scholarly journals Cell-free hemoglobin mediated oxidative stress is associated with acute kidney injury and renal replacement therapy in severe falciparum malaria: an observational study

2017 ◽  
Vol 17 (1) ◽  
Author(s):  
Katherine Plewes ◽  
Hugh W.F. Kingston ◽  
Aniruddha Ghose ◽  
Richard J. Maude ◽  
M. Trent Herdman ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Acute Kidney Injury ◽  
Renal Replacement Therapy ◽  
Observational Study ◽  
Replacement Therapy ◽  
Falciparum Malaria ◽  
Kidney Injury ◽  
Free Hemoglobin ◽  
Severe Falciparum Malaria

scholarly journals Acute kidney injury. the need for renal replacement therapy and complications during the application

2019 ◽  
Vol 3 (1) ◽  
pp. 4
Author(s):  
Katerina Karpathiou ◽  
Dimitris Panagidis ◽  
Olga Kadda ◽  
Helen Dokoutsidou ◽  
Christine Routsi ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Renal Replacement Therapy ◽  
Observational Study ◽  
Replacement Therapy ◽  
Extracorporeal Circulation ◽  
Kidney Injury ◽  
T Test ◽  
Common Complication ◽  
Test Of Independence ◽  
Need For Treatment

Introduction: Acute kidney  injury (AKI) is a  very common complication of critically ill patients in ICU. It  is  associated  with significantly increased morbidity and mortality. Renal replacement is a treatment with a lot of complications.Aim: The  aim of  the present  study  was  to  observe the incidence of  AKI, the need for treatment with continuous renal replacement and the problems during the  therapy.Material and Methods: This  is  an  observational  study. The study sample were patients admitted to the ICU of General  hospital ‘’Evagelismos’’. AKI, was defined according to the  RIFLE criteria. For quantitative variables analysis was used the test of independence through '' t-test (Independent Samples T-Test) '', while the quality was analyzed by X2 test of independence. The analysis was performed with SPSS 19.0 statistical package.Results: Of the 192 study patients, 28% had AKI and the 17% received renal replacement therapy. AKI is associated with increased mortality which increases as increases the severity. The most commonly problems of treatment were:  hypothermia to 57.5%, hypotension and clotting filters in 54.5% and 51.5%, respectively. Factor that affect early clotting of the extracorporeal circulation, is  the use of heparin versus citrate as anticoagulation.Conclusions: AKI  is  associated with severe  mortality which increases as increases the severe  of  AKI  stage , respectively. Factor that is associated with higher rates of unsuccessful completion of treatment, is the choice  of  anticoagulation  strategy.

Increase of urinary TIMP-2 and IGFBP7 as potential predictor of acute kidney injury requiring renal replacement therapy and patients’ outcome following complex endovascular and open thoracic abdominal aortic aneurysm surgery – a prospective observational study

VASA ◽  
2020 ◽  
pp. 1-9
Author(s):  
Alexander Gombert ◽  
Drosos Kotelis ◽  
Marcia V. Rückbeil ◽  
Mohammad Barbati ◽  
Lukas Martin ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Renal Replacement Therapy ◽  
Aortic Aneurysm ◽  
Observational Study ◽  
Replacement Therapy ◽  
Endovascular Repair ◽  
Aortic Surgery ◽  
Total Mortality ◽  
Kidney Injury ◽  
Significant Difference

Summary: Background: Acute kidney injury (AKI) as complication after open and endovascular repair of thoracoabdominal aortic aneurysm (TAAA) is one major predictor of mortality and postoperative complications. We evaluated tissue inhibitor of metalloproteinase 2 (TIMP-2) and insulin-like growth factor-binding protein 7 (IGFBP7) as combined early biomarker for AKI detection and predictor of patients’ outcome. Patients and methods: Between 2014 and 2015, 52 patients have been enrolled in this observational study, of whom 29 (55.8%) underwent elective open repair and 23 (44.2%) endovascular repair. TIMP2 × IGFBP7 were measured until 48 hours after admission on intensive-care unit (ICU) and were analyzed regarding their predictive ability for AKI (defined according to the KDIGO criteria) requiring temporary renal replacement therapy (RRT) and 90-day mortality using ROC curves. Results: Mean patient age was 64.5 years (Min: 43, Max: 85), endovascular treated patients were older ( p <0.0001). 40.4% ( n = 21) developed AKI, and 21.2% ( n = 11) required renal replacement therapy. In-hospital and total mortality rates were 7.7% ( n = 4) and 9.6% ( n = 5), respectively. At no time a significant difference in TIMP2 × IGFB7 levels between patients undergoing open or endovascular surgery was observed. The predictive quality of the TIMP2 × IGFBP7 value on ICU admission was sound regarding AKI requiring temporary renal replacement therapy (sensitivity: 55.56% [38.1–72.1%], specificity: 90.91% [58.7–99.8%] with an area under the curve [AUC]: 0.694 [0.543–0.820]). Mean follow-up was 13.2 months (Min: 2, Max: 20), regarding the 90-day mortality, the predictive property of the TIMP2 × IGFBP7 value was not sufficient (sensitivity: 80% [28.4–99.5%], specificity: 52.38% [36.4–68%], and AUC: 0.607 [0.454–0.746]). Conclusions: TIMP2 × IGFBP7 level measured 6–12 hrs postoperatively may be useful as an early detectable biomarker for AKI requiring temporary renal replacement therapy. It seems not suited to predict patients’ outcome following complex thoracoabdominal aortic surgery, regardless if performed by open or endovascular repair.

scholarly journals Acute Kidney Injury and Jaundice in a Patient With Concurrent Severe Malaria and Acute Exacerbation of Hepatitis B

2021 ◽  
Vol 9 ◽  
pp. 232470962110437
Author(s):  
Jonny Jonny ◽  
Laurencia Violetta
Keyword(s):  
Acute Kidney Injury ◽  
Renal Replacement Therapy ◽  
Hepatitis B ◽  
Replacement Therapy ◽  
Severe Malaria ◽  
Acute Exacerbation ◽  
Falciparum Malaria ◽  
Fatal Case ◽  
Kidney Injury ◽  
Chronic Hbv

Patients chronically infected with hepatitis B virus (HBV) may travel to areas with high endemicity of malaria. The overlap between malaria and HBV infection can be clinically severe and present a diagnostic challenge as both diseases manifest similar symptoms. This case describes a fatal case of a 43-year-old man with chronic HBV infected with Plasmodium falciparum malaria that presents as acute kidney injury (AKI) and jaundice following a trip to malaria-endemic region. Despite administering antimalarial and 6 courses of renal replacement therapy, the patient’s clinical condition did not improve, leading to septic shock, multi-organ dysfunction, and eventually, death. AKI and jaundice are commonly seen in severe P. falciparum malaria, as well as acute exacerbation of chronic HBV. This case emphasizes the importance to consider malarial screening when evaluating sick returning travelers, even in those with underlying chronic HBV. Given the severity of coinfection, prompt identification of this overlap can avert the rapid deterioration of severe malaria by early administration of intravenous artesunate and renal replacement therapy.

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