scholarly journals The Prevalence, Risk Factors and Prognosis of Acute Kidney Injury after Lung Transplantation: A Single-center Cohort Study in China

2020 ◽  
Author(s):  
Ling Sang ◽  
Sibei Chen ◽  
Lingbo Nong ◽  
Yonghao Xu ◽  
Haichong Zheng ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Survival Rate ◽  
Lung Transplantation ◽  
Kidney Injury ◽  
Apache Ii Score ◽  
Single Center ◽  
Short Term ◽  
Stage 1

Abstract Background To evaluate the incidence, risk factors, and prognosis of acute kidney injury (AKI) after lung transplantation (LTx). Methods Records of patients who underwent LTx in a single center were retrospectively reviewed. The prevalence of post-transplant AKI, the use of continuous renal replacement therapy (CRRT), and the risk factors for AKI were investigated. The impact of AKI and CRRT on short-term outcomes and long-term survival was measured. Results 148 patients were included with 67 cases developed post-operative AKI. 31 patients underwent CRRT; the percentage of CRRT was 6.2%, 0%, 10% and 86.2% in no-AKI, and stage 1, 2 and 3 AKI, respectively. Patients with AKI had significantly higher ICU mortality and in-hospital mortality. The 1-year post-LTx survival rate of patients with AKI was 47.8%, significantly lower than those without (74.1%). There was no difference in the 1-year survival rate of those with stage 1 and stage 2 AKI, but patients with stage 3 AKI showed the worst survival. Patients who underwent CRRT had an inferior survival outcome (9.7% vs. 76.1%, P < 0.05). We found that higher APACHE II score (OR 1.082, P = 0.009), and higher intraoperative fluid balance (OR 1.001, P = 0.012) were independent risk factors, and female (OR 2.539) and pulmonary hypertension (OR 2.869) were potential risk factors for post-LTx AKI. A prediction model integration of the above factors showed a good concordance with actual risks and had a C-index of 0.76 (95% CI, 0.66–0.87). Conclusion Severe AKI which needed CRRT had a negative impact on the short-term and long-term outcomes.

scholarly journals ACUTE KIDNEY INJURY AFTER LUNG TRANSPLANTATION: PERIOPERATIVE RISK FACTORS AND OUTCOME

2019 ◽  
Author(s):  
Enora Atchade ◽  
Samira Barour ◽  
Alexy Tran-Dinh ◽  
Sylvain Jean-Baptiste ◽  
Sébastien Tanaka ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Multivariate Analysis ◽  
Lung Transplantation ◽  
Kidney Injury ◽  
Short Term ◽  
Factors Associated ◽  
Icu Stay ◽  
Long Term Mortality

Abstract BACKGROUND Acute kidney injury (AKI) is associated with increased short-term and long-term mortality and morbidity after lung transplantation (LT). The primary objective of this study was to analyze the perioperative factors associated with AKI according to KDIGO criteria during hospitalization in an intensive care unit (ICU) after LT. METHODS This was a single-center observational, prospective study. AKI was defined according to KDIGO criteria. Results are expressed as median, interquartile range, absolute numbers and percentages. Statistical analyses were performed using Chi-square test, Fisher’s exact test and Mann-Witney U test (p<0.05 was considered to be significant). Multivariate analysis was performed to identify independent risk factors. RESULTS Between January 2016 and April 2018, 94 patients (pts) underwent LT (70% bilateral LT). AKI occurred during ICU stay in 46 pts (49%). KDIGO 1 AKI was observed in 16 pts (17%), KDIGO 2 in 14 pts (15%), and KDIGO 3 in 16 pts (17%) including 12 pts (75%) who required renal replacement therapy (RRT). AKI occurred before the fifth day after surgery for 38 patients (82% of the AKI patients). On multivariate analysis, independent factors associated with AKI were bilateral LT and mechanical ventilation (MV) > 3 days (OR 4.26 95%CI [1.49; 13.63] p=0.010 and OR 5.56 [1.25; 11.47] p=0.018, respectively). AKI and the need for RRT were significantly associated with ICU mortality, 28-day mortality and one-year mortality. CONCLUSION AKI is common during ICU stay after LT, especially after bilateral LT and is associated with prolonged MV, and increased short-term and long-term mortality.

Short-term and long-term outcomes of acute kidney injury after lung transplantation

2012 ◽  
Vol 31 (3) ◽  
pp. 244-251 ◽  
Author(s):  
Edgard Wehbe ◽  
Rachel Brock ◽  
Marie Budev ◽  
Meng Xu ◽  
Sevag Demirjian ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Lung Transplantation ◽  
Kidney Injury ◽  
Long Term Outcomes ◽  
Short Term

scholarly journals Incidence, Risk Factors and Clinical Outcomes of Acute Kidney Injury after Heart Transplantation: A Retrospective Single Center Study.

2020 ◽  
Author(s):  
Yiyao Jiang ◽  
Xiangrong Kong
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Heart Transplantation ◽  
Urine Volume ◽  
Kidney Injury ◽  
Single Center ◽  
Term Survival ◽  
Long Term Survival ◽  
One Year

Abstract Objectives This study aimed to identify the incidence rate of Acute kidney injury (AKI) in our center, assess risk factors for one-year mortality, and predict short- and long-term survival after heart transplantation (HTx). Methods This single-center, retrospective study from October 2009 to Jan 2020 analyzed the pre-, intra-, and postoperative characteristics of 87 patients who underwent HTx. AKI was defined according to the Kidney Disease: Improving Global Outcomes (KDIGO) criteria. Risk factors were analyzed by multivariable logistic regression models. The log-rank test was used to compare long-term survival. Results Twenty-six (36.1%) patients developed AKI. The one-year mortality rates in HTx patients with and without AKI were 26.92% and 10.87%, respectively (P > 0.05). Recipients who required renal replacement therapy (RRT) had a one-year mortality rate of 53.85% compared to 10.87% in those without AKI or RRT (P = 0.003). A long cardiopulmonary bypass (CPB) time (OR: 1.622, 95% CI: 1.014 to 2.595, P = 0.044) was positively related to the occurrence of AKI. A high intraoperative urine volume (OR: 0.566, 95% CI: 0.344 to 0.930, P = 0.025) was negatively correlated with AKI. AKI requiring RRT (HR, 6.402; 95% CI, 2.014–20.355, P = 0.002) was a risk factor for death. Overall survival in patients without AKI at 1, 3, and 5 years was higher than that in patients with AKI (P > 0.05). Conclusions AKI is common after HTx and adversely impacts early mortality. A long CPB time and low intraoperative urine volume maybe associated with the occurrence of AKI. AKI requiring RRT could contribute powerful prognostic information to predict short-term survival.

scholarly journals Incidence, risk factors and clinical outcomes of acute kidney injury after heart transplantation: a retrospective single center study

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Yi-Yao Jiang ◽  
Xiang-Rong Kong ◽  
Fen-Long Xue ◽  
Hong-Lei Chen ◽  
Wei Zhou ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Hospital Mortality ◽  
Heart Transplantation ◽  
Urine Volume ◽  
Kidney Injury ◽  
Single Center ◽  
Term Survival ◽  
Long Term Survival

Abstract Objectives This study aimed to identify the incidence rate of Acute kidney injury (AKI) in our center and predict in-hospital mortality and long-term survival after heart transplantation (HTx). Methods This single-center, retrospective study from October 2009 and March 2020 analyzed the pre-, intra-, and postoperative characteristics of 95 patients who underwent HTx. AKI was defined according to the Kidney Disease: Improving Global Outcomes (KDIGO) criteria. Risk factors were analyzed by multivariable logistic regression models. The log-rank test was used to compare long-term survival. Results Thirty-three (34.7%) patients developed AKI. The mortality in hospital in HTx patients with and without AKI were 21.21 and 6.45%, respectively (P < 0.05). Recipients in AKI who required renal replacement therapy (RRT) had a hospital mortality rate of 43.75% compared to 6.45% in those without AKI or RRT (P < 0.0001). A long cardiopulmonary bypass (CPB) time (OR:11.393, 95% CI: 2.183 to 59.465, P = 0.0039) was positively related to the occurrence of AKI. A high intraoperative urine volume (OR: 0.031, 95% CI: 0.005 to 0.212, P = 0.0004) was negatively correlated with AKI. AKI requiring RRT (OR, 11.348; 95% CI, 2.418–53.267, P = 0.002) was a risk factor for mortality in hospital. Overall survival in patients without AKI at 1 and 3 years was not different from that in patients with AKI (P = 0.096). Conclusions AKI is common after HTx. AKI requiring RRT could contribute powerful prognostic information to predict mortality in hospital. A long CPB time and low intraoperative urine volume are associated with the occurrence of AKI.

scholarly journals Diagnostics, Risk Factors, Treatment and Outcomes of Acute Kidney Injury in a New Paradigm

2020 ◽  
Vol 9 (4) ◽  
pp. 1104 ◽  
Author(s):  
Charat Thongprayoon ◽  
Panupong Hansrivijit ◽  
Karthik Kovvuru ◽  
Swetha R. Kanduri ◽  
Aldo Torres-Ortiz ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Kidney Injury ◽  
New Paradigm ◽  
Short Term ◽  
Clinical Environments ◽  
Personalized Approach ◽  
The Impact ◽  
Long Term Mortality

Acute kidney injury (AKI) is a common clinical condition among patients admitted in the hospitals. The condition is associated with both increased short-term and long-term mortality. With the development of a standardized definition for AKI and the acknowledgment of the impact of AKI on patient outcomes, there has been increased recognition of AKI. Two advances from past decades, the usage of computer decision support and the discovery of AKI biomarkers, have the ability to advance the diagnostic method to and further management of AKI. The increasingly widespread use of electronic health records across hospitals has substantially increased the amount of data available to investigators and has shown promise in advancing AKI research. In addition, progress in the finding and validation of different forms of biomarkers of AKI within diversified clinical environments and has provided information and insight on testing, etiology and further prognosis of AKI, leading to future of precision and personalized approach to AKI management. In this this article, we discussed the changing paradigms in AKI: From mechanisms to diagnostics, risk factors, and management of AKI.

scholarly journals Incidence, Risk Factors and Clinical Outcomes of Acute Kidney Injury after Heart Transplantation: A Retrospective Single Center Study.

2020 ◽  
Author(s):  
Yiyao Jiang ◽  
Xiangrong Kong ◽  
Fenlong Xue ◽  
Honglei Chen ◽  
Wei Zhou ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Hospital Mortality ◽  
Heart Transplantation ◽  
Urine Volume ◽  
Kidney Injury ◽  
Single Center ◽  
Term Survival ◽  
Long Term Survival

Abstract Objectives: This study aimed to identify the incidence rate of Acute kidney injury (AKI) in our center and predict in-hospital mortality and long-term survival after heart transplantation (HTx). Methods: This single-center, retrospective study from October 2009 and March 2020 analyzed the pre-, intra-, and postoperative characteristics of 95 patients who underwent HTx. AKI was defined according to the Kidney Disease: Improving Global Outcomes (KDIGO) criteria. Risk factors were analyzed by multivariable logistic regression models. The log-rank test was used to compare long-term survival. Results: : Thirty-three (34.7%) patients developed AKI. The mortality in hospital in HTx patients with and without AKI were 21.21% and 6.45%, respectively (P<0.05). Recipients in AKI who required renal replacement therapy (RRT) had a hospital mortality rate of 43.75% compared to 6.45% in those without AKI or RRT (P<0.0001). A long cardiopulmonary bypass (CPB) time (OR:11.393, 95% CI: 2.183 to 59.465, P=0.0039) was positively related to the occurrence of AKI. A high intraoperative urine volume (OR: 0.031, 95% CI: 0.005 to 0.212, P=0.0004) was negatively correlated with AKI. AKI requiring RRT (OR, 11.348; 95% CI, 2.418-53.267, P=0.002) was a risk factor for mortality in hospital. Overall survival in patients without AKI at 1 and 3 years was not different from that in patients with AKI (P=0.096).Conclusions: AKI is common after HTx. AKI requiring RRT could contribute powerful prognostic information to predict mortality in hospital. A long CPB time and low intraoperative urine volume are associated with the occurrence of AKI.

scholarly journals Assessment of Kidney Function After Transcatheter Aortic Valve Replacement

2021 ◽  
Vol 8 ◽  
pp. 205435812110180
Author(s):  
Orit Kliuk-Ben Bassat ◽  
Sapir Sadon ◽  
Svetlana Sirota ◽  
Arie Steinvil ◽  
Maayan Konigstein ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Renal Function ◽  
Kidney Function ◽  
Transcatheter Aortic Valve Replacement ◽  
Kidney Injury ◽  
Single Center ◽  
Transcatheter Aortic Valve ◽  
Single Center Study ◽  
Center Study

Background: Transcatheter aortic valve replacement (TAVR), although associated with an increased risk for acute kidney injury (AKI), may also result in improvement in renal function. Objective: The aim of this study is to evaluate the magnitude of kidney function improvement (KFI) after TAVR and to assess its significance on long-term mortality. Design: This is a prospective single center study. Setting: The study was conducted in cardiology department, interventional unit, in a tertiary hospital. Patients: The cohort included 1321 patients who underwent TAVR. Measurements: Serum creatinine level was measured at baseline, before the procedure, and over the next 7 days or until discharge. Methods: Kidney function improvement was defined as the mirror image of AKI, a reduction in pre-procedural to post-procedural minimal creatinine of more than 0.3 mg/dL, or a ratio of post-procedural minimal creatinine to pre-procedural creatinine of less than 0.66, up to 7 days after the procedure. Patients were categorized and compared for clinical endpoints according to post-procedural renal function change into 3 groups: KFI, AKI, or preserved kidney function (PKF). The primary endpoint was long-term all-cause mortality. Results: The incidence of KFI was 5%. In 55 out of 66 patients patients, the improvement in kidney function was minor and of unclear clinical significance. Acute kidney injury occurred in 19.1%. Estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2 was a predictor of KFI after multivariable analysis (odds ratio = 0.93 to develop KFI; confidence interval [95% CI]: 0.91-0.95, P < .001). Patients in the KFI group had a higher Society of Thoracic Surgery (STS) score than other groups. Mortality rate did not differ between KFI group and PKF group (43.9% in KFI group and 33.8% in PKF group) but was significantly higher in the AKI group (60.7%, P < .001). Limitations: The following are the limitations: heterozygous definitions of KFI within different studies and a single center study. Although data were collected prospectively, analysis plan was defined after data collection. Conclusions: Improvement in kidney function following TAVR was not a common phenomenon in our cohort and did not reduce overall mortality rate.

scholarly journals Acute kidney injury in children hospitalized for acute gastroenteritis: prevalence and risk factors

2021 ◽  
Author(s):  
Pierluigi Marzuillo ◽  
Maria Baldascino ◽  
Stefano Guarino ◽  
Silverio Perrotta ◽  
Emanuele Miraglia del Giudice ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Acute Gastroenteritis ◽  
Kidney Injury ◽  
Normative Values ◽  
Serum Bicarbonate ◽  
Duration Of Symptoms ◽  
Logistic Regression Models ◽  
Early Predictors ◽  
Stage 1

Abstract Background We aimed to evaluate prevalence of acute kidney injury (AKI) and its risk factors in children hospitalized for acute gastroenteritis (AGE) to identify early predictors of AKI. Methods We retrospectively collected clinical and biochemical data of 114 children (57.9% male; mean age 2.9 ± 2.8 years) hospitalized for AGE. AKI was defined according to Kidney Disease/Improving Global Outcomes creatinine criteria. We considered basal serum creatinine as value of creatinine estimated with Hoste (age) equation assuming basal eGFRs were median age-based eGFR normative values for children ≤ 2 years of age, and eGFR 120 mL/min/1.73m2 for children > 2 years. Univariate and multivariate logistic regression models were used to explore associations with AKI. We included in multivariate analyses only variables with significant p after Bonferroni correction. Results AKI was found in 28/114 (24.6%) patients. No patients required hemodialysis, 2 (1.8%) reached AKI stage 3, 2 (1.8%) AKI stage 2, and 24 (21.0%) AKI stage 1. Mean length of stay was 3.6 ± 1.2, 5.0 ± 1.8, and 10.5 ± 5.8 days, for patients with no, mild, and severe AKI (p < 0.001), respectively. Duration of symptoms before hospitalization (OR = 2.5; 95% CI = 1.3–5.0; p = 0.006), dehydration > 5% (OR = 43.1; 95% CI = 5.4–344.1; p = < 0.001), and serum bicarbonate levels (OR = 1.6; 95% CI = 1.2–2.1; p = 0.001) were independent predictors of AKI. Conclusions About one quarter of patients hospitalized for AGE may suffer from AKI with a longer stay for patients with more severe AKI. Particular attention, however, should be paid to volemia and kidney health of patients with AGE especially in the presence of increased duration of symptoms before hospitalization, dehydration, and lower serum bicarbonate levels. Graphical abstract

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