Incidence and Predictors of Acute Kidney Injury Among Women With Severe Pre-eclampsia at Mbarara 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.

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Anemia as a risk factor of contrast-associated acute kidney injury

Terapevticheskii arkhiv ◽

10.26442/00403660.2020.12.200450 ◽

2020 ◽

Vol 92 (12) ◽

pp. 48-52

Author(s):

O. Iu. Mironova ◽

A. D. Deev ◽

P. G. Lakotka ◽

V. V. Fomin

Keyword(s):

Coronary Artery Disease ◽

Acute Kidney Injury ◽

Risk Factor ◽

Coronary Artery ◽

Serum Creatinine ◽

Statistical Significance ◽

Kidney Injury ◽

Chronic Coronary Artery Disease ◽

Absolute Increase ◽

Artery Disease

Aim.The aim of our study was to assess the role of anemia as a risk factor of contrast-associated acute kidney injury (CA-AKI) in patients with stable coronary artery disease. Materials and methods.1023 patients with chronic coronary artery disease were enrolled in a prospective, open, cohort study (ClinicalTrials.gov ID NCT04014153). 83 patients had anemia. CA-AKI was defined as an increase of 25% or more, or an absolute increase of 0.5 mg/dl or more in serum creatinine from baseline value, assessed at 48 hours following the administration of the contrast. The primary endpoint of the study was the development of CA-AKI according to KDIGO criteria. Results.CA-AKI developed in 12 (14.5%) patients with anemia according to the relative increase of the level of serum creatinine (25% and more from the baseline). With using the absolute increase of the level of serum creatinine the prevalence of CA-AKI was 2 (2.4%) patients. Patients with anemia had higher rate of CA-AKI than the overall population of the study (14.4% versus 12.7%). Although our results were not statistically significant (р=0.61, odds ratio 1.19, 95% confidence interval 0.632.24). Conclusion.The prevalence of CA-AKI was higher in the group of patients with anemia, but didnt meet statistical significance and needs further evaluation in larger studies.

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P0199 : Acute kidney injury in cirrhosis: Baseline serum creatinine predicts patient outcomes

Journal of Hepatology ◽

10.1016/s0168-8278(15)30418-9 ◽

2015 ◽

Vol 62 ◽

pp. S380 ◽

Cited By ~ 2

Author(s):

F. Wong ◽

J.G. O’Leary ◽

K.R. Reddy ◽

G. Garcia-Tsao ◽

M.B. Fallon ◽

...

Keyword(s):

Acute Kidney Injury ◽

Serum Creatinine ◽

Patient Outcomes ◽

Kidney Injury ◽

Baseline Serum ◽

Baseline Serum Creatinine

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FREQUENCY OF ACUTE KIDNEY INJURY AMONG PATIENTS UNDERGOING CORONARY ANGIOGRAPHY

Pakistan Armed Forces Medical Journal ◽

10.51253/pafmj.v70isuppl-4.6033 ◽

2021 ◽

Vol 70 (Suppl-4) ◽

pp. S828-32

Author(s):

Sajid Khan ◽

Abdul Hameed Siddiqui ◽

Ariz Samin ◽

Syed Hassan Mustafa ◽

Akhtar Gul ◽

...

Keyword(s):

Acute Kidney Injury ◽

Coronary Angiography ◽

Serum Creatinine ◽

Study Design ◽

Kidney Injury ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Baseline Serum ◽

Control And Prevention

Objective: To determine the frequency of acute kidney injury among patients undergoing coronary angiography. Study Design: Descriptive cross-sectional study. Place and Duration of Study: Department of Cardiology, Hayatabad Medical Complex, Peshawar, from Jan 2018 to Jul 2018. Methodology: This study was conducted in the in the Department of Cardiology, Hayatabad Medical Complex, Peshawar from 22nd Jan 2018 to 22nd Jul 2018. Through a descriptive cross-sectional study design, a total of 116 patients scheduled for coronary angiography were included in the study in a consecutive manner and baseline / follow up serum creatinine was recorded to detect acute kidney injury. Results: In this study 116 patients were included, 61.2% males and 38.8% females. Mean age of the patients was 55.6 years with a standard deviation of 6.6 years. Mean baseline serum creatinine level was 0.9 ± 0.11mg/dl which was 1.5 ± 0.11 48 hours after coronary angiography (p 0.000). AKI was recorded in 19.8% of patients. Conclusion: Acute kidney injury after coronary angiography is not uncommon in our population. More studies are recommended on its risk factors and complications to draw future directions for its control and prevention.

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Mo1892 Acute Kidney Injury in Cirrhosis: Baseline Serum Creatinine Predicts Patient Outcomes

Gastroenterology ◽

10.1016/s0016-5085(15)33674-x ◽

2015 ◽

Vol 148 (4) ◽

pp. S-1075

Author(s):

Florence Wong ◽

Jacqueline G. O'Leary ◽

K. Rajender Reddy ◽

Guadalupe Garcia-Tsao ◽

Michael B. Fallon ◽

...

Keyword(s):

Acute Kidney Injury ◽

Serum Creatinine ◽

Patient Outcomes ◽

Kidney Injury ◽

Baseline Serum ◽

Baseline Serum Creatinine

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Specific diseases: renal disease

ESC CardioMed ◽

10.1093/med/9780198784906.003.0643 ◽

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.

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376 Cirrhosis Predicts Mortality in Hospitalized Patient Requiring Dialysis for Acute Kidney Injury (AKI) and Is an Independent Risk Factor for New Hemodialysis

Gastroenterology ◽

10.1016/s0016-5085(13)63516-7 ◽

2013 ◽

Vol 144 (5) ◽

pp. S-946

Author(s):

Muhammad Ali ◽

Shahryar Ahmad ◽

Nilay Kumar ◽

Gagan Kumar ◽

Kia Saeian

Keyword(s):

Acute Kidney Injury ◽

Risk Factor ◽

Independent Risk Factor ◽

Kidney Injury ◽

Hospitalized Patient

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Definition and Diagnosis of Acute Kidney Injury in Cirrhosis

Digestive Diseases ◽

10.1159/000375345 ◽

2015 ◽

Vol 33 (4) ◽

pp. 539-547 ◽

Cited By ~ 4

Author(s):

Florence Wong

Keyword(s):

Acute Kidney Injury ◽

Serum Creatinine ◽

Urine Output ◽

Negative Impact ◽

Kidney Injury ◽

Acute Kidney Injury Network ◽

Severe Form ◽

Loss Of Function ◽

Baseline Serum ◽

Advanced Cirrhosis

Background: Acute kidney injury (AKI) is a common complication of advanced cirrhosis. Type 1 hepatorenal syndrome is the best-known and most severe form of AKI, and it has a precise definition and a set of specific diagnostic criteria. More recently, it has become recognized that milder degrees of renal dysfunction also have a negative impact on patient outcome in various patient populations. Key Messages: Several definitions and criteria for staging the severity of AKI have been proposed, including the RIFLE (Risk, Injury, Failure, Loss of Function and End-Stage Renal Disease) group, the Acute Kidney Injury Network (AKIN), and the Kidney Disease: Improving Global Outcome (KDIGO) group. All of them incorporate some changes of serum creatinine and urine output in the definition and staging of AKI. The hepatology community has mostly embraced the AKIN diagnostic and staging criteria and has applied them in the prognostication of patients with advanced cirrhosis. However, the AKIN criteria have not been strictly applied in all studies on cirrhosis. This is partly related to the fact that changes in urine output are difficult to assess in advanced cirrhosis, and partly related to the difficulty in defining the baseline serum creatinine from which the change in serum creatinine is calculated. This has led to some confusion in the interpretation of results of the various studies on AKI in cirrhosis. More recently, some investigators have suggested incorporating the AKIN criteria with setting a lower limit of serum creatinine of 1.5 mg/dl in determining the diagnosis and prognosis of AKI in cirrhosis. Conclusions: This is an ongoing debate as to how best to define AKI in cirrhosis. In the near future there should be prospective clinical trials that will clarify which diagnostic and staging criteria of AKI will best serve the cirrhotic population.

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Risk of acute kidney injury associated with neuroimaging obtained during triage and treatment of patients with acute ischemic stroke symptoms

Journal of NeuroInterventional Surgery ◽

10.1136/neurintsurg-2015-012118 ◽

2016 ◽

Vol 8 (12) ◽

pp. 1231-1234 ◽

Cited By ~ 5

Author(s):

Shelby L Hall ◽

Stephan A Munich ◽

Marshall C Cress ◽

Leonardo Rangel-Castilla ◽

Elad I Levy ◽

...

Keyword(s):

Acute Kidney Injury ◽

Ischemic Stroke ◽

Serum Creatinine ◽

Serum Creatinine Level ◽

Acute Ischemic Stroke ◽

Creatinine Level ◽

Kidney Injury ◽

Vascular Pathology ◽

Baseline Serum ◽

Iodinated Contrast

BackgroundCombining non-contrast CT (NCCT), CT angiography (CTA), and CT perfusion (CTP) imaging (referred to as a CT stroke study, CTSS) provides a rapid evaluation of the cerebrovascular axis during acute ischemic stroke. Iodinated contrast-enhanced CT imaging is not without risk, which includes renal injury. If a patient's CTSS identifies vascular pathology, digital subtraction angiography (DSA) is often performed within 24–48 h. Such patients may receive multiple administrations of iodinated contrast material over a short time period.ObjectiveWe aimed to evaluate the incidence of acute kidney injury (AKI) in patients who underwent a CTSS and DSA for evaluation of acute ischemic symptoms or for stroke intervention within a 48 h period between August 2012 and December 2014.MethodsWe identified 84 patients for inclusion in the analysis. Patients fell into one of two cohorts: AKI, defined as a rise in the serum creatinine level of ≥0.5 mg/dL from baseline, or non-AKI. Clinical parameters included pre- and post-imaging serum creatinine level, time between CTSS and DSA, and type of angiographic procedure (diagnostic vs intervention) performed.ResultsFour patients (4.7%) experienced AKI, one of whom had baseline renal dysfunction (defined as baseline serum creatinine level ≥1.5 mg/dL). The mean difference between baseline and peak creatinine values was found to be significantly greater in patients with AKI than in non-AKI patients (1.65 vs −0.09, respectively; p=0.0008).ConclusionsThis study provides preliminary evidence of the safety and feasibility of obtaining CTSS with additional DSA imaging, whether for diagnosis or intervention, to identify possible acute ischemic stroke.

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