Development of a knowledge mining approach to uncover heterogeneous risk predictors of acute kidney injury across age groups

2021 ◽  
pp. 104661
Author(s):  
Lijuan Wu ◽  
Yong Hu ◽  
Xiangzhou Zhang ◽  
Jia Zhang ◽  
Mei Liu
Keyword(s):  
Acute Kidney Injury ◽  
Age Groups ◽  
Kidney Injury ◽  
Knowledge Mining ◽  
Risk Predictors

ACUTE KIDNEY INJURY IN ELDERLY PATIENTS

2019 ◽  
Vol 72 (8) ◽  
pp. 1466-1472
Author(s):  
Grażyna Kobus ◽  
Jolanta Małyszko ◽  
Hanna Bachórzewska-Gajewska
Keyword(s):  
Acute Kidney Injury ◽  
Renal Failure ◽  
Acute Renal Failure ◽  
Elderly Patients ◽  
Older Patients ◽  
Age Groups ◽  
Kidney Injury ◽  
The Elderly ◽  
Younger Patients ◽  
Common Cause

Introduction: In the elderly, impairment of kidney function occurs. Renal diseases overlap with anatomic and functional changes related to age-related involutionary processes. Mortality among patients with acute renal injury is approximately 50%, despite advances in treatment and diagnosis of AKI. The aim: To assess the incidence of acute kidney injury in elderly patients and to analyze the causes of acute renal failure depending on age. Materials and methods: A retrospective analysis included medical documentation of patients hospitalized in the Nephrology Clinic during the 6-month period. During this period 452 patients were hospitalized in the clinic. A group of 77 patients with acute renal failure as a reason for hospitalization was included in the study. Results: The prerenal form was the most common cause of AKI in both age groups. In both age groups, the most common cause was dehydration; in the group of patients up to 65 years of age, dehydration was 29.17%; in the group of people over 65 years - 43.39%. Renal replacement therapy in patients with AKI was used in 14.29% of patients. In the group of patients up to 65 years of age hemodialysis was 16.67% and above 65 years of age. -13.21% of patients. The average creatinine level in the group of younger patients at admission was 5.16 ± 3.71 mg / dl, in the group of older patients 3.14 ± 1.63 mg / dl. The size of glomerular filtration GFR in the group of younger patients at admission was 21.14 ± 19.54 ml / min, in the group of older patients 23.34 ± 13.33 ml / min. Conclusions: The main cause of acute kidney injury regardless of the age group was dehydration. Due to the high percentage of AKI in the elderly, this group requires more preventive action, not only in the hospital but also at home.

scholarly journals Incidence and risk predictors of acute kidney injury among HIV-positive patients presenting with sepsis in a low resource setting

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Davis Kimweri ◽  
Julian Ategeka ◽  
Faustine Ceasor ◽  
Winnie Muyindike ◽  
Edwin Nuwagira ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Significant Risk ◽  
Kidney Injury ◽  
Significant Risk Factor ◽  
Hiv Positive ◽  
Volume Depletion ◽  
Adjusted Risk ◽  
Adjusted Analysis ◽  
Resource Setting ◽  
Risk Predictors

Abstract Background Acute kidney injury (AKI) is a frequently encountered clinical condition in critically ill patients and is associated with increased morbidity and mortality. In our resource-limited setting (RLS), the most common cause of AKI is sepsis and volume depletion. Sepsis alone, accounts for up to 62 % of the AKI cases in HIV-positive patients. Objective The major goal of this study was to determine the incidence and risk predictors of AKI among HIV-infected patients admitted with sepsis at a tertiary hospital in Uganda. Methods In a prospective cohort study, we enrolled adult patients presenting with sepsis at Mbarara Regional Referral Hospital (MRRH) in southwestern Uganda between March and July 2020. Sepsis was determined using the qSOFA criteria. Patients presenting with CKD or AKI were excluded. Sociodemographic characteristics, physical examination findings, and baseline laboratory values were recorded in a data collection tool. The serum creatinine and urea were done at admission (0-hour) and at the 48-hour mark to determine the presence of AKI. We performed crude and multivariable binomial regression to establish the factors that predicted developing AKI in the first 48 h of admission. Variables with a p < 0.01 in the adjusted analysis were considered as significant predictors of AKI. Results Out of 384 patients screened, 73 (19 %) met our inclusion criteria. Their median age was 38 (IQR 29–46) years and 44 (60.3 %) were male. The median CD4 T-cell count was 67 (IQR 35–200) cells, median MUAC was 23 (IQR 21–27) cm and 54 (74.0 %) participants were on a regimen containing Tenofovir Disoproxil Fumarate (TDF). The incidence of AKI in 48 h was 19.2 % and in the adjusted analysis, thrombocytopenia (Platelet count < 150) (adjusted risk ratio 8.21: 95 % CI: 2.0–33.8, p = 0.004) was an independent predictor of AKI. Conclusions There is a high incidence of AKI among HIV-positive patients admitted with sepsis in Uganda. Thrombocytopenia at admission may be a significant risk factor for developing AKI. The association of thrombocytopenia in sepsis and AKI needs to be investigated.

scholarly journals Acute kidney injury after thoracic surgery: a proposal for a multicentre evaluation (MERITS)

2019 ◽  
Vol 29 (6) ◽  
pp. 861-866
Author(s):  
Vinci Naruka ◽  
Mikel A Mckie ◽  
Rasoel Khushiwal ◽  
James Clayton ◽  
Giuseppe Aresu ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Kidney Disease ◽  
Thoracic Surgery ◽  
Thoracoscopic Surgery ◽  
Age Groups ◽  
Kidney Injury ◽  
Staging System ◽  
Pilot Project ◽  
Old Patients ◽  
Significant Difference

Abstract OBJECTIVES Because the mortality rate is very low in thoracic surgery, its use as a quality discriminator is limited. Acute kidney injury (AKI) is a candidate measure because it is associated with increased rates of morbidity and mortality and is partly preventable. The incidence of AKI after thoracic surgery is not well documented. We conducted an audit to determine the incidence and outcomes of AKI. This audit became a pilot project, and the results indicate the feasibility of a larger study. METHODS Retrospective data on renal function post-thoracic surgery were collected at a tertiary cardiothoracic unit over 12 months. Renal impairment was classified according to the Kidney Disease Improving Global Outcomes criteria. RESULTS Of 568 patients (mean = 59  ±  SD 18; 38% women), AKI was diagnosed in 86 (15.1%) within 72 h post-thoracic surgery based on the Kidney Disease Improving Global Outcomes staging system (stage 1, n = 55; stage 2, n = 25; stage 3, n = 6). Significant differences were found in postoperative length of stay (3 vs 5 days; P < 0.001) of patients with and without AKI. There was a significant difference between the age groups of patients with and without AKI (P < 0.05) in the open surgical group but not in the group having video-assisted thoracoscopic surgery (VATS). There was no significant difference in the mortality rates between patients with and without AKI. CONCLUSIONS The incidence of AKI after thoracic surgery was 15.1%. AKI was associated with longer hospital stays and was more likely in ≥60-year-old patients after open surgery than after VATS. Reducing AKI could improve patient outcomes. We propose that AKI may be a useful quality measure in thoracic surgery. We are developing a multicentre audit based on this approach.

scholarly journals The characteristics and mortality risk factors for acute kidney injury in different age groups in China—a cross sectional study

Renal Failure ◽  
2016 ◽  
Vol 38 (9) ◽  
pp. 1413-1417 ◽  
Author(s):  
Qing Wei ◽  
Hong Liu ◽  
Yan- Tu ◽  
Ri-Ning Tang ◽  
Yan-Li Wang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Mortality Risk ◽  
Age Groups ◽  
Kidney Injury ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional

scholarly journals Outcome of Acute Kidney Injury in Sudanese Children — An Experience from a Sub-Saharan African Unit

2014 ◽  
Vol 34 (5) ◽  
pp. 526-533 ◽  
Author(s):  
Mohamed Abdelraheem ◽  
El-Tigani Ali ◽  
Rania Osman ◽  
Rashid Ellidir ◽  
Amna Bushara ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Developing Countries ◽  
Obstructive Uropathy ◽  
Pediatric Nephrology ◽  
Age Groups ◽  
Kidney Injury ◽  
Admission Rate ◽  
Morbidity And Mortality ◽  
University Hospital ◽  
Acute Glomerulonephritis

BackgroundAcute Kidney Injury (AKI) is an important cause of morbidity and mortality in developing countries. Although continuous renal replacement therapy is gaining more popularity worldwide, peritoneal dialysis (PD) in children remains an appropriate therapy for AKI in children for all age groups including neonates.MethodologyWe retrospectively reviewed all children who have been admitted with AKI at the pediatric nephrology unit, Soba University Hospital, Khartoum, during the period from January 2005 to December 2011.ResultsOver 7 years we recorded 659 children of whom 362 (54.9%) were male. The spectrum of age was variable with the majority being neonates, 178 (27.1%). The average patient admission rate was 94 patients per year, with an estimated incidence of 9.8 patients/million population/year. Common causes of AKI were sepsis 202 (30.8%), acute glomerulonephritis 75 (11.5%) and obstructive uropathy due to stones 56 (8.5%). The most common dialysis modality used was PD, 343 (52.4%), and peritonitis was reported in 53 (15.4%) patients. Recovery from AKI was achieved in 450 (68.9%) children, 37 (5.7%) went into chronic kidney disease (CKD), 33 (5.1%) referred to the pediatric surgery and 194 (29.7%) died.ConclusionIn the setting of developing countries where AKI is a common cause of morbidity and mortality, reasonably equipped renal units with adequately trained medical staff may save many lives. International funding programs for communicable diseases and charity organizations should include AKI management in their programs. Acute PD remains the treatment modality of choice for AKI in developing countries.

scholarly journals Etiology and Outcomes of Acute Kidney Injury in Patients Admitted to a Single Tertiary Care Hospital: Balochistan Institute of Nephrology-Urology Quetta

2021 ◽  
Vol 4 (4) ◽  
pp. 319-323
Author(s):  
Abdul Kareem Zarkoon Zarkoon ◽  
Habib Ullah Rind ◽  
Moin Khan ◽  
Aijaz Ahmed ◽  
Nasir Jakrani ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Age Groups ◽  
Kidney Injury ◽  
Complete Recovery ◽  
Clinical Syndrome ◽  
Obstructive Nephropathy ◽  
Care Hospital ◽  
Number Of Patients

Acute kidney injury (AKI) is a common clinical syndrome with broad spectrum of etiologies and an important cause of morbidity and mortality requiring hospitalization. Depending on the cause and nature of AKI it may complicate to be life threatening or even proceed to Chronic Kidney disease (CKD) compromising the quality of life. Methods: The current retrospective study determines the causes and outcomes of AKI in patients of different age groups, who required hospitalization at our tertiary care hospital from March 2018 to March 2020.  Possible etiologic conditions for AKI were recorded during the study period and AKI was classified according to the causes, age and outcome. Results: records of total of 267 patients with diagnosis of AKI were obtained who were admitted during the study period. Obstetric related diagnosis was the commonest reason for AKI (n= 50 18.7%), another 42 (15.7%) had obstructive nephropathy, prerenal AKI in 35 patients (13.1%) and other causes such as glomerulonephritis, sepsis, pigment nephropathy and drug related interstitial nephritis among others. Majority of the patients needed dialytic support, n=190 (71.2%) and majority of patients n=181 patients (67.7%) recovered completely, and only 11 patients (4.2%) expired. Conclusion: Our study reveals that majority of patients with AKI presenting to BINUQ had reversible causes of AKI with complete recovery in significant number of patients. Community wise programs to early detect AKI with prompt treatment will decrease the likelihood of such patients adding to the CKD population.

Assessment of acute kidney injury by urinary β2-MG and NAG in pediatric cancer patients prescribed with Cisplatin, Carboplatin, and Ifosfamide as the chemotherapeutic agents

2020 ◽  
Author(s):  
Alireza Moafi ◽  
Hanieh Basirkazeruni ◽  
Nahid Reisi ◽  
Moein Dehbashi ◽  
Leila Ghanbarinia ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Cancer Patients ◽  
Pediatric Cancer ◽  
Age Groups ◽  
Kidney Injury ◽  
Chemotherapeutic Agents ◽  
Pediatric Cancer Patients ◽  
The Mean ◽  
Beta 2 Microglobulin ◽  
Kidney Injury Molecule 1

Background: Acute kidney injury (AKI) is defined as a failure in renal function leading to insufficiency of fluid and electrolyte homeostasis. Thus, sensitive biomarkers of renal tubular injury are needed to detect AKI earlier. In this study, urinary beta 2-microglobulin (β2-MG) and urinary N-acetyl-β-D-glucosaminidase (NAG) were evaluated for AKI prognosis/diagnosis in pediatric patients suffering different cancers prescribed with Ifosfamide, Ifosfamide plus Carboplatin, and Ifosfamide plus Cisplatin. Materials and Methods: In this prospective study done in Isfahan, Iran, urinary β2-MG, urinary NAG, blood urea nitrogen (BUN), and serum and urinary creatinine (Cr) were measured in 40 pediatric cancer patients less than 16 years old in three age groups during 61 courses of chemotherapy on day 0, three and six after the treatment. Results: Using ANOVA and t-test, the mean levels of urinary β2-MG (p= 0.001), urinary β2-MG/Cr (p= 0.003) and urinary NAG/Cr (p= 0.001), before and on day six of the treatment were statistically significant (p< 0.05). Also, the mean levels of BUN (p= 0.01), urinary β2-MG (p= 0.001), β2-MG/Cr (p= 0.001) and NAG/Cr (p= 0.004) based on the gender groups, the mean levels of urinary NAG (p=0.001), NAG/Cr (p= 0.001) and β2-MG/Cr (p= 0.008) based on three age groups, and the mean levels of serum Cr (p= 0.047), urinary β2-MG (p= 0.005), β2-MG/Cr (p= 0.032) and NAG/Cr (p= 0.032) based on the Ifosfamide dosage were statistically significant during the time of the treatment. Conclusion: Urinary β2-MG, urinary β2-MG/Cr, and urinary NAG/Cr are more significant biomarkers than serum Cr in earlier diagnosis and treatment of AKI in cancer patients. However, urinary NAG should be further studied to prove its reliability for AKI prognosis/diagnosis. It is suggested that urinary NAG can be used along with other renal biomarkers such as urinary β2-MG, kidney injury molecule-1(KIM-1), or interleukin-18 (IL-18) for AKI prognosis/diagnosis.

Risk Predictors for Postcontrast Acute Kidney Injury

2018 ◽  
Vol 15 (11) ◽  
pp. 1547-1552 ◽  
Author(s):  
Trudy Millard Krause ◽  
Maria Ukhanova ◽  
Frances Lee Revere ◽  
Kevin W. Finkel
Keyword(s):  
Acute Kidney Injury ◽  
Kidney Injury ◽  
Risk Predictors
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