scholarly journals Risk factors and mortality of acute kidney injury within 1 month after lung transplantation

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Nam Eun Kim ◽  
Chi Young Kim ◽  
Song Yee Kim ◽  
Ha Eun Kim ◽  
Jin Gu Lee ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Risk Factor ◽  
Lung Transplantation ◽  
Kidney Injury ◽  
Operative Management ◽  
Rank Test ◽  
Medical Risk ◽  
Severance Hospital ◽  
Medical Risk Factors

AbstractAfter lung transplantation (LT), some patients are at risk of acute kidney injury (AKI), which is associated with worse outcomes and increased mortality. Previous studies focused on AKI development from 72 h to 1 week within LT, and reported main risk factors for AKI such as intraoperative hypotension, need of ECMO support, ischemia time or longer time on waiting list. However, this period interval rarely reflects medical risk factors probably happen in longer post-operative period. So, in this study we aimed to describe the incidence and risk factor of AKI within post-operative 1 month, which is longer follow up duration. Among 161 patients who underwent LT at Severance hospital in Seoul, Korea from October 2012 to September 2017, 148 patients were retrospectively enrolled. Multivariable logistic regression and Cox proportional hazard models were utilized. Among 148 patients, 59 (39.8%) developed AKI within 1-month after LT. Stage I or II, and stage III AKI were recorded in 26 (17.5%) and 33 (22.2%), respectively. We also classified AKI according to occurrence time, within 1 week as early AKI, from 1 week within 1 month was defined as late AKI. AKI III usually occurred within 7 days after transplantation (early vs. late AKI III, 72.5% vs 21.1%). Risk factor for AKI development was pre-operative anemia, higher units of red blood cells transfused during surgery, colistin intravenous infusion for treating multi drug resistant pathogens were independent risk factors for AKI development. Post-operative bleeding, grade 3 PGD within 72 h, and sepsis were more common complication in the AKI group. Patients with AKI III ([24/33] 72.7%) had significantly higher 1-year mortality than the no-AKI ([18/89] 20.2%), and AKI I or II group ([9/26] 34.6%), log-rank test, P < 0.001). AKI was associated with worse post-operative outcome, 3-month, and 1-year mortality after LT. Severity of AKI was usually determined in early post op period (ex. within 7 days) after LT, so optimal post-operative management as well as recipients selection should be considered.

scholarly journals Incidence, risk factors, and mortality of acute kidney injury within 1-month after lung transplantation

2021 ◽  
Author(s):  
Nam Eun Kim ◽  
Chi Young Kim ◽  
Song Yee Kim ◽  
Ha Eun Kim ◽  
Jin Gu Lee ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Lung Transplantation ◽  
Kidney Injury ◽  
Operative Management ◽  
Rank Test ◽  
Severance Hospital ◽  
Incidence Risk ◽  
Independent Risk Factors ◽  
Grade 3

Abstract Background After lung transplantation (LT), some patients are at risk of acute kidney injury (AKI), which is associated with worse outcomes and increased mortality. Method Among 161 patients who underwent LT at Severance hospital in Seoul, Korea from October 2012 to September 2017, 148 patients were retrospectively enrolled. Results 59 (39.8%) developed AKI within 1-month after LT. Stage I or II, and stage III AKI were recorded in 26 (17.5%) and 33 (22.2%), respectively. AKI III usually occurred within 7 days after transplantation (early vs. late AKI III, 72.5% vs 21.1%). Pre-operative anemia, units of red blood cells transfused during surgery, colistin intravenous infusion for treating multi drug resistant pathogens were independent risk factors for AKI development. Post-operative bleeding, grade 3 PGD within 72 hrs, and sepsis were more common in the AKI group. Patients with AKI III ([24/33] 72.7%) had significantly higher 1-year mortality than the no-AKI ([18/89] 20.2%), and AKI I or II group ([9/26] 34.6%), log-rank test, P < 0.001). Conclusion AKI was associated with worse post-operative outcome, 3-month, and 1-year mortality after LT. Severity of AKI was usually determined in early post op period after LT, so optimal post-operative management as well as recipients selection should be considered.

scholarly journals Analysis of risk factors of acute kidney injury in perioperative patients after lung transplantation

2021 ◽  
Vol 0 (0) ◽  
pp. 0-0
Author(s):  
Xiaoshu Liu ◽  
Jing Zhang ◽  
Yang Yang ◽  
Xiaobo Huang ◽  
Xiaoqin Zhang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Lung Transplantation ◽  
Kidney Injury

scholarly journals Acute Kidney Injury After Lung Transplantation: Perioperative Risk Factors and Outcome

2020 ◽  
Vol 52 (3) ◽  
pp. 967-976 ◽  
Author(s):  
E. Atchade ◽  
S. Barour ◽  
A. Tran-Dinh ◽  
S. Jean-Baptiste ◽  
S. Tanaka ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Lung Transplantation ◽  
Kidney Injury ◽  
Perioperative Risk ◽  
Perioperative Risk Factors

scholarly journals Acute kidney injury in renal transplant recipients undergoing cardiac surgery

2020 ◽  
Vol 36 (1) ◽  
pp. 185-196
Author(s):  
Gregory L Hundemer ◽  
Anand Srivastava ◽  
Kirolos A Jacob ◽  
Neeraja Krishnasamudram ◽  
Salman Ahmed ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Cardiac Surgery ◽  
Risk Factor ◽  
Renal Transplant ◽  
Kidney Disease ◽  
Kidney Injury ◽  
Renal Transplant Recipients ◽  
Transplant Recipients ◽  
Trough Levels

Abstract Background Acute kidney injury (AKI) is a key risk factor for chronic kidney disease in the general population, but has not been investigated in detail among renal transplant recipients (RTRs). We investigated the incidence, severity and risk factors for AKI following cardiac surgery among RTRs compared with non-RTRs with otherwise similar clinical characteristics. Methods We conducted a retrospective cohort study of RTRs (n = 83) and non-RTRs (n = 83) who underwent cardiac surgery at two major academic medical centers. Non-RTRs were matched 1:1 to RTRs by age, preoperative (preop) estimated glomerular filtration rate and type of cardiac surgery. We defined AKI according to Kidney Disease: Improving Global Outcomes criteria. Results RTRs had a higher rate of AKI following cardiac surgery compared with non-RTRs [46% versus 28%; adjusted odds ratio 2.77 (95% confidence interval 1.36–5.64)]. Among RTRs, deceased donor (DD) versus living donor (LD) status, as well as higher versus lower preop calcineurin inhibitor (CNI) trough levels, were associated with higher rates of AKI (57% versus 33% among DD-RTRs versus LD-RTRs; P = 0.047; 73% versus 36% among RTRs with higher versus lower CNI trough levels, P = 0.02). The combination of both risk factors (DD status and higher CNI trough level) had an additive effect (88% AKI incidence among patients with both risk factors versus 25% incidence among RTRs with neither risk factor, P = 0.004). Conclusions RTRs have a higher risk of AKI following cardiac surgery compared with non-RTRs with otherwise similar characteristics. Among RTRs, DD-RTRs and those with higher preop CNI trough levels are at the highest risk.

scholarly journals Incidence, Risk Factors, and Outcome of Acute Kidney Injury in Neurocritical Care

2018 ◽  
Vol 35 (4) ◽  
pp. 338-346 ◽  
Author(s):  
Stefan Büttner ◽  
Andrea Stadler ◽  
Christoph Mayer ◽  
Sammy Patyna ◽  
Christoph Betz ◽  
...  
Keyword(s):  
Risk Factors ◽  
Chronic Kidney Disease ◽  
Acute Kidney Injury ◽  
Risk Factor ◽  
Intensive Care ◽  
Kidney Disease ◽  
Neurocritical Care ◽  
Kidney Injury ◽  
Prognostic Impact ◽  
Incidence Risk

Purpose: Acute kidney injury (AKI) is a severe complication in medical and surgical intensive care units accounting for a high morbidity and mortality. Incidence, risk factors, and prognostic impact of this deleterious condition are well established in this setting. Data concerning the neurocritically ill patients is scarce. Therefore, aim of this study was to determine the incidence of AKI and elucidate risk factors in this special population. Methods: Patients admitted to a specialized neurocritical care unit between 2005 and 2011 with a length of stay above 48 hours were analyzed retrospectively for incidence, cause, and outcome of AKI (AKI Network-stage ≥2). Results: The study population comprised 681 neurocritically ill patients from a mixed neurosurgical and neurological intensive care unit. The prevalence of chronic kidney disease (CKD) was 8.4% (57/681). Overall incidence of AKI was 11.6% with 36 (45.6%) patients developing dialysis-requiring AKI. Sepsis was the main cause of AKI in nearly 50% of patients. Acute kidney injury and renal replacement therapy are independent predictors of worse outcome (hazard ratio [HR]: 3.704; 95% confidence interval [CI]: 1.867-7.350; P < .001; and HR: 2.848; CI: 1.301-6.325; P = .009). Chronic kidney disease was the strongest independent risk factor (odds ratio: 12.473; CI: 5.944-26.172; P < .001), whereas surgical intervention or contrast agents were not associated with AKI. Conclusions: Acute kidney injury in neurocritical care has a high incidence and is a crucial risk factor for mortality independently of the underlying neurocritical condition. Sepsis is the main cause of AKI in this setting. Therefore, careful prevention of infectious complications and considering CKD in treatment decisions may lower the incidence of AKI and hereby improve outcome in neurocritical care.

scholarly journals Risk Factors for Acute Kidney Injury in Acute Pancreatitis: A 7-year Retrospective Analysis of Patients in a Large Tertiary Hospital

2020 ◽  
Author(s):  
Bingjun Yu ◽  
Wenhua He ◽  
Nonghua Lu
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Acute Pancreatitis ◽  
Risk Factor ◽  
Organ Failure ◽  
Pancreatic Necrosis ◽  
Kidney Injury ◽  
Smoking History ◽  
Apache Ii Score ◽  
Lengths Of Stay

Abstract Background Acute kidney injury (AKI) is a serious complication of acute pancreatitis (AP) and causes a high risk of mortality. The aim of this study was to investigate the risk factors for AKI in patients in the early phase of AP.Methods In this retrospective observational study, 1655 AP patients were divided into an AKI and a non-AKI group. Age, sex, BMI, APACHE II score, smoking history, hypertriglyceridaemia (HTG), alcohol abuse, biliary disease, organ failure, pancreatic necrosis and necrosis debridement were collected from the hospital record database.Results 1036 males (62.6%) and 619 females (37.4%) were enrolled in this study. 1255 and 430 AP patients were included in the non-AKI and AKI groups, respectively. The mean age was 45.90±11.73 years. Hospital and intensive care unit (ICU) lengths of stay were 18.13±43.26 and 31.53±72.47 days, respectively. The incidence of organ failure and pancreatic necrosis were 25.0% and 32.2%, respectively. The morbidity of percutaneous catheter drainage (PCD) and operative necrosectomy (ON) was 10.9%, and the mortality among AP patients was 6.3%. HTG was identified as a risk factor for AKI in AP (P=0.001). The incidence of organ failure (P=0.001), pancreatic necrosis (P=0.001) and necrosis debridement were greater in the AKI group than those in the non-AKI group.Conclusions HTG is an independent risk factor for AKI in AP. AP patients with AKI have adverse outcomes such as high rates of organ failure, pancreatic necrosis, and necrosis debridement and longer hospital and ICU lengths of stay.

scholarly journals A Case of Acute Kidney Injury in a Patient with Renal Hypouricemia without Intense Exercise

2020 ◽  
Vol 10 (1) ◽  
pp. 26-34
Author(s):  
Daiki Aomura ◽  
Kosuke Sonoda ◽  
Makoto Harada ◽  
Koji Hashimoto ◽  
Yuji Kamijo
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Risk Factor ◽  
Conservative Treatment ◽  
Kidney Injury ◽  
Intense Exercise ◽  
Kidney Dysfunction ◽  
Renal Hypouricemia ◽  
Orthostatic Dysregulation ◽  
Exercise Induced

Exercise-induced acute kidney injury (EIAKI) frequently develops in patients with renal hypouricemia (RHUC). However, several cases of RHUC with acute kidney injury (AKI) but without intense exercise have been reported. We encountered a 15-year-old male with RHUC who experienced AKI. He reported no episodes of intense exercise and displayed no other representative risk factors of EIAKI, although a vasopressor had been administered for orthostatic dysregulation before AKI onset. His kidney dysfunction improved with discontinuation of the vasopressor and conservative treatment. Thus, AKI can develop in patients with RHUC in the absence of intense exercise, for which vasopressors may be a risk factor.

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