scholarly journals A validation study of UCSD-Mayo risk score in predicting hospital-acquired acute kidney injury in COVID-19 patients

Renal Failure ◽  
2021 ◽  
Vol 43 (1) ◽  
pp. 1115-1123
Author(s):  
Zhengying Fang ◽  
Chenni Gao ◽  
Yikai Cai ◽  
Lin Lu ◽  
Haijin Yu ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Risk Score ◽  
Validation Study ◽  
Kidney Injury ◽  
Hospital Acquired

scholarly journals Development and internal validation of a prediction model for hospital-acquired acute kidney injury

2019 ◽  
Author(s):  
Catalina Martin-Cleary ◽  
Luis Miguel Molinero-Casares ◽  
Alberto Ortiz ◽  
Jose Miguel Arce-Obieta
Keyword(s):  
Acute Kidney Injury ◽  
Risk Score ◽  
Bayesian Model Averaging ◽  
Characteristic Curve ◽  
Tertiary Care ◽  
Kidney Injury ◽  
Risk Scores ◽  
Internal Validation ◽  
Clinical Records ◽  
Hospital Acquired

Abstract Background Predictive models and clinical risk scores for hospital-acquired acute kidney injury (AKI) are mainly focused on critical and surgical patients. We have used the electronic clinical records from a tertiary care general hospital to develop a risk score for new-onset AKI in general inpatients that can be estimated automatically from clinical records. Methods A total of 47 466 patients met inclusion criteria within a 2-year period. Of these, 2385 (5.0%) developed hospital-acquired AKI. Step-wise regression modelling and Bayesian model averaging were used to develop the Madrid Acute Kidney Injury Prediction Score (MAKIPS), which contains 23 variables, all obtainable automatically from electronic clinical records at admission. Bootstrap resampling was employed for internal validation. To optimize calibration, a penalized logistic regression model was estimated by the least absolute shrinkage and selection operator (lasso) method of coefficient shrinkage after estimation. Results The area under the curve of the receiver operating characteristic curve of the MAKIPS score to predict hospital-acquired AKI at admission was 0.811. Among individual variables, the highest odds ratios, all >2.5, for hospital-acquired AKI were conferred by abdominal, cardiovascular or urological surgery followed by congestive heart failure. An online tool (http://www.bioestadistica.net/MAKIPS.aspx) will facilitate validation in other hospital environments. Conclusions MAKIPS is a new risk score to predict the risk of hospital-acquired AKI, based on variables present at admission in the electronic clinical records. This may help to identify patients who require specific monitoring because of a high risk of AKI.

scholarly journals Derivation and validation of plasma endostatin for predicting renal recovery from acute kidney injury: a prospective validation study

Critical Care ◽  
2018 ◽  
Vol 22 (1) ◽  
Author(s):  
Hui-Miao Jia ◽  
Yue Zheng ◽  
Li-Feng Huang ◽  
Xin Xin ◽  
Wen-Liang Ma ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Validation Study ◽  
Kidney Injury ◽  
Renal Recovery

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

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.

scholarly journals Admission plasma uromodulin and the risk of acute kidney injury in hospitalized patients with cirrhosis: a pilot study

2019 ◽  
Vol 317 (4) ◽  
pp. G447-G452
Author(s):  
Kavish R. Patidar ◽  
Pranav S. Garimella ◽  
Etienne Macedo ◽  
James E. Slaven ◽  
Marwan S. Ghabril ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Kidney Injury ◽  
Predictive Biomarker ◽  
Hospitalized Patients ◽  
Susceptible Population ◽  
Baseline Creatinine ◽  
Low Levels ◽  
Time Of Admission ◽  
Hospital Acquired

Acute kidney injury (AKI) is a common complication in hospitalized patients with cirrhosis. Uromodulin, a protein uniquely produced by the kidney and released both in the urine and circulation, has been shown to regulate AKI and is linked to tubular reserve. Although low levels of urine uromodulin are associated with AKI after cardiac surgery, it is unclear whether circulating uromodulin can stratify the risk of AKI, particularly in a susceptible population such as hospitalized patients with cirrhosis. Thus, we investigated whether plasma uromodulin measured at the time of admission is associated with subsequent hospital-acquired AKI (defined by a rise in serum creatinine >0.3mg/dL within 48 h or ≥ 1.5 times baseline) in patients with cirrhosis. A total of 98 patients [mean age 54 yr, Model for Endstage Liver Disease Sodium (MELD-Na) score 19, and baseline creatinine of 0.95 mg/dL] were included, of which 13% ( n = 13) developed AKI. Median uromodulin levels were significantly lower in patients who developed AKI compared with patients who did not (9.30 vs. 13.35 ng/mL, P = 0.02). After adjusting for age, sex, diabetes, hypertension, albumin, and MELD-Na score as covariates on multivariable logistic regression, uromodulin was independently associated with AKI [odd ratios of 1.19 (95% confidence interval 1.02, 1.37; P = 0.02)]. Lower uromodulin levels on admission are associated with increased odds of subsequent AKI in hospitalized patients with cirrhosis. Further studies are needed to better understand the role of uromodulin in the pathogenesis and as a predictive biomarker of AKI in this population. NEW & NOTEWORTHY In this study, we found that admission plasma uromodulin levels are significantly lower in patients who developed subsequent acute kidney injury (AKI) during their hospital stay compared with patients who did not. Additionally, uromodulin is independently associated with AKI development after adjusting for clinically relevant parameters such as age, sex, diabetes, hypertension, severity of cirrhosis, and kidney function. To our knowledge, this is the first study linking plasma uromodulin with AKI development in patients with cirrhosis.

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