Acute kidney injury in Chinese patients with lupus nephritis: a large cohort study from a single center

Lupus ◽  
2011 ◽  
Vol 20 (14) ◽  
pp. 1557-1565 ◽  
Author(s):  
D Zhu ◽  
Z Qu ◽  
Y Tan ◽  
F Yu ◽  
M-h Zhao
Keyword(s):  
Acute Kidney Injury ◽  
Risk Factor ◽  
Lupus Nephritis ◽  
Independent Risk Factor ◽  
Kidney Injury ◽  
Large Cohort ◽  
Chinese Patients ◽  
Renal Outcome ◽  
Male Predominance ◽  
The Impact

Objective In this study we assess clinicopathologic characteristics, treatment and prognosis of acute kidney injury (AKI) in a large cohort of Chinese patients with lupus nephritis. Methods The clinical, laboratory, renal histopathology, treatment and outcome data were retrospectively collected and compared between lupus nephritis patients with and without AKI. The impact of AKI on renal outcome was evaluated. Results Among 322 patients with renal biopsy-proven lupus nephritis, 66 (20.5%) were identified as AKI. Male predominance was observed in patients with AKI ( p < 0.001). In comparison with the non-AKI group, patients with AKI had significantly higher proportions of serositis ( p < 0.001), neurologic disorder ( p = 0.026), anemia ( p < 0.001), thrombocytopenia ( p = 0.013) and nephrotic syndrome ( p = 0.011), but significant lower serum C3 ( p < 0.001). The Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) scores, renal pathological activity indices and chronicity indices were significantly higher in the AKI group ( p < 0.001 in all cases). Regarding outcome, the AKI group had a significantly poorer renal outcome compared with non-AKI group ( p < 0.001). In the AKI group, patients with crescentic glomerulonephritis and thrombotic microangiopathy had the worst renal outcome. AKI was an independent risk factor for renal outcome (hazard ratio [HR] = 5.819, 95% confidence interval 2.411–14.044 , p < 0.001). Conclusions AKI is common in lupus nephritis and is an independent risk factor for renal outcome.

scholarly journals A High Triglyceride-Glucose Index Is Associated With Contrast-Induced Acute Kidney Injury in Chinese Patients With Type 2 Diabetes Mellitus

2021 ◽  
Vol 11 ◽  
Author(s):  
Yuhan Qin ◽  
Haixia Tang ◽  
Gaoliang Yan ◽  
Dong Wang ◽  
Yong Qiao ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Acute Kidney Injury ◽  
Risk Factor ◽  
Predictive Value ◽  
Independent Risk Factor ◽  
Kidney Injury ◽  
Chinese Patients ◽  
Tyg Index ◽  
Increased Risk

Background and ObjectivesTriglyceride-glucose (TyG) is an emerging vital indicator of insulin resistance and is associated with increased risk of T2DM and cardiovascular events. We aimed to explore the TyG index and contrast-induced acute kidney injury (CI-AKI) in patients with type 2 diabetes who underwent coronary angiology.MethodsThis study enrolled 928 patients with suspected coronary artery disease who underwent coronary angiology or percutaneous coronary intervention in Zhongda hospital. Patient data were divided into quartiles according to the TyG index: group 1: TyG ≤ 8.62; group 2: 8.62&lt;TyG ≤ 9.04; group 3: 9.04&lt;TyG ≤ 9.45; and group 4: TyG&gt;9.45. CI-AKI was diagnosed according to the KIDIGO criteria. Demographic data, hematological parameters, coronary angiology data, and medications were all recorded. We calculated the TyG index using the following formula: ln [fasting TG (mg/dL)×FPG (mg/dL)/2].ResultsPatients who developed CI-AKI exhibited significantly higher TyG index levels compared to patients who did not develop CI-AKI. The incidence of CI-AKI sharply increased with increasing TyG. Univariate and multivariate analysis identified TyG as an independent risk factor for CI-AKI. The AUC of the ROC curve was as high as 0.728 when the value of TyG was 8.88. The corresponding sensitivity was as high as 94.9%. Adding the variable TyG to the model for predicting CI-AKI risk further increased the predictive value of the model from 80.4% to 82%.ConclusionsHigh TyG is closely associated with increased incidence of CI-AKI, demonstrating that TyG is an independent risk factor for CI-AKI. TyG has potentially predictive value for CI-AKI and may play a crucial role in risk stratification in clinical practice.

scholarly journals Incidence and Predictors of Acute Kidney Injury Among Women With Severe Pre-eclampsia at Mbarara Regional Referral Hospital

2021 ◽  
Author(s):  
Mariam Hassan ◽  
Roland Mayanja ◽  
Wasswa G.M Ssalongo ◽  
Natumanya Robert ◽  
Lugobe Henry Mark ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Risk Factor ◽  
Serum Creatinine ◽  
Independent Risk Factor ◽  
Statistical Significance ◽  
Kidney Injury ◽  
Referral Hospital ◽  
Chronic Hypertension ◽  
Baseline Serum ◽  
Regional Referral Hospital

Abstract BackgroundThe presence of acute kidney injury (AKI) in pre-eclampsia complicates treatment including; increasing length of hospital stay and a need to access services like dialysis which are largely expensive in resource-limited settings. We aimed to determine incidence and predictors of acute kidney injury among women with severe pre-eclampsia at Mbarara Regional Referral Hospital in southwestern Uganda. MethodsWe carried out a hospital-based prospective cohort study from 16 November 2018 to 18 April 2019, among pregnant women with severe preeclampsia followed up in the hospital. We enrolled 70 mothers with severe pre-eclampsia and eclampsia; we excluded patients with a history of chronic renal disease, chronic hypertension, and gestational hypertension.Data on socio-demographics, laboratory parameters, health system, obstetric and medical factors were collected. Baseline serum creatinine, complete blood count, and CD4 T-cell count were all done at admission (0-hour). Second serum creatinine was done at 48-hours to determine the presence of AKI. AKI was defined as a rise in serum creatinine of 0.3mg/dl or more from the baseline. The proportion of women diagnosed with acute kidney injury among the total number of women with severe pre-eclampsia was reported as incidence proportion. Univariate and multivariate logistic regression was used to establish the association of acute kidney injury and severe pre-eclampsia.ResultsIncidence of acute kidney injury was high (41.4%) among women with severe pre-eclampsia. Antenatal care attendance was protective 0.36 (0.16, 0.80), p<0.013 at bivariate analysis but had no statistical significance at multivariate analysis. Eclampsia was an independent risk factor for acute kidney injury. (aRR 2.74 (1.06, 7.08), P<0. 037.ConclusionThe incidence of acute kidney injury in patients with preeclampsia is high. Eclampsia is an independent risk factor of acute kidney injury.

Specific diseases: renal disease

ESC CardioMed ◽  
2018 ◽  
pp. 2670-2673
Author(s):  
Susanna Price
Keyword(s):  
Cardiovascular Disease ◽  
Chronic Kidney Disease ◽  
Acute Kidney Injury ◽  
Risk Factor ◽  
Kidney Disease ◽  
Renal Disease ◽  
Independent Risk Factor ◽  
Hospital Admissions ◽  
Kidney Injury ◽  
Potential Methods

Chronic kidney disease is a global health burden, with an estimated prevalence of 11–13%, with the majority of patients diagnosed as stage 3, and is an independent risk factor for cardiovascular disease. The incidence of acute kidney injury is increasing, and estimated to be present in one in five acute hospital admissions, and there is a bidirectional relationship between acute and chronic kidney disease. The relevance to the patient with cardiovascular disease relates to increased perioperative risk, as reduced kidney function is an independent risk factor for adverse postoperative cardiovascular outcomes including myocardial infarction, stroke, and progression of heart failure. Furthermore, patients undergoing cardiovascular investigations are at risk of developing acute kidney injury, in particular where iodinated contrast is administered. This chapter reviews the classification of renal disease and its impact on cardiovascular disease, as well as potential methods for reducing the development of contrast-induced acute kidney injury.

scholarly journals Immunopathology of Acute Kidney Injury in Severe Malaria

2021 ◽  
Vol 12 ◽  
Author(s):  
Orestis Katsoulis ◽  
Athina Georgiadou ◽  
Aubrey J. Cunnington
Keyword(s):  
Acute Kidney Injury ◽  
Risk Factor ◽  
Inflammatory Response ◽  
Severe Malaria ◽  
Independent Risk Factor ◽  
Microvascular Obstruction ◽  
Kidney Injury ◽  
Systemic Effects ◽  
Intravascular Hemolysis ◽  
Host Inflammatory Response

Acute kidney injury (AKI) is a common feature of severe malaria, and an independent risk factor for death. Previous research has suggested that an overactivation of the host inflammatory response is at least partly involved in mediating the kidney damage observed inP. falciparumpatients with AKI, however the exact pathophysiology of AKI in severe malaria remains unknown. The purpose of this mini-review is to describe how different aspects of malaria pathology, including parasite sequestration, microvascular obstruction and extensive intravascular hemolysis, may interact with each other and contribute to the development of AKI in severe malaria, by amplifying the damaging effects of the host inflammatory response. Here, we highlight the importance of considering how the systemic effects and multi-organ involvement of malaria are intertwined with the localized effects on the kidney.

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