Acute Kidney Injury, Renal Function, and the Elderly Obese Surgical Patient

Acute tubulointerstitial nephritis (ATIN) is an important cause of acute kidney injury which has a diverse aetiology but is most frequently caused by either an infection or drug reaction. Clinical features are usually non-specific or absent, although early accounts emphasized fever, rash, and eosinophilia. ATIN should be considered in all cases of acute kidney injury, especially when there is no obvious precipitant. If deemed clinically safe an early renal biopsy is recommended for diagnosis. Renal outcome will usually be good but in a significant minority, particularly the elderly, the outcome may be poor. There is evidence from a number of series that early treatment with corticosteroids leads to a more rapid and complete recovery of renal function.

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Acute kidney injury after contrast-enhanced examination among elderly

Revista Latino-Americana de Enfermagem ◽

10.1590/0104-1169.3440.2462 ◽

2014 ◽

Vol 22 (4) ◽

pp. 637-644 ◽

Cited By ~ 4

Author(s):

Beatriz Bonadio Aoki ◽

Dayana Fram ◽

Mônica Taminato ◽

Ruth Ester Sayad Batista ◽

Angélica Belasco ◽

...

Keyword(s):

Acute Kidney Injury ◽

Renal Function ◽

Kidney Injury ◽

The Elderly ◽

Post Contrast ◽

Hospitalized Elderly ◽

Contrast Enhanced ◽

Before And After ◽

N 93 ◽

Enhanced Computed Tomography

OBJECTIVES: to assess renal function in elderly patients undergoing contrast-enhanced computed tomography and identify the preventive measures of acute kidney injury in the period before and after the examination.METHOD: longitudinal cohort study conducted at the Federal University of São Paulo Hospital, from March 2011 to March 2013. All hospitalized elderly, of both sexes, aged 60 years and above, who performed the examination, were included (n=93). We collected sociodemographic data, data related to the examination and to the care provided, and creatinine values prior and post exam.RESULTS: an alteration in renal function was observed in 51 patients (54%) with a statistically significant increase of creatinine values (p<0.04), and two patients (4.0%) required hemodialysis.CONCLUSION: There is an urgent need for protocols prior to and post contrast-enhanced examination in the elderly, and other studies to verify the prognosis of this population.

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Effect of Probiotics and Prebiotics in Renal Function in Septic Acute Kidney Injury Patients

Case Medical Research ◽

10.31525/ct1-nct03877081 ◽

2019 ◽

Author(s):

Keyword(s):

Acute Kidney Injury ◽

Renal Function ◽

Kidney Injury ◽

Septic Acute Kidney Injury

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ACUTE KIDNEY INJURY IN ELDERLY PATIENTS

Wiadomości Lekarskie ◽

10.36740/wlek201908109 ◽

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.

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Lupus cystitis: unusual cause of renal failure in systemic lupus erythematosus

BMJ Case Reports ◽

10.1136/bcr-2019-233446 ◽

2019 ◽

Vol 12 (12) ◽

pp. e233446

Author(s):

Kevin John ◽

Krupa Varughese ◽

Ranil Johann Boaz ◽

Tarun George

Keyword(s):

Systemic Lupus Erythematosus ◽

Acute Kidney Injury ◽

Renal Failure ◽

Renal Function ◽

Lupus Erythematosus ◽

Kidney Injury ◽

Systemic Lupus ◽

Uncommon Presentation ◽

Acute Dyspnoea ◽

Chronic Fever

A 42-year-old woman presented with chronic fever, abdominal pain, intermittent loose stools and dysuria for 3 months. She had recently developed acute dyspnoea with acute kidney injury. She was found to have a contracted, thick-walled bladder with bilateral hydroureteronephrosis. She underwent bilateral percutaneous nephrostomies, following which her renal function recovered. She satisfied the clinical and immunological features of the Systemic Lupus International Collaborating Clinics criteria for systemic lupus erythematosus (SLE). She was initiated on immunosuppression. Lupus cystitis with a contracted bladder is an uncommon presentation of SLE.

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Long-term continuous use of proton-pump inhibitors is associated with renal function decline in patients without acute kidney injury

Clinical and Experimental Nephrology ◽

10.1007/s10157-021-02066-z ◽

2021 ◽

Author(s):

Yutaka Hatakeyama ◽

Taro Horino ◽

Tatsuki Matsumoto ◽

Yoshio Terada ◽

Yoshiyasu Okuhara

Keyword(s):

Acute Kidney Injury ◽

Renal Function ◽

Proton Pump Inhibitors ◽

Proton Pump ◽

Kidney Injury ◽

Renal Function Decline ◽

Continuous Use

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Contrast Associated Acute Kidney Injury and Mortality in Older Adults with Acute Coronary Syndrome: A Pooled Analysis of the FRASER and HULK Studies

Journal of Clinical Medicine ◽

10.3390/jcm10102151 ◽

2021 ◽

Vol 10 (10) ◽

pp. 2151

Author(s):

Rita Pavasini ◽

Matteo Tebaldi ◽

Giulia Bugani ◽

Elisabetta Tonet ◽

Roberta Campana ◽

...

Keyword(s):

Acute Kidney Injury ◽

Renal Function ◽

Multivariable Analysis ◽

Kidney Injury ◽

Coronary Intervention ◽

Pooled Analysis ◽

Coronary Syndrome ◽

Risk Of Mortality ◽

Increased Risk ◽

Short Term Mortality

Whether contrast-associated acute kidney injury (CA-AKI) is only a bystander or a risk factor for mortality in older patients undergoing percutaneous coronary intervention (PCI) is not well understood. Data from FRASER (NCT02386124) and HULK (NCT03021044) studies have been analysed. All patients enrolled underwent coronary angiography. The occurrence of CA-AKI was defined based on KDIGO criteria. The primary outcome of the study was to test the relation between CA-AKI and 3-month mortality. Overall, 870 older ACS adults were included in the analysis (mean age 78 ± 5 years; 28% females). CA-AKI occurred in 136 (16%) patients. At 3 months, 13 (9.6%) patients with CA-AKI died as compared with 13 (1.8%) without it (p < 0.001). At multivariable analysis, CA-AKI emerged as independent predictor of 3-month mortality (HR 3.51, 95%CI 1.05–7.01). After 3 months, renal function returned to the baseline value in 78 (63%) with CA-AKI. Those without recovered renal function (n = 45, 37%) showed an increased risk of mortality as compared to recovered renal function and no CA-AKI subgroups (HR 2.01, 95%CI 1.55–2.59, p = 0.009 and HR 2.71, 95%CI 1.45–5.89, p < 0.001, respectively). In conclusion, CA-AKI occurs in a not negligible portion of older MI patients undergoing invasive strategy and it is associated with short-term mortality.

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Assessment of Kidney Function After Transcatheter Aortic Valve Replacement

Canadian Journal of Kidney Health and Disease ◽

10.1177/20543581211018029 ◽

2021 ◽

Vol 8 ◽

pp. 205435812110180

Author(s):

Orit Kliuk-Ben Bassat ◽

Sapir Sadon ◽

Svetlana Sirota ◽

Arie Steinvil ◽

Maayan Konigstein ◽

...

Keyword(s):

Acute Kidney Injury ◽

Renal Function ◽

Kidney Function ◽

Transcatheter Aortic Valve Replacement ◽

Kidney Injury ◽

Single Center ◽

Transcatheter Aortic Valve ◽

Single Center Study ◽

Center Study

Background: Transcatheter aortic valve replacement (TAVR), although associated with an increased risk for acute kidney injury (AKI), may also result in improvement in renal function. Objective: The aim of this study is to evaluate the magnitude of kidney function improvement (KFI) after TAVR and to assess its significance on long-term mortality. Design: This is a prospective single center study. Setting: The study was conducted in cardiology department, interventional unit, in a tertiary hospital. Patients: The cohort included 1321 patients who underwent TAVR. Measurements: Serum creatinine level was measured at baseline, before the procedure, and over the next 7 days or until discharge. Methods: Kidney function improvement was defined as the mirror image of AKI, a reduction in pre-procedural to post-procedural minimal creatinine of more than 0.3 mg/dL, or a ratio of post-procedural minimal creatinine to pre-procedural creatinine of less than 0.66, up to 7 days after the procedure. Patients were categorized and compared for clinical endpoints according to post-procedural renal function change into 3 groups: KFI, AKI, or preserved kidney function (PKF). The primary endpoint was long-term all-cause mortality. Results: The incidence of KFI was 5%. In 55 out of 66 patients patients, the improvement in kidney function was minor and of unclear clinical significance. Acute kidney injury occurred in 19.1%. Estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2 was a predictor of KFI after multivariable analysis (odds ratio = 0.93 to develop KFI; confidence interval [95% CI]: 0.91-0.95, P < .001). Patients in the KFI group had a higher Society of Thoracic Surgery (STS) score than other groups. Mortality rate did not differ between KFI group and PKF group (43.9% in KFI group and 33.8% in PKF group) but was significantly higher in the AKI group (60.7%, P < .001). Limitations: The following are the limitations: heterozygous definitions of KFI within different studies and a single center study. Although data were collected prospectively, analysis plan was defined after data collection. Conclusions: Improvement in kidney function following TAVR was not a common phenomenon in our cohort and did not reduce overall mortality rate.

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