Predictive risk factors of acute kidney injury after cytoreductive surgery and cisplatin-based hyperthermic intra-peritoneal chemotherapy for ovarian peritoneal carcinomatosis

ObjectiveThe aim of our study was to assess the incidence and identify the predictive risk factors of acute kidney injury after cytoreductive surgery and cisplatin-based hyperthermic intra-peritoneal chemotherapy.MethodsThis is a retrospective study from two centers evaluating patients with advanced or recurrent ovarian cancer who underwent cytoreductive surgery followed by cisplatin-based hyperthermic intra-peritoneal chemotherapy from January 2007 to December 2013. Patients were classified into two groups according to the occurrence of acute kidney injury, defined as a glomerular filtration rate at post-operative day 7 25% lower than at day 0. We also evaluated acute kidney injury following Risk, Injury, Failure, Lost and End-stage kidney function criteria. Univariate and multivariate analyses were conducted in order to assess the association between different variables and the occurrence of acute kidney injury.ResultsSixty-six patients were included: 29 (44%) underwent first-line treatment and 37 (56%) were treated for recurrent disease. The incidence of post-operative acute kidney injury was 48%. After multivariate analysis, hypertension (OR 18.6; 95% CI 1.9 to 182.3; p=0.012) and low intra-operative diuresis (OR 0.5; 95% CI 0.4 to 0.8; p=0.001) were associated with acute kidney injury.ConclusionThe incidence of acute kidney injury after cytoreductive surgery and cisplatin-based hyperthermic intra-peritoneal chemotherapy was high. Hypertension and low intra-operative diuresis were independent risk factors for this complication. Adequate peri-operative hydration, in order to maintain correct diuresis, could decrease the occurrence of acute kidney injury in patients undergoing cytoreductive surgery plus hyperthermic intra-peritoneal chemotherapy.

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EP781 Predictive risk factors of acute kidney injury after cytoreductive surgery and cisplatin-based hyperthermic intraperitoneal chemotherapy for ovarian peritoneal carcinomatosis

10.1136/ijgc-2019-esgo.832 ◽

2019 ◽

Author(s):

MA Angeles ◽

F Quenet ◽

P Vieille ◽

L Gladieff ◽

J Ruiz ◽

...

Keyword(s):

Risk Factors ◽

Acute Kidney Injury ◽

Peritoneal Carcinomatosis ◽

Intraperitoneal Chemotherapy ◽

Cytoreductive Surgery ◽

Hyperthermic Intraperitoneal Chemotherapy ◽

Kidney Injury ◽

Predictive Risk

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Factors Determining Nephrotoxicity and Mortality in Critical Care Patients Receiving Colistin

The Journal of Infection in Developing Countries ◽

10.3855/jidc.9443 ◽

2018 ◽

Vol 11 (12) ◽

pp. 912-917 ◽

Cited By ~ 1

Author(s):

Ali Ciftci ◽

Seval Izdes ◽

Neriman Defne Altintas

Keyword(s):

Risk Factors ◽

Acute Kidney Injury ◽

Demographic Data ◽

Kidney Injury ◽

Apache Ii ◽

Factors Affecting ◽

Acute Kidney Injury Group ◽

Injury Group ◽

Independent Risk Factors ◽

Critical Patients

Introduction: We aimed to determine risk factors for nephrotoxicity and factors affecting mortality in patients who received colistin. Methodology: Critical patients who received colistin were enrolled. Pregnancy, age < 18 years, basal creatinine level > 2 mg/dL, colistin use for < 48 hours, and previous renal replacement therapy were exclusion criteria. KDIGO stages were determined according to creatinine levels. Patients were grouped as those with no acute kidney injury (Group N0) and those with acute kidney injury (Group N). Their demographic data, APACHE II and SOFA scores, treatments, and laboratory results were recorded. Results: A total of 91 patients were included: 27 in Group N0 and 64 in Group N. Demographic data were similar between groups; however, higher admission APACHE-II scores (OR:1.179, 95% CI:1.033-1.346, p = 0.015) and need for vasopressors (OR:5.486, 95% CI:1.522–19.769, p = 0.009) were found to be independent risk factors for nephrotoxicity. Higher APACHE II scores (OR:1.253, %95 CI:1.093-1.437, p = 0.001), presence of coronary artery disease (OR:7.720, % 95 CI: 1.613-36.956, p = 0.011), need for vasopressors (OR: 4.587, % 95 CI: 1.224 – 17.241, p = 0.024), hypoalbuminemia (OR: 4.721, % 95 CI: 1.088 – 20.469, p = 0.038), and higher direct bilirubin levels (OR: 1.806, % 95 CI: 1.055 – 3.092, p = 0.031) were independent risk factors for mortality. Conclusion: When use of colistin is considered in ICU patients, presence of modifiable risk factors for nephrotoxicity such as hypoalbuminemia, nephrotoxic drug administration, and presence of shock should be determined and managed to prevent nephrotoxicity.

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

10.21203/rs.3.rs-199319/v1 ◽

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.

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Clinical course and outcome of 107 patients infected with the novel coronavirus, SARS-CoV-2, discharged from two hospitals in Wuhan, China.

10.21203/rs.3.rs-16485/v2 ◽

2020 ◽

Author(s):

Dawei Wang ◽

Yimei Yin ◽

Chang Hu ◽

Xing Liu ◽

Xingguo Zhang ◽

...

Keyword(s):

Risk Factors ◽

Acute Kidney Injury ◽

Clinical Course ◽

Case Series ◽

Kidney Injury ◽

Retrospective Case ◽

Illness Onset ◽

Independent Risk Factors ◽

Systemic Symptoms ◽

Novel Coronavirus

Abstract Background In December 2019, Coronavirus Disease 2019 (COVID-19) outbreak was reported from Wuhan, China. Information on the clinical course and prognosis of COVID-19 was not thoroughly described. We described the clinical courses and prognosis in COVID-19 patients. Methods Retrospective case series of COVID-19 patients from Zhongnan Hospital of Wuhan University in Wuhan, and Xi-shui Hospital, Hubei Province, China, up to February 10, 2020. Epidemiological, demographic and clinical data were collected. Clinical course of survivors and non-survivors were compared. Risk factors for death were analyzed. Results A total of 107 discharged patients with COVID-19 were enrolled. The clinical course of COVID-19 presented as a tri-phasic pattern. Week 1 after illness onset was characterized by fever, cough, dyspnea, lymphopenia and radiological multilobar pulmonary infiltrates. In severe cases, thrombocytopenia, acute kidney injury, acute myocardial injury or adult respiratory distress syndrome were observed. During week 2, in mild cases, fever, cough and systemic symptoms began to resolve and platelet count rose to normal range, but lymphopenia persisted. In severe cases, leukocytosis, neutrophilia and deteriorating multi-organ dysfunction were dominant. By week 3, mild cases had clinically resolved except for lymphopenia. However, severe cases showed persistent lymphopenia, severe acute respiratory dyspnea syndrome , refractory shock, anuric acute kidney injury, coagulopathy, thrombocytopenia and death. Older age and male sex were independent risk factors for poor outcome of the illness. Conclusions A period of 7–13 days after illness onset is the critical stage in COVID-19 course. Age and male gender were independent risk factors for death of COVID-19.

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Chronic severe hepatitis and preoperative creatinine are independent risk factors for acute kidney injury after liver transplantation

Annals of Translational Medicine ◽

10.21037/atm-20-7680 ◽

2020 ◽

Vol 8 (24) ◽

pp. 1663-1663

Author(s):

Yingqi Chen ◽

Shanshan Mu ◽

Jing Wang ◽

Anshi Wu

Keyword(s):

Risk Factors ◽

Liver Transplantation ◽

Acute Kidney Injury ◽

Kidney Injury ◽

Severe Hepatitis ◽

Independent Risk Factors ◽

Preoperative Creatinine

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Acute kidney injury at early stage as a negative prognostic indicator of patients with COVID-19: a hospital-based retrospective analysis

10.1101/2020.03.24.20042408 ◽

2020 ◽

Cited By ~ 21

Author(s):

Shen Xu ◽

Lin Fu ◽

Jun Fei ◽

Hui-Xian Xiang ◽

Ying Xiang ◽

...

Keyword(s):

Risk Factors ◽

Acute Kidney Injury ◽

Early Stage ◽

Kidney Injury ◽

Oxygenation Index ◽

Prognostic Indicator ◽

Critical Ill Patients ◽

Patients With Diabetes ◽

Independent Risk Factors ◽

Critical Ill

AbstractCoronavirus disease 2019 (COVID-19) is a newly emerged infection of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and has been pandemic all over the world. This study described acute kidney injury (AKI) at early stage of COVID-19 and its clinical significance. Three-hundred and fifty-five COVID-19 patients with were recruited and clinical data were collected from electronic medical records. Patient’s prognosis was tracked and risk factors of AKI was analyzed. Of 355 COVID-19 patients, common, severe and critical ill cases accounted for 63.1%, 16.9% and 20.0%, respectively. On admission, 56 (15.8%) patients were with AKI. Although AKI was more common in critical ill patients with COVID-19, there was no significant association between oxygenation index and renal functional indices among COVID-19 patients with AKI. By multivariate logistic regression, male, older age and comorbidity with diabetes were three important independent risk factors predicting AKI among COVID-19 patients. Among 56 COVID-19 patients with AKI, 33.9% were died on mean 10.9 day after hospitalization. Fatality rate was obviously higher among COVID-+19 patients with AKI than those without AKI (RR=7.08, P<0.001). In conclusion, male elderly COVID-19 patients with diabetes are more susceptible to AKI. AKI at early stage may be a negative prognostic indicator for COVID-19.

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Cardiac Surgery–Associated Acute Kidney Injury

Cardiothoracic Critical Care ◽

10.1093/med/9780190082482.003.0037 ◽

2020 ◽

pp. 353-366

Author(s):

Coilin Smyth ◽

Sinead Galvin

Keyword(s):

Risk Factors ◽

Acute Kidney Injury ◽

Cardiac Surgery ◽

End Stage Renal Disease ◽

Artery Bypass ◽

Kidney Injury ◽

Timing Of Surgery ◽

Stage Renal Disease ◽

End Stage ◽

Separate Cohort

This chapter on the topic of cardiac surgery–associated acute kidney injury (CS-AKI) examines the risk factors for and the prevention, diagnosis, and management of this serious and common consequence of cardiothoracic surgery. The chapter follows the clinical course of a patient with a moderate risk of CS-AKI undergoing an aortic valve replacement and coronary artery bypass grafting. The risk factors, both patient- and surgery-specific, are demonstrated in tabular form. Methods to mitigate against these risk factors are explained, including optimizing the timing of surgery. The most up-to-date diagnostic criteria for AKI are compared. It also recommends the most accurate formulae to evaluate the severity of CS-AKI. The value of medical therapies prior to renal replacement therapy (RRT) is examined. The clinical decisions regarding the mode of RRT, timing of RRT, anticoagulation methods, and vascular access are highlighted. Patients with already established end-stage renal disease are discussed as a separate cohort. The chapter concludes by discussing the short- and longer-term prognosis associated with CS-AKI.

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P0568INCIDENCE AND RISK FACTORS OF ACUTE KIDNEY INJURY AND TUMOR LYSIS SYNDROME IN PATIENTS WITH MULTIPLE MYELOMA TREATED WITH BORTEZOMIB

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfaa142.p0568 ◽

2020 ◽

Vol 35 (Supplement_3) ◽

Author(s):

SEUNGMIN SONG ◽

Hyo jin Boo ◽

Hye Ryoun Jang ◽

Wooseong Huh ◽

Dae Joong Kim ◽

...

Keyword(s):

Risk Factors ◽

Multiple Myeloma ◽

Acute Kidney Injury ◽

High Risk ◽

Multivariate Analyses ◽

Tumor Lysis Syndrome ◽

Kidney Injury ◽

Renal Amyloidosis ◽

Tumor Lysis ◽

Β2 Microglobulin

Abstract Background and Aims Nephrotoxicity of bortezomib, a proteasome inhibitor, has not yet been described frequently, while tumor lysis syndrome (TLS) associated with multiple myeloma (MM) has been increased after introduction of the drug. This study compared the incidence and risk factors of acute kidney injury (AKI) and TLS in patients with MM after bortezomib-based chemotherapy to investigate the drug-related nephrotoxicity. Method From 2006 to 2017, 276 patients who underwent first cycle of bortezomib-based chemotherapy for MM were identified in single tertiary hospital. Laboratory TLS was defined according to the Cairo-Bishop definition. Development of AKI was assessed by AKI Network (AKIN) criteria within 7 days after first chemotherapy. Results The age was 65 [56-72] years old, and 47% (n=131) of participants were female and baseline estimated glomerular filtration rate (eGFR) was 61.3 [34.1-89.1] mL/min/1.73m2. The incidences of AKI and laboratory TLS were 17% (n=47) and 13% (n=36), respectively. Ten (3.6%) subjects corresponded to the both AKI and TLS criteria. Multivariate analyses showed that lower eGFR category (30∼59, odds ratio [OR]=3.063 [1.278-7.339]; 15∼29, OR=3.417 [1.088-10.726]; <15, OR=10.080 [2.677-37.951] vs ≥ 60), lower serum albumin level (OR=0.491 [0.278-0.868], P=0.0144) and renal amyloidosis (OR=11.174 [3.974-31.420], P<0.0001) were predictors of development of AKI. MM stages and β2-microglobulin were not associated with AKI occurrence. Regarding laboratory TLS, MM stage and β2-microglobulin were higher in those with TLS. In multivariate analyses, β2-microglobulin levels (OR=1.194 [1.066-1.337], P=0.0021) and any chromosomes abnormalities at high risk (OR=0.115 [0.026-0.503], P=0.0041) were associated with higher risk of TLS. Conclusion Development of AKI was often observed without being accompanied by TLS in patients with MM after treatment of bortezomib. In addition, risk factors of AKI and TLS were widely different. These findings implicated the potential nephrotoxicity of bortezomib besides TLS in patients with decreased kidney function. The efforts to prevent bortezomib associated AKI are needed in patients at high risk.

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