Incidence, risk factors and outcome of renal dysfunction after coronary surgery in patients with preoperative normal renal function

2007 ◽  
Vol 24 (Supplement 39) ◽  
pp. 39
Author(s):  
A. Flo ◽  
A. Escudero ◽  
M. Sariñena ◽  
E. Massó ◽  
E. Moret
Keyword(s):  
Risk Factors ◽  
Renal Function ◽  
Renal Dysfunction ◽  
Normal Renal Function ◽  
Coronary Surgery ◽  
Incidence Risk

scholarly journals Off-Pump Technique May Prevent Worsening of Renal Function in CAD with CKD Undergoing CABG

2021 ◽  
Vol 05 (01) ◽  
pp. 007-011
Author(s):  
Shaheen Afsal ◽  
K. Sujani ◽  
Shashank Viswanathan ◽  
Akshay Bhati ◽  
Harish BR ◽  
...  
Keyword(s):  
Renal Function ◽  
Cardiac Surgery ◽  
Serum Creatinine ◽  
Renal Dysfunction ◽  
Normal Renal Function ◽  
Artery Bypass ◽  
Significant Proportion ◽  
Renal Dialysis ◽  
Off Pump ◽  
Preoperative Serum

AbstractCardiovascular disease (CVD) is a major cause for a significant proportion of all deaths and disability worldwide. Postoperative renal dysfunction following cardiac surgery is not an uncommon complication of cardiac surgery, which has serious implications with regard to morbidity, mortality, financial expenditure, and resource utilization. This study was performed to compare outcomes of patients with preoperative renal dysfunction with those having normal renal function undergoing off-pump coronary artery bypass grafting (OPCABG). Patients were divided into two categories, depending on their preoperative serum creatinine and glomerular filtration rate (GFR). The preoperative renal dysfunction was defined as serum creatinine >1.3 mg/dL and/or estimated GFR (eGFR) of <60 mL/min/1.73 m2. The category A patients had normal renal function defined as serum creatinine ≤1.3 mg/dL and/or eGFR of ≥60 mL/min/1.73 m2 while the category B patients had preoperative renal dysfunction that did not necessitate renal dialysis. Blood samples were collected from both category patients for serum creatinine prior to surgery, following surgery, on postoperative days 1, 2, 3, 4, 5, and on the day of discharge. The occurrence of acute kidney injury (AKI) was defined as an increase in the serum creatinine levels of ≥0.3 mg/dL within 48 hours or an increase of ≥1.5 above baseline known or presumed to have occurred within the previous 7 days based on Kidney Disease Improving Global Outcomes criteria. This study demonstrated that there was worsening of renal function in 7.4% of patients with normal renal function and 10.74% of patients with renal dysfunction that was not statistically different. Based on the results, we conclude that preoperative renal dysfunction may be a contributing predictor of AKI following OPCABG, and we recommend that the patients with more severe renal dysfunction with eGFR of 45–60 mL/min should be studied to demonstrate this hypothesis.

scholarly journals Effects of mild and moderate renal dysfunction on pharmacokinetics, pharmacodynamics, and safety of dotinurad: a novel selective urate reabsorption inhibitor

2019 ◽  
Vol 24 (S1) ◽  
pp. 17-24 ◽  
Author(s):  
Hiroyuki Fukase ◽  
Daisuke Okui ◽  
Tomomitsu Sasaki ◽  
Masahiko Fushimi ◽  
Tetsuo Ohashi ◽  
...  
Keyword(s):  
Renal Function ◽  
Uric Acid ◽  
Renal Dysfunction ◽  
Serum Uric Acid ◽  
Normal Renal Function ◽  
Reduction Rate ◽  
Significant Difference ◽  
Function Group ◽  
Urate Reabsorption ◽  
Renal Function Group

Abstract Background Dotinurad, a novel selective urate reabsorption inhibitor, exerts a serum uric acid-lowering effect by selectively inhibiting urate transporter 1 (URAT1) in patients with hyperuricemia. It is generally known that the progression of renal dysfunction is associated with a reduction in the serum uric acid-lowering effects of uricosuric drugs. We, therefore, investigated the pharmacokinetics (PK), pharmacodynamics (PD), and safety of dotinurad in subjects with renal dysfunction. Methods This was a parallel-group, open-label, single-dose clinical pharmacology study. Dotinurad (1 mg) was administered once, orally to subjects with mild (estimated glomerular filtration rate [eGFR], ≥ 60 to < 90 mL/min/1.73 m2) or moderate (eGFR, ≥ 30 to < 60 mL/min/1.73 m2) renal dysfunction or normal (eGFR, ≥ 90 mL/min/1.73 m2) renal function. Results The time-course of mean plasma concentration of dotinurad had similar profiles across the groups. Regarding PK, there was no significant difference between the renal dysfunction groups and normal renal function group. Regarding PD, the maximum reduction rate in serum uric acid levels and the fractional uric acid excretion (FE) ratio (FE0–24/FE−24–0) were significantly lower in the moderate renal dysfunction group than in the normal renal function group. However, other PD parameters were not significantly different among the groups. No notable adverse events or adverse drug reactions were observed in this study. Conclusion These results suggested that no dose adjustment might be necessary when administering dotinurad to patients with mild-to-moderate renal dysfunction. ClinicalTrials.gov Identifier: NCT02347046.

Ramadan fasting in kidney transplant recipients with normal renal function and with mild-to-moderate renal dysfunction

2008 ◽  
Vol 41 (2) ◽  
pp. 417-422 ◽  
Author(s):  
Behzad Einollahi ◽  
Mahboob Lessan-Pezeshki ◽  
Vahid Pourfarziani ◽  
Behroz Aghdam ◽  
Jamshid Rouzbeh ◽  
...  
Keyword(s):  
Renal Function ◽  
Renal Dysfunction ◽  
Kidney Transplant ◽  
Normal Renal Function ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Ramadan Fasting

scholarly journals Sex Differences in the Renal Function Decline of Patients with Type 2 Diabetes

2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Ayami Kajiwara ◽  
Ayana Kita ◽  
Junji Saruwatari ◽  
Hiroko Miyazaki ◽  
Yuki Kawata ◽  
...  
Keyword(s):  
Risk Factors ◽  
Renal Function ◽  
Sex Differences ◽  
Renal Dysfunction ◽  
Ldl Cholesterol ◽  
Early Stage ◽  
Interactive Effects ◽  
Renal Function Decline ◽  
Egfr Decline

Aims. We aimed to investigate the sex differences in the renal function decline among patients with type 2 diabetic mellitus (T2DM), focusing on the differences in the risk factors at early stage of renal dysfunction.Methods. A clinic-based retrospective longitudinal study (follow-up duration:8.1±1.4years) was conducted to assess the sex differences in the annual estimated glomerular filtration rate (eGFR) change in 344 (247 male and 97 female) Japanese T2DM patients. The sex differences in the risk factors of annual eGFR decline were subjected to linear regression analyses.Results. The mean annual eGFR change was-3.5±2.7%/year in females and-2.0±2.2%/year in males (P<0.001). Baseline retinopathy and proteinuria were significantly associated with a larger eGFR decline, irrespective of sex, while HbA1c and LDL-cholesterol levels were significantly associated with an eGFR decline in females only. Interactive effects were observed between sex and the HbA1c, LDL-cholesterol, retinopathy, or proteinuria levels on the annual eGFR decline.Conclusions. The increased susceptibility to poor metabolic control seemed to contribute to a higher risk of renal dysfunction in females with T2DM. Our study highlights the importance of aggressive therapeutic intervention to improve metabolic profiles at early stage, especially in females.

Renal Dysfunction After Cardiac Surgery with Normothermic Cardiopulmonary Bypass: Incidence, Risk Factors, and Effect on Clinical Outcome

2003 ◽  
pp. 1258-1264 ◽  
Author(s):  
Sophie Provench??re ◽  
Gaetan Plantef??ve ◽  
Gilles Hufnagel ◽  
Eric Vicaut ◽  
Cyrille de Vaumas ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiac Surgery ◽  
Cardiopulmonary Bypass ◽  
Clinical Outcome ◽  
Renal Dysfunction ◽  
Incidence Risk

scholarly journals Drug-induced renal disorder-A Mini Review

2020 ◽  
Vol 11 (1) ◽  
pp. 166-172 ◽  
Author(s):  
Divya M ◽  
Nivetha S. R. ◽  
Lekshmi Mohan ◽  
Arul B* ◽  
Kothai R
Keyword(s):  
Risk Factors ◽  
Renal Function ◽  
Renal Dysfunction ◽  
Renal Scarring ◽  
Kidney Injury ◽  
Drug Induced ◽  
Related Factors ◽  
Renal Disorder ◽  
Renal Obstruction ◽  
Renal Tubular Cells

Drug-induced kidney disorder/disease (DKID) is an origin of kidney disease followed by acute renal failure. Drug-induced renal toxicity is more common in infants and young children in certain clinical circumstances where underlying renal dysfunction and cardiovascular diseases. Sometimes, administered drugs may cause acute renal injury, intra-renal obstruction, interstitial nephritis, nephrotic syndrome, and acid-base and fluid electrolytes disorders in patients. Certain drugs may cause alterations in intra-glomerular hemodynamics, inflammatory changes in renal tubular cells, leading to acute kidney injury (AKI), interstitial tubule disease, and renal scarring. Common risk factors include; pre-existing renal dysfunction, volume-depleted state, old age, and use of nephrotoxic drugs. Therefore, the prevention from the disease includes the knowledge about the nephrotoxicity, assessing considering the patient-related, kidney-related, and drug-related factors while prescribing medicines, using of alternative drugs, which are non-nephrotoxic, assessing the baseline of renal function before starting the treatment, monitor the renal function during the treatment and avoid the nephrotoxic drug combinations and withdrawing the offending drugs due to toxicity. The ADRs of the prescribed/ administered are identified at the earliest to prevent the development of the last-stage renal disorder. This review discusses the risk factors associated with drug-induced renal disease, estimation of renal function, mechanism of drug-induced nephrotoxicity, and certain drugs that cause nephrotoxicity.

P1579Impact of Renal Dysfunction on Real-world Outcome of the ESC 0/1-hour Algorithm

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
R Twerenbold ◽  
J P Costabel ◽  
R Campos ◽  
M Cortes ◽  
T Nestelberger ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Renal Function ◽  
Renal Dysfunction ◽  
Real World ◽  
Normal Renal Function ◽  
Clinical Care ◽  
Outpatient Management ◽  
Cardiac Events ◽  
Real World Data ◽  
Rule Out

Abstract Background The ESC recommends the use of a 0/1h-algorithm for rapid triage of patients with suspected non-ST-elevation myocardial infarction (NSTEMI) using high-sensitivity cardiac troponin (hs-cTn) concentrations irrespective of renal function. Patients with renal dysfunction (RD, defined as a GFR <60ml/min) are at higher risk of NSTEMI and are presenting more often with elevated levels of hs-cTn even in absence of NSTEMI, which may contribute to an impaired efficacy and safety of the ESC 0/1h-algorithm. Purpose We aimed to assess and directly compare the real-world adherence, effectiveness, efficacy, and ultimately safety of the ESC 0/1h-algorithm when applied in patients with RD and normal renal function. Methods In a prospective international multicenter study enrolling unselected patients presenting with suspected NSTEMI to the ED, patients were assessed according to the ESC 0/1h-algorithm embedded in routine clinical care. Safety was quantified by the 30-day incidence of major adverse cardiac events (MACE, defined as the composite of cardiovascular death and myocardial infarction including the index event) in the rule-out group and in outpatients. Results Among 2296 enrolled patients, RD was present in 129 (6%) patients. NSTEMI prevalence was substantially higher in RD as compared with normal renal function (19% versus 9%, p<0.001). Adherence to the ESC 0/1h-algorithm protocol was excellent with no violations observed in patients with RD as compared with 132 (6%) violations in patients with normal renal function (p=0.004). Effectiveness was very high in RD and comparable to normal renal function: 94% of patients triaged towards rule-out by the ESC 0/1h-algorithm did not require additional cardiac investigations including hs-cTnT measurements at later time points (e.g. 3–12h) or coronary CT-angiography in the ED as compared with 98% in normal renal function. Median time to discharge or transfer from the ED was significantly longer in RD (285 minutes [q1174, q3392]) as compared with normal renal function (150 minutes [q1132, q3222]). Efficacy of the ESC 0/1h-algorithm was lower in RD as it triaged 13% of patients towards rule-out and 34% towards rule-in of NSTEMI as compared with 65% and 12% in normal renal function, respectively (p<0.001). Overall, 30% of patients with RD underwent outpatient management as compared with 73% in normal renal function (p<0.001). Safety of rule-out and outpatient management were excellent in RD with a 30-day MACE incidence of both 0% and comparable with 0.2% and 0.1% in normal renal function, respectively (p=0.010). Conclusions These real-world data document for the first time the excellent adherence, effectiveness, and safety of the ESC 0/1h-algorithm when routinely applied in patients with RD. Compared with patients with normal renal function, fewer patients with RD could be triaged towards rule-out or were treated as outpatients, most likely due to the higher prevalence of NSTEMI and comorbidities in RD.

scholarly journals Rhabdomyolysis: a rare adverse effect of levetiracetam

2019 ◽  
Vol 12 (8) ◽  
pp. e230851 ◽  
Author(s):  
Liza Thomas ◽  
Madiha Muhammed Farooq Mirza ◽  
Niaz Ahmed Shaikh ◽  
Nahla Ahmed
Keyword(s):  
Risk Factors ◽  
Adverse Effect ◽  
Creatine Kinase ◽  
Renal Function ◽  
Normal Renal Function ◽  
Downward Trend ◽  
Healthy Male ◽  
Clonic Seizures ◽  
New Onset

A 62-year-old previously healthy male was admitted with new onset generalised tonic-clonic seizures. Treatment was initiated with the antiepileptic levetiracetam and he had no further episodes of seizures. Creatine kinase (CPK) level was 1812 IU/L 12-hour postadmission. Despite good hydration, his CPK levels continued to rise dramatically and reached a level of 19 000 IU/L on day 5. This rise was unexplained as he did not have any further seizures and had a normal renal function. In the absence of other risk factors, the rare possibility of levetiracetam being responsible for the disproportionately high CPK was considered. Within 12 hours of withdrawal of levetiracetam, there was a downward trend in the CPK levels, with a 10-fold decrease in CPK levels over the next 4 days. This is only the ninth case reported in literature regarding this rare and potentially serious adverse effect of levetiracetam.

An Analysis of Occurrence and Prognosis Related Factors of Renal Dysfunction in Patients with Multiple Myeloma.

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 4732-4732
Author(s):  
Rong Fu ◽  
Ting Wang ◽  
Zonghong Shao
Keyword(s):  
Risk Factors ◽  
Multiple Myeloma ◽  
Renal Function ◽  
Renal Dysfunction ◽  
Tumor Burden ◽  
Protection Factor ◽  
Related Factors ◽  
Factors Associated ◽  
Renal Function Recovery ◽  
Function Recovery

Abstract Objective To analysis the occurrence and prognosis related factors in renal dysfunction with multiple myeloma(MM). Methods Seventy-four cases with MM were enrolled in this study. The risk factors of occurrence and prognosis were analyzed. Results The incidence of renal dysfunction (RD) with MM was 56.8%, Age, hypertention, hemoglobin, serum ALB and GLO levels, serum β2MG, serum calcium and phosphonium level, the percentage of myeloma cells in bone marrow, types of MM, Durie-Salmon stage were the single factors associated with the incidence of RD with MM. Hypertention, serum β2MG and ALB levels were the multiple factors associated with the incidence of RD with MM. ALB was the protection factor and the other two were risk factors. The renal function recovered rapidly in the patients who received CR or received blood transfusion. The patients with renal dysfunction survived shorter (28±5months) than those with normal renal function (42±6months). Renal dysfunction caused more MM patients death(84.6%) in 3 months. Conclusion Hypertention and high tumor burden were the risk factors of renal dysfunction in MM, effective chemothemapy and support treatment help renal function recovery.

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