scholarly journals Study of causes and prognosis of acute kidney injury (AKI) in tertiary care institute

2017 ◽  
Vol 4 (4) ◽  
pp. 1165
Author(s):  
Nagabhushana S. ◽  
Ranganatha M. ◽  
Ranjith Kumar G. K. ◽  
Kamath Virupakshappa
Keyword(s):  
Acute Kidney Injury ◽  
Serum Creatinine ◽  
Tertiary Care ◽  
Emergency Obstetric Care ◽  
Kidney Injury ◽  
Obstetric Care ◽  
Clinical Syndrome ◽  
Oral Rehydration ◽  
Medical Wards ◽  
Wbc Count

Background: Acute kidney injury (AKI) is a common clinical syndrome with a broad aetiological profile. It is associated with major morbidity and significant mortality. This study is to determine the various causes of AKI, in our hospital and to find out the incidence of AKI by using renal failure indices and to analyze outcome of AKI pertaining to the aetiology.Methods: Study is conducted on 100 AKI patients on haemodialysis admitted in various medical wards of the Mc Gann Hospital attached to Shimoga institute of medical sciences, Shimoga. From January 1st, 2017 to June 30th, 2017 detailed history was taken in all the patients and a through physical examination was done. Baseline and peak levels of serum Creatinine, urine output was documented. Data regarding laboratory investigations were collected to confirm the etiology of AKI.Results: There were 65 males and 35 females. The highest number of cases are in age group 51 to 60 year (32%). Average age is 56±5.6 years. Fever, nausea and oliguria are the most common clinical features seen 66,66 and 64 percentage respectively, followed by edema (23%) and loses tools (17%). Blood urea (>100), serum Creatinine (>4) in 44% and 46% respectively. Hb <10 gm/dl in 54%. WBC count >12000 in 65%. Sepsis and gastroenteritis are leading medical causes 25% and 12% respectively. Surgical causes are 14% and obstetrics causes are 11%.Conclusions: AKI remains a common disorder among critically ill patients Consistent with other studies from developing world; this study has also shown that infections, nephrotoxins and gastroenteritis are the primary causes of AKI at our institute. Most of these causes can be prevented with simple interventions such as health education on oral rehydration, quality prenatal and emergency obstetric care, appropriate management of infections and taking appropriate precautions when prescribing potentially nephrotoxic medications.

scholarly journals Biomarkers of acute kidney disease. potential application in practice

2021 ◽  
Vol 23 (1) ◽  
pp. 15-19
Author(s):  
Ekaterina S. Schelkanovtseva ◽  
◽  
Ekaterina S. Schelkanovtseva ◽  
Olga Iu. Mironova ◽  
Viktor V. Fomin ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Clinical Practice ◽  
Kidney Disease ◽  
Serum Creatinine ◽  
Potential Application ◽  
Kidney Injury ◽  
Clinical Syndrome ◽  
Acute Kidney Disease ◽  
Definition Of ◽  
New Biomarkers

Acute kidney injury (AKI) is a common clinical syndrome. Its variety of presentation explains the absence of “kidney troponin”. Many research projects of new biomarkers are ongoing now. The enormous number of biomarkers has been identified already. It makes difficult to choose the correct test and dictates the importance of the fastest and most accurate introduction of AKI biomarkers into clinical practice. The integration of appropriately selected biomarkers in routine clinical practice for high-risk patients of AKI is very important. Currently, serum creatinine (sCr) and urine output are used to define AKI in accordance with the definition of KDIGO (Kidney Disease: Improving Global Outcomes), which have a number of significant limitations for practitioners, including the inability to diagnose AKI before serum creatinine levels increase. Practitioners need systematic information about the latest AKI markers and possible situations, when and for which patient groups they can be used. This is the main goal of our review. Keywords: acute kidney injury, biomarkers, NGAL, TIMP-2, IGFBP7, cystatin C, markers, injury, kidney stress For citation: Schelkanovtseva ES, Mironova OIu, Fomin VV. Biomarkers of acute kidney disease. Potential application in practice. Consilium Medicum. 2021; 23 (1): 15–19. DOI: 10.26442/20751753.2021.1.200729

scholarly journals Etiology and Outcomes of Acute Kidney Injury in Patients Admitted to a Single Tertiary Care Hospital: Balochistan Institute of Nephrology-Urology Quetta

2021 ◽  
Vol 4 (4) ◽  
pp. 319-323
Author(s):  
Abdul Kareem Zarkoon Zarkoon ◽  
Habib Ullah Rind ◽  
Moin Khan ◽  
Aijaz Ahmed ◽  
Nasir Jakrani ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Age Groups ◽  
Kidney Injury ◽  
Complete Recovery ◽  
Clinical Syndrome ◽  
Obstructive Nephropathy ◽  
Care Hospital ◽  
Number Of Patients

Acute kidney injury (AKI) is a common clinical syndrome with broad spectrum of etiologies and an important cause of morbidity and mortality requiring hospitalization. Depending on the cause and nature of AKI it may complicate to be life threatening or even proceed to Chronic Kidney disease (CKD) compromising the quality of life. Methods: The current retrospective study determines the causes and outcomes of AKI in patients of different age groups, who required hospitalization at our tertiary care hospital from March 2018 to March 2020.  Possible etiologic conditions for AKI were recorded during the study period and AKI was classified according to the causes, age and outcome. Results: records of total of 267 patients with diagnosis of AKI were obtained who were admitted during the study period. Obstetric related diagnosis was the commonest reason for AKI (n= 50 18.7%), another 42 (15.7%) had obstructive nephropathy, prerenal AKI in 35 patients (13.1%) and other causes such as glomerulonephritis, sepsis, pigment nephropathy and drug related interstitial nephritis among others. Majority of the patients needed dialytic support, n=190 (71.2%) and majority of patients n=181 patients (67.7%) recovered completely, and only 11 patients (4.2%) expired. Conclusion: Our study reveals that majority of patients with AKI presenting to BINUQ had reversible causes of AKI with complete recovery in significant number of patients. Community wise programs to early detect AKI with prompt treatment will decrease the likelihood of such patients adding to the CKD population.

scholarly journals INCIDENCE AND CAUSES OF ACUTE KIDNEY INJURY IN SICK NEONATE : A STUDY FROM A TERTIARY CARE NEONATAL UNIT

2020 ◽  
pp. 1-2
Author(s):  
Krishnendu Karmakar ◽  
Sumanta Laha ◽  
Bhaswati Ghoshal ◽  
Pradip Kumar Das
Keyword(s):  
Acute Kidney Injury ◽  
Birth Weight ◽  
Kidney Disease ◽  
Serum Creatinine ◽  
Perinatal Asphyxia ◽  
Tertiary Care ◽  
Kidney Injury ◽  
Care Hospital ◽  
Cross Sectional ◽  
Normal Birth

Objective To find out the incidence of Acute Kidney Injury(AKI) and various causes responsible for the AKI in sick neonates in a tertiary care hospital. Material and Method In this observational cross sectional study we included all neonates with features suggestive of AKI with exclusion criteria of extreme prematurity, chronic kidney disease and major congenital anomaly. We diagnose AKI according to the KIDIGO(Kidney Disease: Improving Global Outcome)guideline where we take serum creatinine value and urinary output as determinant. Serum creatinine value measured at 48 and 72 hrs of admission and repeated at 96 hrs if there is rising trend of creatinine..Now we find out the incidence of AKI in relation to gender, birth weight, mode of delivary . Among the AKI case we sort out the causative factors like perinatal asphyxia,sepsis, shock, prematurity etc and analysed all the results statistically. Results Out of total 1872 neonates admitted during the 18 months study period we found AKI in 111 neonates(5.93%).There is male preponderance and most neonates are of normal birth wt.Among the various causes of AKI perinatal asphyxia is the leading cause followed by sepsis and prematurity.Other imp causes are congenital heart disease,shock, PPHN , nephrotoxic drug use and RDS of newborn. We found asphyxia as the leading cause of AKI in normal vaginal delivary group whereas sepsis is the main cause of AKI in cesarean section group. Conclusion AKI is fairly common in sick neonates , even in normal birth weight babies and perinatal asphyxia and sepsis are the two most prevalent cause for AKI in this study.

scholarly journals Clinical profile and outcome of acute kidney injury in neonatal sepsis in a tertiary care centre

2017 ◽  
Vol 4 (2) ◽  
pp. 635
Author(s):  
Divya Durga ◽  
Sudha Rudrappa
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Renal Failure ◽  
Serum Creatinine ◽  
Neonatal Sepsis ◽  
Tertiary Care ◽  
Significant Risk ◽  
Kidney Injury ◽  
Morbidity And Mortality ◽  
Incidence And Mortality

Background: Septicemia remains a leading cause of morbidity and mortality among neonates with AKI complicating as many as 3.4 to 24% of them. The actual incidence of renal failure in all sepsis cases is not documented. There are several studies in the literature on renal failure in neonates which were based on older definitions using blood urea and urine output as parameters. The major limitation of the older studies was that they did not use the current acute kidney injury network (AKIN) definition. In the present study, we have attempted to investigate AKI in neonatal sepsis using the AKIN definition based on serum creatinine (Table1). We also attempted to determine the predictors of AKI in neonatal sepsis.Methods: The present study was an explorative study conducted in the neonatal unit of Cheluvamba hospital attached to Mysore Medical College and Research Institute in which a total of 50 neonates with clinical/ culture positive sepsis were enrolled during the period of June 2014 to June 2015.Results: These neonates were investigated for the presence of AKI based on serum creatinine values of three consecutive days and were divided into two groups. Group 1 consisted of septic neonates with AKI and group 2 consisted of septic neonates without AKI. Both the groups were followed up till discharge or death. The risk factors associated with sepsis were compared in both the groups and predictors of morbidity and mortality associated with AKI in sepsis were also determined.Conclusions: Incidence and mortality associated with AKI in sepsis was found to be 24% and 75% respectively. Factors like PROM, foul smelling liquor, > 3 unclean vaginal examinations during labour were significant risk factors for development of AKI in sepsis. Culture positivity, associated meningitis, DIC, shock and need for assisted ventilation were poor prognostic indicators and were significantly associated with mortality. 

scholarly journals Pattern of acute kidney injury and its outcome in a tertiary care centre

2020 ◽  
Vol 8 (2) ◽  
pp. 618
Author(s):  
Jennie Santhanam ◽  
Meenakshi Sundari Subramaniyan Natarajan ◽  
Annam Lakshmanan ◽  
Rajeswari K. Balakrishnan
Keyword(s):  
Acute Kidney Injury ◽  
Kidney Disease ◽  
Serum Creatinine ◽  
Tertiary Care ◽  
Kidney Injury ◽  
Risk Category ◽  
Care Hospital ◽  
Tertiary Care Centre ◽  
Disease Category ◽  
The Mean

Background: Acute kidney injury is a multiplex disease with severe morbidity and mortality. The trends of acute kidney injury vary according to the regions and the population under study. The aim of this study is to evaluate the trends of acute kidney injury and its outcome in a tertiary care hospital.Methods: The study was a prospective observational study conducted at a tertiary care hospital in a metropolitan city. A total of 102 patients of acute kidney injury were selected based on the Kidney Disease Improving Global Outcomes guidelines of acute kidney injury. The main trends of acute kidney injury presentation and its outcome were assessed.Results: Of 102 patients admitted, 42 had a sepsis related diagnosis (42.41%), 17 patients (17.16%) had cardiovascular disease related acute kidney injury and 12 patients (12.12%) had developed acute kidney injury due to drugs and poisons. According to RIFLE (risk of renal failure, injury to kidney, failure and loss of function and end-stage kidney disease) category, 43.96% of patients belonged to the risk category and 30.77% to the injury category. Of 34 patients in failure category, 23 recovered and 11 did not recover. Authors compared the trends of acute kidney injury in patients who recovered and who deteriorated. The mean serum creatinine values were 3.42 mg/dl in patients who didn’t recover from acute kidney injury and 2.05 mg/dl in patients who recovered. In patients of the recovered group, the mean urine output value is 783 ml/day; in deterioration group, 445 ml/day.Conclusions: Most common etiologies of acute kidney injury in this study include sepsis, drugs and poisons, cardiovascular diseases and diarrheal diseases in order of occurrence. High serum creatinine at admission and oliguria were the most common factors that contributed to deterioration in acute kidney injury.

scholarly journals Acute kidney injury among paediatric emergency room admissions in a tertiary hospital in South West Nigeria: a cohort study

2018 ◽  
Vol 12 (4) ◽  
pp. 521-526 ◽  
Author(s):  
Adebowale D Ademola ◽  
Adanze O Asinobi ◽  
Esther Ekpe-Adewuyi ◽  
Adejumoke I Ayede ◽  
Samuel O Ajayi ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Serum Creatinine ◽  
Emergency Room ◽  
Tertiary Care ◽  
Kidney Injury ◽  
Sub Saharan Africa ◽  
Care Hospital ◽  
College Hospital ◽  
Paediatric Emergency ◽  
Sub Saharan

Abstract Background Epidemiological data on paediatric acute kidney injury (AKI) in sub-Saharan Africa are limited and largely retrospective. We performed a prospective study of AKI among patients admitted through the emergency room. Methods Children admitted to the post-neonatal emergency room of the University College Hospital, Ibadan, Nigeria between February 2016 and January 2017 were studied. AKI was defined by Kidney Disease: Improving Global Outcomes serum creatinine criteria. AKI ascertainment relied on serum creatinine measurements carried out in routine care by post-admission Day 1. We compared in-hospital mortality by post-admission Day 7 for patients with and without AKI (no-AKI). Results Of the 1344 children admitted to the emergency room, 331 were included in the study. AKI occurred in 112 patients (33.8%) with a median age of 3.1 years [interquartile range (IQR) 0.9–9.4] and was Stage 3 in 50.5% of the cases. The no-AKI group had a median age of 1.8 (IQR 0.7–5.8) years. The underlying diagnoses in patients with AKI were sepsis (33.0%), malaria (12.5%) and primary renal disorders (13.4%). Twenty-four of the patients with AKI underwent dialysis: haemodialysis in 20 and peritoneal dialysis in 4. By Day 7 of admission, 7 of 98 (7.1%) patients in the AKI group had died compared with 5 of 175 (2.9%) patients in the no-AKI group [odds ratio 2.6 (95% confidence interval 0.8–8.5)]. Outcome data were not available for 58 (17.5%) patients. Conclusions AKI is common among paediatric emergency room admissions in a tertiary care hospital in sub-Saharan Africa. It is associated with high mortality risk that may be worse in settings without dialysis.

scholarly journals P0609THE INCIDENCE AND RISK OF CONTRAST INDUCED ACUTE KIDNEY INJURY IN THE ELDERLY UNDERGOING PULMONARY COMPUTED TOMOGRAPHY ANGIOGRAPHY

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Alrowaie Fadel ◽  
Khalid Almatham ◽  
Saud Almousa ◽  
Majed Abonab ◽  
Abdullah AlJaser ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Acute Kidney Injury ◽  
Serum Creatinine ◽  
Computed Tomography Angiography ◽  
Tertiary Care ◽  
Kidney Injury ◽  
The Elderly ◽  
Base Line ◽  
Care Hospital ◽  
Prophylactic Measures

Abstract Background and Aims Contrast-induced acute kidney injury nephropathy (CI-AKI) is a leading cause of acquired acute kidney injury and has been associated with prolonged hospitalization and adverse clinical outcomes. Advanced age has been reported as risk factor for CI-AKI. However, limited studies available to determine the exact incidence of CI-AKI in elderly patient. The aim of this study was to investigate the incidence of, risk factors for developing CI-AKI in patient above 65 years old who underwent Pulmonary Computed Tomography Angiography (PCTA). Method This single center retrospective study, performed in a large, tertiary care hospital in Riyadh, Saudi Arabia. It is a sub-study of (3 P-CIAKI) The Practice Pattern of Preventive Measures for Contrast Induced Acute Kidney Injury in Patients Undergoing Pulmonary Computed Tomography Angiography. Patients &gt; 65 years of age, who underwent PCTA during a 5-year period (2014 to 2018) were included. Patients receiving long-term hemodialysis or peritoneal dialysis, and those without repeated serum creatinine 48-72 hours post procedure were excluded from the analysis. CI-AKI defined as raise of serum creatinine by 44 mmol/l 48-72 hours post PCTA. Results 272 out of 908 patients, with a mean age of 74.93 ± 7.09 years, 58.1% having diabetes mellitus (DM) and estimated GFR of 74.92 ± 23.57 ml/min per 1.73 m2 were enrolled. 201 patients (73.9%) had eGFR &gt; 60 ml/min. Diuretics was used by 37.1% of the patients, while 33.1 % of the patients on ACEI / ARBs. Prophylactic measures used in 35.7 % of the procedures. CI-AKI occurred in 19 cases (7.0 %) as compared with 4.7 % in the original 3 P-CIAKI study with mean age of 52 years and eGFR 97 ml/min. Renal replacement therapy required in 3 patients who had CI-AKI. DM status was only significant predictor for the development of CI-AKI. Conclusion Elderly patients are at greater risk for the development of CI-AKI even with eGFR above 60 ml/min specially in DM patient .The Incidence of CI-AKI in patients &gt; 65 years of age is up to 7 %, that is less than the reported in the literature and this can be explained by higher base line eGFR in our study .

scholarly journals Perioperative use of serum creatinine and postoperative acute kidney injury: a single-centre, observational retrospective study to explore physicians’ perception and practice

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Gianluca Villa ◽  
Silvia De Rosa ◽  
Caterina Scirè Calabrisotto ◽  
Alessandro Nerini ◽  
Thomas Saitta ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Retrospective Study ◽  
High Risk ◽  
Abdominal Surgery ◽  
Serum Creatinine ◽  
Malignant Disease ◽  
Kidney Injury ◽  
Major Surgery ◽  
Single Centre

Abstract Background Postoperative acute kidney injury (PO-AKI) is a leading cause of short- and long-term morbidity and mortality, as well as progression to chronic kidney disease (CKD). The aim of this study was to explore the physicians’ attitude toward the use of perioperative serum creatinine (sCr) for the identification of patients at risk for PO-AKI and long-term CKD. We also evaluated the incidence and risk factors associated with PO-AKI and renal function deterioration in patients undergoing major surgery for malignant disease. Methods Adult oncological patients who underwent major abdominal surgery from November 2016 to February 2017 were considered for this single-centre, observational retrospective study. Routinely available sCr values were used to define AKI in the first three postoperative days. Long-term kidney dysfunction (LT-KDys) was defined as a reduction in the estimated glomerular filtration rate by more than 10 ml/min/m2 at 12 months postoperatively. A questionnaire was administered to 125 physicians caring for the enrolled patients to collect information on local attitudes regarding the use of sCr perioperatively and its relationship with PO-AKI. Results A total of 423 patients were observed. sCr was not available in 59 patients (13.9%); the remaining 364 (86.1%) had at least one sCr value measured to allow for detection of postoperative kidney impairment. Among these, PO-AKI was diagnosed in 8.2% of cases. Of the 334 patients who had a sCr result available at 12-month follow-up, 56 (16.8%) developed LT-KDys. Data on long-term kidney function were not available for 21% of patients. Interestingly, 33 of 423 patients (7.8%) did not have a sCr result available in the immediate postoperative period or long term. All the physicians who participated in the survey (83 out of 125) recognised that postoperative assessment of sCr is required after major oncological abdominal surgery, particularly in those patients at high risk for PO-AKI and LT-KDys. Conclusion PO-AKI after major surgery for malignant disease is common, but clinical practice of measuring sCr is variable. As a result, the exact incidence of PO-AKI and long-term renal prognosis are unclear, including in high-risk patients. Trial registration ClinicalTrials.gov, NCT04341974.

The Effect of a Short Course of Tocolytic Indomethacin on Urinary Biomarkers in Premature Infants

2021 ◽  
Author(s):  
Ahmad El Samra ◽  
Ayesa Mian ◽  
Marc Lande ◽  
Hongyue Wang ◽  
Ronnie Guillet
Keyword(s):  
Acute Kidney Injury ◽  
Serum Creatinine ◽  
Kidney Injury ◽  
Urinary Biomarkers ◽  
Bivariate Analysis ◽  
Neutrophil Gelatinase Associated Lipocalin ◽  
Short Course ◽  
Medication Exposure ◽  
Epidermal Growth ◽  
Neutrophil Gelatinase

Objective The aim of this study was to determine the effects of a 2-day prenatal course of indomethacin on the premature kidney as reflected by serum creatinine and urinary biomarkers. Study Design Urine of infants ≤ 32 weeks was collected for the first 14 days and analyzed for cystatin C, neutrophil gelatinase-associated lipocalin, osteopontin, β2 microglobulin, epidermal growth factor, uromodulin, and microalbumin. Bivariate analysis compared serum creatinine and biomarkers of exposed (INDO) and unexposed (CONT) subjects. Results Fifty-seven infants (35 CONT and 22 INDO) were studied. The cohorts were similar in gestational age, birthweight, race, gender, nephrotoxic medication exposure, and Apgar scores. CONT had more dopamine exposure and included more pre-eclamptic mothers (p = 0.005). No difference in creatinine-based acute kidney injury or the log transformed mean, maximum, and minimum values of urinary biomarkers was detected. Conclusion Our findings suggest that a short course of tocolytic indomethacin does not result in neonatal acute kidney injury. Key Points

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