgery, in predicting AKI. We also investigated whether the performance of these prognostic markers varies with preoperative patient characteristics. METHODS: In 82 patients undergoing on-pump cardiac surgery, blood samples were taken upon induction of anesthesia and upon entry into the intensive care unit...
July 29, 2021: Journal of Cardiac Surgery
Brendan L Thoms, Varun Agrawal, Elvira R Umyarova, Pamela C Gibson, Richard J Solomon
Antineutrophil cytoplasmic autoantibody (ANCA) vasculitis has occasionally been associated with other systemic glomerulonephritis, such as anti-glomerular basement membrane disease. Here, we report the first clinical case of ANCA-associated crescentic glomerulonephritis with AL amyloidosis. An 81-years-old gentleman presented to the hospital with acute kidney injury (serum creatinine 4.7 mg/dL) on a background of chronic kidney disease and volume overload. Autoimmune serology was remarkable for p-ANCA and myeloperoxidase positivity...
May 2021: Case Reports in Nephrology and Dialysis
Richard Kelly, David Semple, Alana Harper
Acute kidney injury with severe loin pain and patchy renal ischaemia after anaerobic exercise (ALPE) is a rare clinical syndrome. ALPE has predominantly been described in Japanese and Korean populations to date. Many cases and most recurrent examples are associated with renal hypouricaemia. We describe a 28-year-old New Zealand European male without renal hypouricaemia who developed recurrent ALPE whilst performing elite-level sport. Avoiding elite-level anaerobic exercise was successful at preventing further episodes...
May 2021: Case Reports in Nephrology and Dialysis
Zubaida Al-Falahi, Salma Al-Harthi, Hatem Farhan, Ibrahim Al Busaidi, Abdullah M Al Alawi
A 47-year-old man presented to the emergency department with persistent fever, chest pain and neck swelling, two months following a mild coronavirus disease 2019 (COVID-19) infection. He was found to have persistent fever, hypotension, cervical lymphadenitis, myocarditis, and acute kidney injury, collectively meeting the multi-system inflammatory syndrome criteria in adults (MIS-A). The patient responded well to methylprednisolone therapy and intravenous immunoglobulins with a complete clinical recovery. This case demonstrates that MIS-A can present as a delayed complication of COVID-19 infection...
June 2021: Curēus
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