Pre-existing chronic kidney disease and acute kidney injury among critically ill patients

Heart & Lung ◽  
2020 ◽  
Vol 49 (5) ◽  
pp. 626-629
Author(s):  
Maysoon S. Abdalrahim ◽  
Amani A. Khalil ◽  
Manal Alramly ◽  
Khalid Nabeel Alshlool ◽  
Mona A. Abed ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Acute Kidney Injury ◽  
Kidney Disease ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Kidney Injury

scholarly journals The Incidence of Chronic Kidney Disease Three Years after Non-Severe Acute Kidney Injury in Critically Ill Patients: A Single-Center Cohort Study

2019 ◽  
Vol 8 (12) ◽  
pp. 2215 ◽  
Author(s):  
Sébastien Rubin ◽  
Arthur Orieux ◽  
Benjamin Clouzeau ◽  
Claire Rigothier ◽  
Christian Combe ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Acute Kidney Injury ◽  
Kidney Disease ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Kidney Injury ◽  
Single Center ◽  
Frequent Event ◽  
Incidence Of Ckd

The risk of chronic kidney disease (CKD) following severe acute kidney injury (AKI) in critically ill patients is well documented, but not after less severe AKI. The main objective of this study was to evaluate the long-term incidence of CKD after non-severe AKI in critically ill patients. This prospective single-center observational three-years follow-up study was conducted in the medical intensive care unit in Bordeaux’s hospital (France). From 2013 to 2015, all patients with severe (kidney disease improving global outcomes (KDIGO) stage 3) and non-severe AKI (KDIGO stages 1, 2) were enrolled. Patients with prior eGFR < 90 mL/min/1.73 m2 were excluded. Primary outcome was the three-year incidence of CKD stages 3 to 5 in the non-severe AKI group. We enrolled 232 patients. Non-severe AKI was observed in 112 and severe AKI in 120. In the non-severe AKI group, 71 (63%) were male, age was 62 ± 16 years. The reason for admission was sepsis for 56/112 (50%). Sixty-two (55%) patients died and nine (8%) were lost to follow-up. At the end of the follow-up the incidence of CKD was 22% (9/41); Confidence Interval (CI) 95% (9.3–33.60)% in the non-severe AKI group, tending to be significantly lower than in the severe AKI group (44% (14/30); CI 95% (28.8–64.5)%; p = 0.052). The development of CKD three years after non-severe AKI, despite it being lower than after severe AKI, appears to be a frequent event highlighting the need for prolonged follow-up.

scholarly journals A survey on acute kidney injury in severely and critically ill COVID-19 patients without chronic kidney disease

2021 ◽  
Vol 10 (13) ◽  
pp. 42-42
Author(s):  
Yue Yu ◽  
Huipeng Ge ◽  
Xiufen Wang ◽  
Zhonghua Huang ◽  
Lei Chen ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Acute Kidney Injury ◽  
Kidney Disease ◽  
Critically Ill ◽  
Kidney Injury

scholarly journals Acute Kidney Injury in Critically Ill Children and Subsequent Chronic Kidney Disease

2019 ◽  
Vol 6 ◽  
pp. 205435811988018 ◽  
Author(s):  
Erin Hessey ◽  
Sylvie Perreault ◽  
Marc Dorais ◽  
Louise Roy ◽  
Michael Zappitelli
Keyword(s):  
Health Care ◽  
Chronic Kidney Disease ◽  
Acute Kidney Injury ◽  
Kidney Disease ◽  
Renal Disease ◽  
Critically Ill ◽  
Administrative Data ◽  
Kidney Injury ◽  
Critically Ill Children ◽  
Post Discharge

Background: The progression from acute kidney injury (AKI) to chronic kidney disease (CKD) is not well understood in children. Objectives: We aimed to develop a pediatric CKD definition using administrative data and use it to evaluate the association between AKI in critically ill children and CKD 5 years after hospital discharge. Design: Retrospective cohort study using chart collection and administrative data. Setting: Two-center study in Montreal, Canada. Patients: Children (≤18 years old) admitted to two pediatric intensive care units (ICUs) between 2003 and 2005. We a priori excluded patients with end-stage renal disease or no health care number. Only the first admission during the study period was included. We excluded patients who could not be linked to administrative data, did not survive hospitalization, or had preexisting renal disease. Measurements: Acute kidney injury was defined using Kidney Disease: Improving Global Outcomes (KDIGO) criteria. Patients were defined as having CKD 5 years post-discharge if they had ≥1 CKD diagnostic code or ≥1 CKD-specific medication prescription. Methods: Chart data used to define the exposure (AKI) were merged with provincial administrative data used to define the outcome (CKD). Cox regression was used to evaluate the AKI-CKD association. Results: A total of 2235 (56% male) patients were included, and the median admission age was 3.7 years. A total of 464 (21%) patients developed AKI during pediatric ICU admission. At 5 years post-discharge, 43 (2%) patients had a CKD diagnosis. Patients with both stage 1 and stage 2-3 AKI had increased risk of a CKD diagnosis, with the adjusted hazard ratios (95% confidence intervals) of 2.2 (1.1-4.5) and 2.5 (1.1-5.7), respectively ( P < .001). Limitations: Results may not be generalizable to non-ICU patients. We were not able to control for post-discharge variables; future research should try to explore these additional potential risk factors further. Conclusions: Acute kidney injury is associated with 5-year post-discharge CKD diagnosis defined by administrative health care data.

Acute Kidney Injury in Critically Ill Patients

2018 ◽  
Author(s):  
Monica G Valero ◽  
Zara Cooper
Keyword(s):  
Acute Kidney Injury ◽  
Kidney Disease ◽  
Replacement Therapy ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Kidney Injury ◽  
Acute Kidney Injury Network ◽  
Morbidity And Mortality ◽  
Common Disease ◽  
High Level

Acute kidney injury is a common disease that affects critically ill patients and increases morbidity and mortality. Even though there have been extensive efforts to prevent this disease, the incidence has steadily increased over the last decade. This could be attributed to better recognition or to overestimation of the disease based on the most recent consensus criteria. Complications of acute kidney injury have a significant effect on quality of life, morbidity, and mortality. Despite advances in the field, this disease continues to be a challenge, and decreasing the mortality associated with it remains difficult. Plenty of literature has been published about the appropriate definition, diagnosis, and treatment of the disease. One of the topics of ongoing discussion deals with the lack of consensus about the exact timing for initiation of renal replacement therapy (RRT). Even though RRT adds more complexity to the treatment, recent publications suggest that early versus late initiation of RRT is related to reduced mortality in critically ill patients. Further high-level studies of this intervention are warranted to standardize treatment. This review contains 5 figures, 7 tables, and 77 references.               Key words: Acute Kidney Injury Network (AKIN), acute kidney injury, chronic kidney disease, Kidney Disease: Improving Global Outcomes (KDIGO), renal biomarkers, replacement therapy, Risk, Injury, Failure, Loss of kidney function and End-stage kidney disease (RIFLE)

scholarly journals External validation of urinary C–C motif chemokine ligand 14 (CCL14) for prediction of persistent acute kidney injury

Critical Care ◽  
2021 ◽  
Vol 25 (1) ◽  
Author(s):  
Sean M. Bagshaw ◽  
Ali Al-Khafaji ◽  
Antonio Artigas ◽  
Danielle Davison ◽  
Michael Haase ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Kidney Disease ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
External Validation ◽  
Secondary Analysis ◽  
Kidney Injury ◽  
Urinary Concentration ◽  
Baseline Serum ◽  
Chemokine Ligand

Abstract Background Persistent acute kidney injury (AKI) portends worse clinical outcomes and remains a therapeutic challenge for clinicians. A recent study found that urinary C–C motif chemokine ligand 14 (CCL14) can predict the development of persistent AKI. We aimed to externally validate urinary CCL14 for the prediction of persistent AKI in critically ill patients. Methods This was a secondary analysis of the prospective multi-center SAPPHIRE study. We evaluated critically ill patients with cardiac and/or respiratory dysfunction who developed Kidney Disease: Improving Global Outcomes (KDIGO) stage 2–3 AKI within one week of enrollment. The main exposure was the urinary concentration of CCL14 measured at the onset of AKI stage 2–3. The primary endpoint was the development of persistent severe AKI, defined as  ≥ 72 h of KDIGO stage 3 AKI or death or renal-replacement therapy (RRT) prior to 72 h. The secondary endpoint was a composite of RRT and/or death by 90 days. We used receiver operating characteristic (ROC) curve analysis to assess discriminative ability of urinary CCL14 for the development of persistent severe AKI and multivariate analysis to compare tertiles of urinary CCL14 and outcomes. Results We included 195 patients who developed KDIGO stage 2–3 AKI. Of these, 28 (14%) developed persistent severe AKI, of whom 15 had AKI  ≥ 72 h, 12 received RRT and 1 died prior to  ≥ 72 h of KDIGO stage 3 AKI. Persistent severe AKI was associated with chronic kidney disease, diabetes mellitus, higher non-renal APACHE III score, greater fluid balance, vasopressor use, and greater change in baseline serum creatinine. The AUC for urinary CCL14 to predict persistent severe AKI was 0.81 (95% CI, 0.72–0.89). The risk of persistent severe AKI increased with higher values of urinary CCL14. RRT and/or death at 90 days increased within tertiles of urinary CCL14 concentration. Conclusions This secondary analysis externally validates urinary CCL14 to predict persistent severe AKI in critically ill patients.

Acute Kidney Injury in Critically Ill Patients

2017 ◽  
Author(s):  
Monica G Valero ◽  
Zara Cooper
Keyword(s):  
Acute Kidney Injury ◽  
Kidney Disease ◽  
Replacement Therapy ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Kidney Injury ◽  
Acute Kidney Injury Network ◽  
Morbidity And Mortality ◽  
Common Disease ◽  
High Level

Acute kidney injury is a common disease that affects critically ill patients and increases morbidity and mortality. Even though there have been extensive efforts to prevent this disease, the incidence has steadily increased over the last decade. This could be attributed to better recognition or to overestimation of the disease based on the most recent consensus criteria. Complications of acute kidney injury have a significant effect on quality of life, morbidity, and mortality. Despite advances in the field, this disease continues to be a challenge, and decreasing the mortality associated with it remains difficult. Plenty of literature has been published about the appropriate definition, diagnosis, and treatment of the disease. One of the topics of ongoing discussion deals with the lack of consensus about the exact timing for initiation of renal replacement therapy (RRT). Even though RRT adds more complexity to the treatment, recent publications suggest that early versus late initiation of RRT is related to reduced mortality in critically ill patients. Further high-level studies of this intervention are warranted to standardize treatment. This review contains 5 figures, 7 tables, and 77 references.               Key words: Acute Kidney Injury Network (AKIN), acute kidney injury, chronic kidney disease, Kidney Disease: Improving Global Outcomes (KDIGO), renal biomarkers, replacement therapy, Risk, Injury, Failure, Loss of kidney function and End-stage kidney disease (RIFLE)

scholarly journals Common Inflammation-Related Candidate Gene Variants and Acute Kidney Injury in 2647 Critically Ill Finnish Patients

2019 ◽  
Vol 8 (3) ◽  
pp. 342 ◽  
Author(s):  
Laura M. Vilander ◽  
Suvi T. Vaara ◽  
Mari A. Kaunisto ◽  
Ville Pettilä ◽  
Keyword(s):  
Acute Kidney Injury ◽  
Kidney Disease ◽  
Candidate Gene ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Genetic Model ◽  
Kidney Injury ◽  
Gene Variants ◽  
Association Analyses ◽  
The Individual

Acute kidney injury (AKI) is a syndrome with high incidence among the critically ill. Because the clinical variables and currently used biomarkers have failed to predict the individual susceptibility to AKI, candidate gene variants for the trait have been studied. Studies about genetic predisposition to AKI have been mainly underpowered and of moderate quality. We report the association study of 27 genetic variants in a cohort of Finnish critically ill patients, focusing on the replication of associations detected with variants in genes related to inflammation, cell survival, or circulation. In this prospective, observational Finnish Acute Kidney Injury (FINNAKI) study, 2647 patients without chronic kidney disease were genotyped. We defined AKI according to Kidney Disease: Improving Global Outcomes (KDIGO) criteria. We compared severe AKI (Stages 2 and 3, n = 625) to controls (Stage 0, n = 1582). For genotyping we used iPLEXTM Assay (Agena Bioscience). We performed the association analyses with PLINK software, using an additive genetic model in logistic regression. Despite the numerous, although contradictory, studies about association between polymorphisms rs1800629 in TNFA and rs1800896 in IL10 and AKI, we found no association (odds ratios 1.06 (95% CI 0.89–1.28, p = 0.51) and 0.92 (95% CI 0.80–1.05, p = 0.20), respectively). Adjusting for confounders did not change the results. To conclude, we could not confirm the associations reported in previous studies in a cohort of critically ill patients.

Sign in / Sign up

Export Citation Format

Share Document