Influence of volume administration on Doppler-based renal resistive index, renal hemodynamics and renal function in medical intensive care unit patients with septic-induced acute kidney injury: a pilot study

2016 ◽  
Vol 48 (8) ◽  
pp. 1327-1334 ◽  
Author(s):  
Tobias Lahmer ◽  
Sebastian Rasch ◽  
Christopher Schnappauf ◽  
Roland M. Schmid ◽  
Wolfgang Huber
Keyword(s):  
Intensive Care Unit ◽  
Acute Kidney Injury ◽  
Renal Function ◽  
Intensive Care ◽  
Pilot Study ◽  
Medical Intensive Care Unit ◽  
Resistive Index ◽  
Kidney Injury ◽  
Renal Resistive Index ◽  
Medical Intensive Care

scholarly journals Acute Kidney Injury Outcomes of Elderly and Nonelderly Patients in the Medical Intensive Care Unit of a University Hospital in a Developing Country

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Wanjak Pongsittisak ◽  
Kashane Phonsawang ◽  
Solos Jaturapisanukul ◽  
Surazee Prommool ◽  
Sathit Kurathong
Keyword(s):  
Intensive Care Unit ◽  
Acute Kidney Injury ◽  
Intensive Care ◽  
Mortality Rate ◽  
Hospital Mortality ◽  
Medical Intensive Care Unit ◽  
Kidney Injury ◽  
The Elderly ◽  
University Hospital ◽  
Medical Intensive Care

Background. Aging is associated with a high risk of acute kidney injury (AKI), and the elderly with AKI show a higher mortality rate than those without AKI. In this study, we compared AKI outcomes between elderly and nonelderly patients in a university hospital in a developing country. Materials and Methods. This retrospective cohort study included patients with AKI who were admitted to the medical intensive care unit (ICU) between January 1, 2012, and December 31, 2017. The patients were divided into the elderly (eAKI; age ≥65 years; n = 158) and nonelderly (nAKI; n = 142) groups. Baseline characteristics, comorbidities, principle diagnosis, renal replacement therapy (RRT) requirement, hospital course, and in-hospital mortality were recorded. The primary outcome was in-hospital mortality. Results. The eAKI group included more females, patients with higher Acute Physiology and Chronic Health Evaluation II scores, and patients with more comorbidities than the nAKI group. The etiology and staging of AKI were similar between the two groups. There were no significant differences in in-hospital mortality (p=0.338) and RRT requirement (p=0.802) between the two groups. After adjusting for covariates, the 28-day mortality rate was similar between the two groups (p=0.654), but the 28-day RRT requirement was higher in the eAKI group than in the nAKI group (p=0.042). Conclusion. Elderly and nonelderly ICU patients showed similar survival outcomes of AKI, although the elderly were at a higher risk of requiring RRT.

scholarly journals CLINICAL PROFILE OF ACUTE KIDNEY INJURY PATIENTS ADMITTED IN MEDICAL INTENSIVE CARE UNIT IN TERTIARY CARE CENTRE

2019 ◽  
pp. 1-3
Author(s):  
Manisha Netam ◽  
R. S. Jagat ◽  
Nitin Nahar*
Keyword(s):  
Intensive Care Unit ◽  
Acute Kidney Injury ◽  
Intensive Care ◽  
Medical Intensive Care Unit ◽  
Tertiary Care ◽  
Kidney Injury ◽  
Common Causes ◽  
Patient Load ◽  
Medical Intensive Care ◽  
Morbid Conditions

Acute kidney injury is one of the major conditions complicating the outcome of hospital admitted patients. Early detection and treatment of AKI can help reduce the mortality to a signicant level. The most common conditions succumbing to AKI are hypovolemia, sepsis, drug induced kidney injury, cardiac conditions (reduced cardiac output). Common co-morbid conditions associated are hypertension, diabetes, chronic debilitating conditions like CVA and CAD. OBJECTIVE- The study aimed at evaluating the etiological factors and co-morbid conditions associated with acute kidney injury in medical intensive care unit in tertiary care setting in central India. MATERIAL AND MATERIAL AND METHODS- Total 200 patients admitted in medical ICU were selected based on AKIN criteria. pre-exiting conditions like hypertension, diabetes, CAD, CVA were noted. Increase in serum creatinine >1.5 times or >0.3mg/dl and decrease in urine output <0.5ml/kg/h for 6-12 hrs were the criteria for selection. Patients were observed till the time of discharge or death. Data collected was analysed statistically. RESULTS-Out of the 200 enrolled in the study,81 patients were female and 119 males. Majority of the patients were found to be under the age group of 35-54 years with a total number of 101. Hypertension was found to be the major co-morbid condition with a patient load of 62, followed by diabetes, CVA, CAD with a patient load of 30,24and 5 respectively. Sepsis and shock were found to complicating majority of the illnesses and contributing 87.6% and 67.6% to the total mortality. Infective conditions like acute gastroenteritis and UTI were the most common causes with a total load of 76 and 15 respectively. Chronic liver disease and hemolytic conditions like malaria were found to contributing a lower patient load but higher mortality. Other causes found to be associated with AKI were found to be post natal cases, snake bite and poisoning. CONCLUSION- pre- renal causes were found to be the most common causes of AKI. Early recognition and vigorous management is the key to reduce mortality and long term complications

scholarly journals ETIOLOGICAL FACTORS AND CLINICAL PROFILE OF ACUTE KIDNEY INJURY IN MICU

2019 ◽  
Vol 2 (11) ◽  
Author(s):  
Mekha K Mathew ◽  
Radha
Keyword(s):  
Intensive Care Unit ◽  
Acute Kidney Injury ◽  
Intensive Care ◽  
Management Practices ◽  
Medical Intensive Care Unit ◽  
Kidney Injury ◽  
Febrile Illness ◽  
Study Group ◽  
Ventilator Support ◽  
Medical Intensive Care

Background and Objectives Data on the etiology, management practices and outcome in patients admitted to intensive care units in Kerala has not been studied in depth. The etiology and patterns of AKI, as well as management practices are likely to differ in countries with resource limitations and variations in disease patterns. The present study was undertaken to identify the etiologic factors and outcome of patients with Acute Kidney Injury admitted in Medical ICU. Methods The study is a cross sectional study, done in 150 consecutive patients admitted to Medical Intensive Care Unit, Government Medical College, Kottayam meeting the AKIN creatinine criteria for acute kidney injury over a period of 12 months. Results and Discussion The most common diagnosis in the patients admitted with AKI in MICU was Leptospirosis (22%) followed by undifferentiated fever (21%) and sepsis seen in 17%. Dialysis was required in 81.3% among those with undifferentiated febrile illness and 78.8% among those with leptospirosis. Significant association was identified between etiology of AKI and the need for dialysis. The most common stage of AKI in the patients in this study group on admission to the medical intensive care unit was stage 3 in 64.7%. 45% of the patients required dialysis, among which 24% underwent CRRT while the 76% underwent hemodialysis. Out of 150 cases 59% survived and 41% expired. Mortality was more in the patients in this study with undifferentiated acute febrile illness, 43.8% and leptospirosis, 36.4%. Mortality was 48.5% in those who underwent dialysis. But no significant association was identified between requirement of dialysis or diagnosis and mortality. Significant association was identified between patients with breathlessness, basal crepitations, later stage of AKI, inotropic support, ventilator support and mortality with p value <0.05. By logistic regression analysis of the factors having association with mortality, requirement of ventilator support and inotropic supports were independent predictors of mortality. Conclusion The most common etiology was leptospirosis (22%) followed by undifferentiated fever (21%). Mortality was 41% in the patients in the study group. Requirement of ventilator support and inotropic supports were independent predictors of mortality.

scholarly journals Renal resistive index is associated with acute kidney injury in COVID-19 patients treated in the intensive care unit

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Mårten Renberg ◽  
Olof Jonmarker ◽  
Naima Kilhamn ◽  
Claire Rimes-Stigare ◽  
Max Bell ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Acute Kidney Injury ◽  
Intensive Care ◽  
Critically Ill ◽  
Resistive Index ◽  
Kidney Injury ◽  
University Hospital ◽  
Renal Resistive Index ◽  
Promising Tool ◽  
Stage 1

Abstract Background Renal resistive index (RRI) is a promising tool for the assessment of acute kidney injury (AKI) in critically ill patients in general, but its role and association to AKI among patients with Coronavirus disease 2019 (COVID-19) is not known. Objective The aim of this study was to describe the pattern of RRI in relation to AKI in patients with COVID-19 treated in the intensive care unit. Methods In this observational cohort study, RRI was measured in COVID-19 patients in six intensive care units at two sites of a Swedish University Hospital. AKI was defined by the creatinine criteria in the Kidney Disease Improving Global Outcomes classification. We investigated the association between RRI and AKI diagnosis, different AKI stages and urine output. Results RRI was measured in 51 patients, of which 23 patients (45%) had AKI at the time of measurement. Median RRI in patients with AKI was 0.80 (IQR 0.71–0.85) compared to 0.72 (IQR 0.67–0.78) in patients without AKI (p = 0.004). Compared to patients without AKI, RRI was higher in patients with AKI stage 3 (median 0.83, IQR 0.71–0.85, p = 0.006) but not in patients with AKI stage 1 (median 0.76, IQR 0.71–0.83, p = 0.347) or AKI stage 2 (median 0.79, min/max 0.79/0.80, n = 2, p = 0.134). RRI was higher in patients with an ongoing AKI episode compared to patients who never developed AKI (median 0.72, IQR 0.69–0.78, p = 0.015) or patients who developed AKI but had recovered at the time of measurement (median 0.68, IQR 0.67–0.81, p = 0.021). Oliguric patients had higher RRI (median 0.84, IQR 0.83–0.85) compared to non-oliguric patients (median 0.74, IQR 0.69–0.81) (p = 0.009). After multivariable adjustment, RRI was independently associated with AKI (OR for 0.01 increments of RRI 1.22, 95% CI 1.07–1.41). Conclusions Critically ill COVID-19 patients with AKI have higher RRI compared to those without AKI, and elevated RRI may have a role in identifying severe and oliguric AKI at the bedside in these patients.

scholarly journals Circulating Proenkephalin, Acute Kidney Injury, and Its Improvement in Patients with Severe Sepsis or Shock

2018 ◽  
Vol 64 (9) ◽  
pp. 1361-1369 ◽  
Author(s):  
Pietro Caironi ◽  
Roberto Latini ◽  
Joachim Struck ◽  
Oliver Hartmann ◽  
Andreas Bergmann ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Septic Shock ◽  
Acute Kidney Injury ◽  
Renal Function ◽  
Intensive Care ◽  
Serum Creatinine ◽  
Odds Ratio ◽  
Adjusted Odds Ratio ◽  
Kidney Injury ◽  
Baseline Serum

Abstract BACKGROUND Acute kidney injury (AKI) occurs in many critically ill patients and is associated with high mortality. We examined whether proenkephalin could predict incident AKI and its improvement in septic patients. METHODS Plasma proenkephalin A 119–159 (penKid) was assayed in 956 patients with sepsis or septic shock enrolled in the multicenter Albumin Italian Outcome Sepsis (ALBIOS) trial to test its association with incident AKI, improvement of renal function, need for renal replacement therapy (RRT), and mortality. RESULTS Median [Q1–Q3] plasma penKid concentration on day 1 [84 (20–159) pmol/L[ was correlated with serum creatinine concentration (r = 0.74); it was higher in patients with chronic renal failure and rose progressively with the renal Sequential Organ Failure Assessment subscore. It predicted incident AKI within 48 h (adjusted odds ratio, 3.3; 95% CI, 2.1–5.1; P &lt; 0.0001) or 1 week [adjusted hazard ratio, 2.1 (1.7–2.8); P &lt; 0.0001] and future RRT during the intensive care unit stay [odds ratio, 4.0 (3.0–5.4)]. PenKid was also associated with improvements in renal function in patients with baseline serum creatinine &gt;2 mg/dL, both within the next 48 h [adjusted odds ratio, 0.31 (0.18–0.54), P &lt; 0.0001] and 1 week [0.23 (0.12–0.45)]. The time course of penKid concentrations predicted AKI and 90-day mortality. CONCLUSIONS Early measurement and the trajectory of penKid predict incident AKI, improvement of renal function, and the need for RRT in the acute phase after intensive care unit admission during sepsis or septic shock. PenKid measurement may be a valuable tool to test early therapies aimed at preventing the risk of AKI in sepsis.

scholarly journals Prevention of acute kidney injury and protection of renal function in the intensive care unit

2009 ◽  
Vol 36 (3) ◽  
pp. 392-411 ◽  
Author(s):  
Michael Joannidis ◽  
Wilfred Druml ◽  
Lui G. Forni ◽  
A. B. Johan Groeneveld ◽  
Patrick Honore ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Acute Kidney Injury ◽  
Renal Function ◽  
Intensive Care ◽  
Kidney Injury
Sign in / Sign up

Export Citation Format

Share Document