scholarly journals Clinical Characteristics of Acute Kidney Injury in Community-acquired and Hospital-acquired Patients in Xinjiang

2015 ◽  
Vol 17 (2) ◽  
pp. S98
Author(s):  
Suhua Li ◽  
Mingming Qiao ◽  
Shun Wang ◽  
Caichang Li ◽  
Li Zhang ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Clinical Characteristics ◽  
Kidney Injury ◽  
Hospital Acquired

scholarly journals Clinical Characteristics and Outcomes of Community- and Hospital-Acquired Acute Kidney Injury with COVID-19 in a US Inner City Hospital System

2020 ◽  
Vol 10 (4) ◽  
pp. 223-231 ◽  
Author(s):  
Jerald Pelayo ◽  
Kevin Bryan Lo ◽  
Ruchika Bhargav ◽  
Fahad Gul ◽  
Eric Peterson ◽  
...  
Keyword(s):  
Heart Failure ◽  
Acute Kidney Injury ◽  
African American ◽  
Clinical Outcomes ◽  
Clinical Characteristics ◽  
Kidney Injury ◽  
Hospital Death ◽  
City Hospital ◽  
History Of ◽  
Hospital Acquired

Introduction: Emerging data have described poor clinical outcomes from infection with the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV 2) among African American patients and those from underserved socioeconomic groups. We sought to describe the clinical characteristics and outcomes of acute kidney injury (AKI) in this special population. Methods: This is a retrospective study conducted in an underserved area with a predominance of African American patients with coronavirus disease 2019 (COVID-19). Descriptive statistics were used to characterize the sample population. The onset of AKI and relation to clinical outcomes were determined. Multivariate logistic regression was used to determine factors associated with AKI. Results: Nearly half (49.3%) of the patients with COVID-19 had AKI. Patients with AKI had a significantly lower baseline estimated glomerular filtration rate (eGFR) and higher FiO2 requirement and D-dimer levels on admission. More subnephrotic proteinuria and microhematuria was seen in these patients, and the majority had a pre-renal urine electrolyte profile. Patients with hospital-acquired AKI (HA-AKI) as opposed to those with community-acquired AKI (CA-AKI) had higher rates of in-hospital death (52 vs. 23%, p = 0.005), need for vasopressors (42 vs. 25%, p = 0.024), and need for intubation (55 vs. 25%, p = 0.006). A history of heart failure was significantly associated with AKI after adjusting for baseline eGFR (OR 3.382, 95% CI 1.121–13.231, p = 0.032). Conclusion: We report a high burden of AKI among underserved COVID-19 patients with multiple comorbidities. Those who had HA-AKI had worse clinical outcomes compared to those who with CA-AKI. A history of heart failure is an independent predictor of AKI in patients with COVID-19.

Hospital-Acquired Acute Kidney Injury in Older Patients: Clinical Characteristics and Drug Analysis

Gerontology ◽  
2021 ◽  
pp. 1-8
Author(s):  
Wei Liu ◽  
Xing-ji Lian ◽  
Yuan-han Chen ◽  
Yi-ping Zou ◽  
Jie-shan Lin ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Hospital Mortality ◽  
Older Patients ◽  
Clinical Characteristics ◽  
Kidney Injury ◽  
Hospital Outcomes ◽  
Prior Use ◽  
Nephrotoxic Drugs ◽  
Medical Wards ◽  
Hospital Acquired

<b><i>Background:</i></b> Information on older patients with hospital-acquired acute kidney injury (HA-AKI) and use of drugs is limited. <b><i>Aim:</i></b> This study aimed to assess the clinical characteristics, drug uses, and in-hospital outcomes of hospitalized older patients with HA-AKI. <b><i>Methods:</i></b> Patients aged ≥65 years who were hospitalized in medical wards were retrospectively analyzed. The study patients were divided into the HA-AKI and non-AKI groups based on the changes in serum creatinine. Disease incidence, risk factors, drug uses, and in-hospital outcomes were compared between the groups. <b><i>Results:</i></b> Of 26,710 older patients in medical wards, 4,491 (16.8%) developed HA-AKI. Older patients with HA-AKI had higher rates of multiple comorbidities and Charlson Comorbidity Index score than those without AKI (<i>p</i> &#x3c; 0.001). In the HA-AKI group, the proportion of patients with prior use of drugs with possible nephrotoxicity was higher than that of patients with prior use of drugs with identified nephrotoxicity (<i>p</i> &#x3c; 0.05). The proportions of patients with critical illness, use of nephrotoxic drugs, and the requirements of intensive care unit treatment, cardiopulmonary resuscitation, and dialysis as well as in-hospital mortality and hospitalization duration and costs were higher in the HA-AKI than the non-AKI group; these increased with HA-AKI severity (all <i>p</i> for trend &#x3c;0.001). With the increase in the number of patients with continued use of drugs with possible nephrotoxicity after HA-AKI, the clinical outcomes showed a tendency to worsen (<i>p</i> &#x3c; 0.001). Moreover, HA-AKI incidence (adjusted odds ratio [OR], 10.26; 95% confidence interval (CI), 8.27–12.74; <i>p</i> &#x3c; 0.001), and nephrotoxic drugs exposure (adjusted OR, 1.76; 95% CI, 1.63–1.91; <i>p</i> &#x3c; 0.001) had an association with an increased in-hospital mortality risk. <b><i>Conclusion:</i></b> AKI incidence was high among hospitalized older patients. Older patients with HA-AKI had worse in-hospital outcomes and higher resource utilization. Nephrotoxic drug exposure and HA-AKI incidence were associated with an increased in-hospital mortality risk.

scholarly journals Clinical Characteristics and Outcomes of Community-Acquired versus Hospital-Acquired Acute Kidney Injury: A Meta-Analysis

2019 ◽  
Vol 44 (5) ◽  
pp. 879-896 ◽  
Author(s):  
Linxi Huang ◽  
Cheng Xue ◽  
Jianke Kuai ◽  
Mengna Ruan ◽  
Bo Yang ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Hospital Stay ◽  
Clinical Characteristics ◽  
Meta Analysis ◽  
Clinical Manifestations ◽  
Kidney Injury ◽  
Length Of Hospital Stay ◽  
Renal Recovery ◽  
Significant Difference ◽  
Hospital Acquired

Background: The different clinical characteristics of community-acquired acute kidney injury (CA-AKI) versus hospital-acquired AKI (HA-AKI) have remained inconclusive, and thus, a meta-analysis was conducted to summarize and quantify the clinical significance distinguishing the 2 types of AKI. Methods: We identified observational studies reporting the clinical characteristics and prognosis of HA-AKI and CA-AKI. ORs and mean differences (MDs) were extracted for each outcome and the results aggregated. The primary outcome was defined as the mortality rate; renal recovery, oliguria incidence, dialysis, intensive care unit (ICU) requirement, and length of hospital stay were secondary outcomes. Results: Fifteen eligible studies involving 46,157 patients (22,791 CA-AKI patients and 23,366 HA-AKI patients) were included. Mortality was significantly lower in CA-AKI than in HA-AKI patients, with an OR of 0.43 (95% CI 0.35–0.53). The incidence of oliguria and need for ICU were also lower in CA-AKI patients (OR 0.58, 95% CI 0.38–0.88; OR 0.24, 95% CI 0.14–0.40, respectively). CA-AKI patients had a shorter hospital stay (MD –9.42, 95% CI –13.73 to –5.12). The renal recovery rate and dialysis need between CA- and HA-AKI were similar (OR 1.27, 95% CI 0.53–3.02; OR 1.05, 95% CI 0.82–1.34, respectively). Conclusions: CA-AKI showed better clinical manifestations with a lower incidence of oliguria, reduced risk of ICU treatment, and shorter hospital stay. Mortality associated with CA-AKI was lower compared with HA-AKI, indicating a better prognosis. The rate of renal recovery and need for dialysis showed no significant difference between the 2 groups.

scholarly journals Clinical characteristics and prognosis of postpartum acute kidney injury

2021 ◽  
Vol 49 (2) ◽  
pp. 030006052098838
Author(s):  
Hong Shu ◽  
Fang Nie
Keyword(s):  
Acute Kidney Injury ◽  
Clinical Characteristics ◽  
Survival Rates ◽  
Kidney Injury ◽  
Renal Recovery ◽  
Replacement Treatment ◽  
Elevated Liver Enzymes ◽  
Recovery Times ◽  
Low Platelet Count ◽  
Lost To Follow Up

Objective To investigate the clinical characteristics and prognoses of patients with postpartum acute kidney injury (PPAKI). Methods We retrospectively reviewed the clinical presentations, laboratory examinations, treatments, and outcomes of patients with PPAKI admitted to our hospital from January 2013 to December 2017. We then analyzed the clinical characteristics and prognoses of the mothers and their infants. Results Of 37 patients diagnosed with PPAKI, 26 (70.3%) received treatment in the intensive care unit, mainly for hemolysis, elevated liver enzymes, low platelet count (HELLP) syndrome (28/37, 75.7%), pre-eclampsia (26/37, 70.3%), and postpartum hemorrhage (22/37, 59.5%). Twenty patients required renal replacement treatment (RRT), but renal recovery times were similar in the RRT and non-RRT groups. Renal function recovered completely in 30 patients (81.1%) and partially in one patient (2.7%), and was not re-examined in two patients (5.4%). Three patients (8.1%) were lost to follow-up. Only one patient (2.7%) remained dialysis-dependent, and no maternal deaths occurred. The preterm birth, low birth weight, and infant survival rates were 70.7% (29/41), 68.3% (28/41), and 78.0% (32/41), respectively. Conclusion RRT does not reduce renal recovery time compared with non-RRT. Overall, the prognoses of both mothers and their fetuses are good following treatment for PPAKI.

scholarly journals The ratio of CRP to prealbumin levels predict mortality in patients with hospital-acquired acute kidney injury

2011 ◽  
Vol 12 (1) ◽  
Author(s):  
Qionghong Xie ◽  
Ying Zhou ◽  
Zhongye Xu ◽  
Yanjiao Yang ◽  
Dingwei Kuang ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Kidney Injury ◽  
Hospital Acquired

scholarly journals Clinical characteristics and mortality risk prediction in children with acute kidney injury

2015 ◽  
Vol 56 (5) ◽  
pp. 327 ◽  
Author(s):  
Alireza Teimouri ◽  
Simin Sadeghi-Bojd ◽  
NoorMohammad Noori ◽  
Mehdi Mohammadi
Keyword(s):  
Acute Kidney Injury ◽  
Risk Prediction ◽  
Mortality Risk ◽  
Clinical Characteristics ◽  
Kidney Injury

Biomarkers of acute kidney injury: time to learn from implementation

2021 ◽  
Vol 23 (2) ◽  
pp. 137-140
Author(s):  
Zoltán H Endre ◽  
Keyword(s):  
Acute Kidney Injury ◽  
Kidney Injury ◽  
Clinical Problem ◽  
Time To Learn ◽  
Hospital Acquired ◽  
Major Clinical Problem

Acute kidney injury (AKI) is a major clinical problem in the community and in hospital, with hospital-acquired AKI reported in about 20% of adult and 30% of paediatric admissions.

Nephrology In-Reach Services Lead to Improvement in Mortality in Acute Kidney Injury – 3 (AKI-3)

2020 ◽  
Author(s):  
E. Gkekas ◽  
TYT. Tang ◽  
M. Brazell ◽  
M. Brennan ◽  
H. Ayub ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Mortality Rate ◽  
District Hospital ◽  
Care Pathway ◽  
Kidney Injury ◽  
Evaluation Study ◽  
Community Settings ◽  
Inclusion Criteria ◽  
Hospital Acquired ◽  
Overall Mortality

Abstract Background: Acute Kidney Injury (AKI) is a sudden decline in kidney function. Early detection and prompt treatment of AKI is vital in improving the outcome of patients. We introduced in-reach nephrology services at South Tyneside District Hospital (STDH) as part of a reconfiguration of local NHS services. Aims: The principal aim of this study is to analyse patient outcomes relating to service developments and to explore prognostic characteristics among a cohort of AKI-3 patients Design: This was a single centre retrospective impact evaluation study.Methods: We studied all patients (n=246) who either presented with or developed AKI-3 during their admission at South Tyneside District Hospital from 2016 to 2018. The inclusion criteria included age 18-95 years and a diagnosis of AKI-3 as per KDIGO classification. Exclusion include those on established dialysis regime or on palliative care. Results: A total of 246 patients were admitted with AKI-3. There were 64 deaths from AKI-3 over the three-year period. Mortality decreased from 29.5% to 20.7% from 2016 to 2018. In patients with Community Acquired (CA-AKI3) the overall mortality rate was 24.2% (n=182), whereas the overall mortality rate of those with Hospital Acquired (HA-AKI3) was 31.3% (n=64). The pre-AKI use of ACEi, A2RB or diuretics increased from 39.7% in 2016 (n=78), to 59.3% in 2017 (n=86) and 64.6% in 2018 (n=82). Conversely, mortality associated with the use of these medications reduced each consecutive year (32.3%, 25.5%, 18.9%).Conclusion: Development of nephrology in-reach services, staff education measures and a primary care pathway could reduce AKI-3 mortality among patients in inpatient and community settings.

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