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By Juan Castellanos Physician, general practitioner in Bogota Colombia. Interested in Critical Care and Epidemiology.
Tian Zuo, Lu Jiang, Shuai Mao, Xuehui Liu, Xin Yin, Liheng Guo
BACKGROUND: Hyperuricemia may be associated with an increased risk of contrast-induced acute kidney injury (CI-AKI). In recent years, studies about the relationship between them gradually appeared. We performed a systematic review and meta-analysis to investigate whether hyperuricemia is an independent risk factor for CI-AKI. METHODS: Relevant studies were searched in PubMed, Embase, Cochrane Library, and CBM (Chinese Biomedical Literature database) databases until April 18, 2016, without language restriction...
December 1, 2016: International Journal of Cardiology
Yuanyuan Xie, Qin Wang, Chunlin Wang, Chaojun Qi, Zhaohui Ni, Shan Mou
BACKGROUND: Acute kidney injury (AKI) is a common clinical syndrome with poor prognosis. The insensitivity and non-specificity of traditional markers of renal dysfunction prevent timely estimation of the severity of renal injury, and the administration of possible therapeutic agents. Urinary kidney injury molecule-1 (uKIM-1) is a marker of epithelial injury of renal tubules. Different uKIM-1 levels are associated with various degrees of renal injury. This study sought to evaluate uKIM-1 as a predictor of renal prognosis by analyzing uKIM-1 levels in patients with AKI...
September 10, 2016: Critical Care: the Official Journal of the Critical Care Forum
Ron Wald, Neill K J Adhikari, Orla M Smith, Matthew A Weir, Karen Pope, Ashley Cohen, Kevin Thorpe, Lauralyn McIntyre, Francois Lamontagne, Mark Soth, Margaret Herridge, Stephen Lapinsky, Edward Clark, Amit X Garg, Swapnil Hiremath, David Klein, C David Mazer, Robert M A Richardson, M Elizabeth Wilcox, Jan O Friedrich, Karen E A Burns, Sean M Bagshaw
In patients with severe acute kidney injury (AKI) but no urgent indication for renal replacement therapy (RRT), the optimal time to initiate RRT remains controversial. While starting RRT preemptively may have benefits, this may expose patients to unnecessary RRT. To study this, we conducted a 12-center open-label pilot trial of critically ill adults with volume replete severe AKI. Patients were randomized to accelerated (12 h or less from eligibility) or standard RRT initiation. Outcomes were adherence to protocol-defined time windows for RRT initiation (primary), proportion of eligible patients enrolled, follow-up to 90 days, and safety in 101 fully eligible patients (57 with sepsis) with a mean age of 63 years...
October 2015: Kidney International
Alexander Zarbock, Christoph Schmidt, Hugo Van Aken, Carola Wempe, Sven Martens, Peter K Zahn, Britta Wolf, Ulrich Goebel, Christian I Schwer, Peter Rosenberger, Helene Haeberle, Dennis Görlich, John A Kellum, Melanie Meersch
IMPORTANCE: No interventions have yet been identified to reduce the risk of acute kidney injury in the setting of cardiac surgery. OBJECTIVE: To determine whether remote ischemic preconditioning reduces the rate and severity of acute kidney injury in patients undergoing cardiac surgery. DESIGN, SETTING, AND PARTICIPANTS: In this multicenter trial, we enrolled 240 patients at high risk for acute kidney injury, as identified by a Cleveland Clinic Foundation score of 6 or higher, between August 2013 and June 2014 at 4 hospitals in Germany...
June 2, 2015: JAMA: the Journal of the American Medical Association
Seon Ha Baek, Se Hyun Kim, Jin Won Kim, Yu Jung Kim, Keun-Wook Lee, Ki Young Na
BACKGROUND: Cisplatin is a potent chemotherapeutic agent, but its nephrotoxicity, which results in acute kidney injury (AKI), often limits its clinical application. Although many studies have attempted to target the mechanism responsible for its nephrotoxicity, no such method has been demonstrated to be effective in clinical trials. Recently, a dipeptidyl peptidase-4 (DPP4) inhibitor has been reported to have a renoprotective effect in a mouse model of cisplatin-induced AKI. Therefore, we will evaluate whether a DPP4 inhibitor protects the kidney from cisplatin-induced injury in humans...
May 29, 2015: Trials
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