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Renal Recovery

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187 papers 100 to 500 followers
By Isabel Acosta-Ochoa Nephrology senior staff. Valladolid. Spain
Keita Sueyoshi, Yusuke Watanabe, Tsutomu Inoue, Yoichi Ohno, Hiroyuki Nakajima, Hirokazu Okada
The long-term prognosis of patients with postoperative acute kidney injury (AKI) requiring continuous renal replacement therapy (CRRT) after cardiovascular surgery is unclear. We aimed to investigate long-term renal outcomes and survival in these patients to determine the risk factors for negative outcomes. Long-term prognosis was examined in 144 hospital survivors. All patients were independent and on renal replacement therapy at hospital discharge. The median age at operation was 72.0 years, and the median pre-operative estimated glomerular filtration rate (eGFR) was 39...
2019: PloS One
Thorir E Long, Solveig Helgadottir, Dadi Helgason, Gisli H Sigurdsson, Tomas Gudbjartsson, Runolfur Palsson, Olafur S Indridason, Martin I Sigurdsson
BACKGROUND: The aim of this study was to examine different definitions of renal recovery following postoperative acute kidney injury (AKI) and how these definitions associate with survival and the development and progression of chronic kidney disease (CKD). METHODS: This was a retrospective study of all patients who underwent abdominal, cardiothoracic, vascular, or orthopedic surgery at a single university hospital between 1998 and 2015. Recovery of renal function following postoperative AKI was assessed comparing 4 different definitions: serum creatinine (SCr) (i) < 1...
January 30, 2019: American Journal of Nephrology
Yvelynne P Kelly, Sushrut S Waikar, Mallika L Mendu
There is wide variation in clinical practice regarding timing of discontinuation of renal replacement therapy (RRT) in patients with acute kidney injury (AKI). Prolonged, unnecessary RRT treatment can contribute to length of stay, overall hospital costs, and risk of complications associated with RRT. In addition, prolonged RRT can paradoxically lengthen the time for which the patient remains dialysis-dependent. Well-designed, randomized clinical trials have utilized varied discontinuation criteria specifically related to urine output and creatinine clearance, which impedes the comparison of outcomes from such studies...
January 28, 2019: Seminars in Dialysis
Chunyuan Guo, Guie Dong, Xinling Liang, Zheng Dong
Acute kidney injury (AKI) is a major public health concern associated with high morbidity and mortality. Despite decades of research, the pathogenesis of AKI remains incompletely understood and effective therapies are lacking. An increasing body of evidence suggests a role for epigenetic regulation in the process of AKI and kidney repair, involving remarkable changes in histone modifications, DNA methylation and the expression of various non-coding RNAs. For instance, increases in levels of histone acetylation seem to protect kidneys from AKI and promote kidney repair...
January 16, 2019: Nature Reviews. Nephrology
Hayo Castrop
The healthy kidney is considered to be a relatively stable organ with little baseline cell turnover. Nevertheless, cells are constantly replaced to conserve the structural and functional integrity of the organ. The mechanisms of the baseline regenerative processes may also be relevant in situations of insults to the kidney, when the need for cellular replacement considerable exceeds the baseline cell turnover. This review will focus on the mechanisms of the regeneration of the tubular system, in particular the proximal tubule...
January 11, 2019: Nephron
Benjamin R Griffin, Anna Jovanovich, Zhiying You, Paul Palevsky, Sarah Faubel, Diana Jalal
OBJECTIVES: Thrombocytopenia is common in critically ill patients with severe acute kidney injury and may be worsened by the use of renal replacement therapy. In this study, we evaluate the effects of renal replacement therapy on subsequent platelet values, the prognostic significance of a decrease in platelets, and potential risk factors for platelet decreases. DESIGN: Post hoc analysis of the Acute Renal Failure Trial Network Study. SETTING: The Acute Renal Failure Trial Network study was a multicenter, prospective, randomized, parallel-group trial of two strategies for renal replacement therapy in critically ill patients with acute kidney injury conducted between November 2003 and July 2007 at 27 Veterans Affairs and university-affiliated medical centers...
December 21, 2018: Critical Care Medicine
A S Truche, S Perinel Ragey, B Souweine, S Bailly, L Zafrani, L Bouadma, C Clec'h, M Garrouste-Orgeas, G Lacave, C Schwebel, F Guebre-Egziabher, C Adrie, A S Dumenil, Ph Zaoui, L Argaud, S Jamali, D Goldran Toledano, G Marcotte, J F Timsit, M Darmon
BACKGROUND: Transient and persistent acute kidney injury (AKI) could share similar physiopathological mechanisms. The objective of our study was to assess prognostic impact of AKI duration on ICU mortality. DESIGN: Retrospective analysis of a prospective database via cause-specific model, with 28-day ICU mortality as primary end point, considering discharge alive as a competing event and taking into account time-dependent nature of renal recovery. Renal recovery was defined as a decrease of at least one KDIGO class compared to the previous day...
December 17, 2018: Annals of Intensive Care
Hou-Yong Dai, Bin Yang
Klotho is highly expressed in the kidney, while soluble Klotho is detectable in the blood, urine, and cerebrospinal fluid, and has multiple hormone-like functions. The role of Klotho in kidney injury has attracted more and more attentions from researchers. Emerging evidence revealed that the transient deficiency of Klotho is an early event of acute kidney injury (AKI), whereas, in chronic kidney disease, this deficiency is sustained not only in the kidney, but also in other organ systems. Therefore, Klotho could be a potential biomarker for early diagnosis of AKI, as well as for its progression to chronic kidney disease...
December 25, 2018: Sheng Li Xue Bao: [Acta Physiologica Sinica]
Etienne Macedo, Ravindra L Mehta
No abstract text is available yet for this article.
December 12, 2018: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Kevin T Barton, Aadil Kakajiwala, Dennis J Dietzen, Charles W Goss, Hongjie Gu, Vikas R Dharnidharka
Beta-2-microglobulin (B2M) is a marker of proximal tubular injury and glomerular filtration. Analyses using older/non-standardized definitions have shown low efficacy of B2M to predict acute kidney injury (AKI). We assessed if elevated levels of B2M would associate with either the diagnosis of AKI [under current Kidney Disease: Improving Global Outcomes (KDIGO) criteria] or recovery from AKI. We performed a retrospective study, including children who had urine B2M (uB2M) and/or serum B2M (sB2M) measured by immunoturbidimetry in our clinical laboratory between January 2011 and December 2015...
December 2018: Clinical Kidney Journal
Amir Azarbal, David J Malenka, Yi-Ling Huang, Cathy S Ross, Richard J Solomon, James T DeVries, James M Flynn, David Butzel, Matthew McKay, Harold L Dauerman
Acute Kidney Recovery (AKR) is a potential benefit of transcatheter aortic valve implantation (TAVI). We determined the incidence and predictors of AKR in a multicenter prospective registry of TAVI. After excluding patients on dialysis or who died within 48 hours postprocedure, we reviewed 1,502 consecutive patients underwent TAVI in Northern New England from 2012 to 2017. Patients were categorized into 3 groups based on the change in postprocedure estimated glomerular filtration rate (eGFR): Acute Kidney Injury (AKI, decrease in eGFR >25%), AKR (increase in eGFR >25%) or no change in kidney function on discharge creatinine following TAVI...
November 6, 2018: American Journal of Cardiology
Aaron J Polichnowski
Acute kidney injury (AKI) is a major complication in hospitalized patients and is associated with elevated mortality rates. Numerous recent studies indicate that AKI also significantly increases the risk of chronic kidney disease (CKD), end-stage renal disease (ESRD), hypertension, cardiovascular disease, and mortality in those patients who survive AKI. Moreover, the risk of ESRD and mortality after AKI is substantially higher in patients with preexisting CKD. However, the underlying mechanisms by which AKI and CKD interact to promote ESRD remain poorly understood...
December 1, 2018: American Journal of Physiology. Renal Physiology
Shuang Cui, Liling Wu, Xiaodan Feng, Huanjuan Su, Zhanmei Zhou, Weihong Luo, Cailing Su, Yajing Li, Meng Shi, Zhichen Yang, Wei Cao
One of the major obstacles to prevent AKI-CKD transition is the lack of effective methods to follow and predict the ongoing kidney injury after an AKI episode. In the present study, we test the utility of urinary angiotensinogen (UAGT) for dynamically evaluating renal structural changes and predicting AKI-CKD progression by using both mild and severe bilateral renal ischemia/reperfusion injury mice. UAGT returns to pre-ischemic levels 14 days after mild AKI followed by kidney architecture restoration, whereas sustained increase in UAGT accompanies by ongoing renal fibrosis after severe AKI...
October 15, 2018: Clinical Science (1979-)
Zoltán H Endre
While there are no clear definitions of recovery, it is clear that the goals of recovery depend on the severity of acute kidney injury and the clinical context. The degree of renal recovery affects both renal and clinical prognosis. There are presently few guidelines on recovery targets, which range in extent from dialysis independence via normalization of serum creatinine to recovery of renal functional reserve. However, while there are no validated biomarkers for predicting recovery, evidence suggests that both functional and damage biomarkers can aid the assessment of recovery...
2018: Nephron
Esther Peters, Massimo Antonelli, Xavier Wittebole, Rahul Nanchal, Bruno François, Yasser Sakr, Jean-Louis Vincent, Peter Pickkers
BACKGROUND: Acute kidney injury (AKI) is a common complication of critical illness and is associated with worse outcomes. However, the influence of deterioration or improvement in renal function on clinical outcomes is unclear. Using a large international database, we evaluated the prevalence and evolution of AKI over a 7-day period and its effects on clinical outcomes in septic and non-septic critically ill patients worldwide. METHODS: From the 10,069 adult intensive care unit (ICU) patients in the Intensive Care Over Nations database, all those with creatinine and urine output data were included in this substudy...
August 3, 2018: Critical Care: the Official Journal of the Critical Care Forum
Jianchun Chen, Huaizhou You, Yan Li, You Xu, Qian He, Raymond C Harris
BACKGROUND: Increasing evidence indicates that renal recovery from AKI stems from dedifferentiation and proliferation of surviving tubule epithelial cells. Both EGF receptor (EGFR) and the Hippo signaling pathway are implicated in cell proliferation and differentiation, and previous studies showed that activation of EGFR in renal proximal tubule epithelial cells (RPTCs) plays a critical role in recovery from ischemia-reperfusion injury (IRI). In this study, we explored RPTC activation of Yes-associated protein (YAP) and transcriptional coactivator with PDZ binding motif (TAZ), two key downstream effectors of the Hippo pathway, and their potential involvement in recovery from AKI...
September 2018: Journal of the American Society of Nephrology: JASN
Helmut Schiffl
INTRODUCTION: Severe acute kidney injury (AKI-D) is common in critically ill patients and contributes substantially to short- and long-term morbidity and mortality. Acute renal replacement therapy (RRT) is an increasingly widely utilized life-sustaining support strategy for AKI-D patients, providing a bridge to renal recovery in many survivors of AKI. However, key aspects (when and how) of this therapy's appropriate cessation remain unclear. Today, wide variation in clinical practice exists regarding the indication for and the timing of RTT discontinuation, likely due to the poor current evidence base...
October 2018: International Urology and Nephrology
Faeq Husain-Syed, Fiorenza Ferrari, Aashish Sharma, Tommaso Hinna Danesi, Pércia Bezerra, Salvador Lopez-Giacoman, Sara Samoni, Massimo de Cal, Valentina Corradi, Grazia Maria Virzì, Silvia De Rosa, María Jimena Muciño Bermejo, Carla Estremadoyro, Gianluca Villa, Jose J Zaragoza, Carlotta Caprara, Alessandra Brocca, Horst-Walter Birk, Hans-Dieter Walmrath, Werner Seeger, Federico Nalesso, Monica Zanella, Alessandra Brendolan, Davide Giavarina, Loris Salvador, Rinaldo Bellomo, Mitchell H Rosner, John A Kellum, Claudio Ronco
Background: Cardiac surgery is a leading cause of acute kidney injury (AKI). Such AKI patients may develop progressive chronic kidney disease (CKD). Others, who appear to have sustained no permanent loss of function (normal serum creatinine), may still lose renal functional reserve (RFR). Methods: We extended the follow-up in the observational 'Preoperative RFR Predicts Risk of AKI after Cardiac Surgery' study from hospital discharge to 3 months after surgery for 86 (78...
July 19, 2018: Nephrology, Dialysis, Transplantation
Giuseppe Orlando, Richard Danger, Hayrettin Okut, Lauren Edgar, Benedetta Bussolati, Emily Gall, Christopher R Bergman, Riccardo Tamburrini, Carlo Gazia, Alan C Farney, Barry I Freedman, Gwen McPherson, Jeffrey Rogers, Robert J Stratta, Sophie Brouard, Stephen J Walker
OBJECTIVE: To test the hypothesis that gene expression profiling in peripheral blood from patients who have undergone kidney transplantation (KT) will provide mechanistic insights regarding graft repair and regeneration. BACKGROUND: Renal grafts obtained from living donors (LD) typically function immediately, whereas organs from donation after cardiac death (DCD) or acute kidney injury (AKI) donors may experience delayed function with eventual recovery. Thus, recipients of LD, DCD, and AKI kidneys were studied to provide a more complete understanding of the molecular basis for renal recovery...
July 24, 2018: Annals of Surgery
Maija Eskola, Suvi T Vaara, Anna-Maija Korhonen, Jukka Sauranen, Niina Koivuviita, Eero Honkanen, Ville Pettilä, Mikko Haapio
BACKGROUND: Studies reporting renal and overall survival after acute kidney injury (AKI) treated exclusively with intermittent modalities of renal replacement therapy (IRRT) are rare. This study focused on outcomes of AKI patients treated with IRRT both in intensive care units (ICUs) and non-ICU dialysis units. METHODS: This prospective observational study was carried on during a 5-month period in 17 ICUs and 17 non-ICUs. ICU and non-ICU patients (total n = 138; 65 ICU, 73 non-ICU) requiring RRT for AKI and chosen to receive IRRT were included...
November 2018: Acta Anaesthesiologica Scandinavica
2018-07-08 08:45:25
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