scholarly journals Respiratory and nonrespiratory COVID-19 complications in patients with obesity: recent developments

2022 ◽  
Author(s):  
Esther Liu ◽  
Hudson Lee ◽  
Briana Lui ◽  
Robert S White ◽  
Jon D Samuels
Keyword(s):  
Intensive Care Unit ◽  
Acute Kidney Injury ◽  
Risk Factor ◽  
Cardiac Injury ◽  
Kidney Injury ◽  
Severe Pneumonia ◽  
Increased Risk ◽  
Recent Developments ◽  
Pubmed Search ◽  
Future Work

This narrative review summarizes recent reports to provide an updated understanding of the multiorgan effects of SARS-CoV-2 infection in obese individuals. A PubMed search of 528 primary articles was performed, with inclusion based on novelty, relevance and redundancy. Obesity confers an increased risk for hospitalization, intensive care unit admission, severe pneumonia, intubation and acute kidney injury in COVID-19 patients. Obesity is also associated with higher levels of inflammatory and thrombotic markers. However, the associations between obesity and mortality or cardiac injury in COVID-19 patients remain unclear. Obesity is a risk factor for several respiratory and nonrespiratory COVID-19 complications. Future work is needed to further explore these relationships and optimize the management of obese COVID-19 patients.

scholarly journals Etiology & Outcome of Acute kidney Injury in Intensive Care Unit Settings of a Tertiary Care Hospital

2020 ◽  
Vol 4 (2) ◽  
pp. 01-05
Author(s):  
Hassan Mumtaz
Keyword(s):  
Intensive Care Unit ◽  
Acute Kidney Injury ◽  
Risk Factor ◽  
Intensive Care ◽  
Tertiary Care ◽  
Hospital Setting ◽  
Kidney Injury ◽  
Morbidity And Mortality ◽  
High Morbidity ◽  
Care Hospital

Introduction: Acute kidney injury (AKI) is defined as a rapid loss of kidney function occurring over few hours or days. In intensive care unit settings, acute kidney injury (AKI) is a very prevalent condition as most of the patients who are admitted in intensive care units are critically ill. The incidence of acute kidney injury is increasing throughout the world mainly because of aging population and co morbidities which are associated with aging. In intensive care unit settings, the incidence of AKI may reach up to 67%. Though AKI effects depend on clinical situation yet associated with high morbidity and mortality. The rationale of this study is that, as acute kidney is one of major factors contributing in mortality and morbidity of ICU patients, this study will be helpful in identifying important risk factor for development of acute kidney injury in ICU settings, leading to its early detection and thus decreasing associated morbidity and mortality. Objective: To determine the frequency of etiology and outcome of acute kidney injury in medical intensive care unit of KRL Hospital. Setting: Medical ICU, KRL Hospital, Islamabad. Duration: six months from 17th May 2017 to 17th November 2017. Study design: Descriptive case series. Material and method: In this study 118 patients were observed. After screening and application of exclusion criteria, a total of 118 patients who were fulfilling the inclusion criteria were selected as the study sample and were included in the final analysis regarding prevalence of risk factors associated with AKI and the outcome associated with AKI. AKI was further classified using acute kidney injury network (AKIN) classification system. Patient age, gender, serum creatinine, etiology and outcome in form of recovery or mortality was recorded. Results: Overall incidence of AKI in ICU settings in this study was 37.8% (n=118). Out of 118 patients who had AKI, 59.3% (n=70) were male, whereas 40.7% (n=48) were females. Most common risk factor associated with development of AKI was sepsis secondary to infectious illnesses and 39% (n=46) of the patients who developed AKI were suffering from infectious illnesses. Gastrointestinal, drugs and cardiac causes constitutes the 32.2 % (n=38), 18.6% (n=22) and 10.2% (n=12) respectively of the AKI in ICU settings. In terms of outcome, mortality rate in patients with AKI was significantly higher as compared to patients without AKI(P =<0.001) and 56.8%(n=67) of the patients who had AKI died during their ICU stay as compared to 30.4%(n=59) in patients without AKI. Conclusion: Our study concludes that the frequency of etiology including infectious causes was 39%, cardiac pathology 10%, GI causes 32%, drugs was 19% and mortality was 56.8% in patients with acute kidney injury.

scholarly journals Hypertension as a Risk Factor for Contrast-Associated Acute Kidney Injury: A Meta-Analysis Including 2,830,338 Patients

2021 ◽  
pp. 1-23
Author(s):  
Zhubin Lun ◽  
Ziling Mai ◽  
Liwei Liu ◽  
Guanzhong Chen ◽  
Huanqiang Li ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Risk Factor ◽  
Meta Analysis ◽  
Kidney Injury ◽  
Cochrane Database ◽  
Number Of Patients ◽  
Increased Risk ◽  
Random Models ◽  
Definition Of ◽  
The Relationship

<b><i>Objective:</i></b> Previous studies have shown that the relationship between hypertension (HT) and contrast-associated acute kidney injury (CA-AKI) is not clear. We apply a systematic review and meta-analysis to assess the association between HT and CA-AKI. <b><i>Methods:</i></b> We searched for articles on the study of risk factors for CA-AKI in the Embase, Medline, and Cochrane Database of Systematic Reviews (by March 25, 2021). Two authors independently performed quality assessment and extracted data such as the studies’ clinical setting, the definition of CA-AKI, and the number of patients. The CA-AKI was defined as a serum creatinine (SCr) increase ≥25% or ≥0.5 mg/dL from baseline within 72 h. We used fixed or random models to pool adjusted OR (aOR) by STATA. <b><i>Results:</i></b> A total of 45 studies (2,830,338 patients) were identified, and the average incidence of CA-AKI was 6.48%. There was an increased risk of CA-AKI associated with HT (aOR: 1.378, 95% CI: 1.211–1.567, <i>I</i><sup>2</sup> = 67.9%). In CA-AKI with a SCr increase ≥50% or ≥0.3 mg/dL from baseline within 72 h, an increased risk of CA-AKI was associated with HT (aOR: 1.414, 95% CI: 1.152–1.736, <i>I</i><sup><i>2</i></sup> = 0%). In CA-AKI with a Scr increase ≥50% or ≥0.3 mg/dL from baseline within 7 days, HT increases the risk of CA-AKI (aOR: 1.317, 95% CI: 1.049–1.654, <i>I</i><sup><i>2</i></sup> = 51.5%). <b><i>Conclusion:</i></b> Our meta-analysis confirmed that HT is an independent risk factor for CA-AKI and can be used to identify risk stratification. Physicians should pay more attention toward prevention and treatment of patients with HT in clinical practice.

scholarly journals Clinical characteristics of 34 COVID-19 patients admitted to ICU in Hangzhou, China

2020 ◽  
Author(s):  
Yi Zheng ◽  
Lijun Sun ◽  
Mi Xu ◽  
Jian Pan ◽  
Yuntao Zhang ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Mechanical Ventilation ◽  
Acute Kidney Injury ◽  
Clinical Characteristics ◽  
Acute Liver Injury ◽  
Invasive Mechanical Ventilation ◽  
Cardiac Injury ◽  
Kidney Injury ◽  
Progressive Decrease ◽  
Complications Rate

AbstractIntroductionThe purpose of the study was to summarize the clinical and laboratory characteristics of the coronavirus disease 2019 patients admitted to intensive care unit.MethodsWe tracked the data until March 5, 2020. The cases in our cohort were divided into cases only received noninvasive ventilation (NIV) and cases required invasive mechanical ventilation (IMV). The characteristics between the two groups were compared.Results34 cases were included in the study. The complications rate (including, acute liver injury, acute cardiac injury and acute kidney injury) were higher in IMV cases. Lymphocytopenia and neutrophilia occurred in most cases in both groups on the admission day, however, lymphocyte levels dropped progressively and more severe lymphopenia occurred in IMV group. Increased amounts of plasma IL-6 and IL-10 were found in both groups on the admission day, the progressive decrease of which occurred in NIV cases rather than IMV cases, and the levels were higher in IMV cases during hospitalization.ConclusionsLymphocytopenia, neutrophilia, and increase of IL-6 and IL-10 occurred in SARS-CoV-2 infected patients in ICU, however, the dynamics of those were significantly different in IMV cases and NIV cases during hospitalization.

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 Ureteral stone with hydronephrosis and urolithiasis alone are risk factors for acute kidney injury in patients with urinary tract infection

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Chih-Yen Hsiao ◽  
Tsung-Hsien Chen ◽  
Yi-Chien Lee ◽  
Ming-Cheng Wang
Keyword(s):  
Acute Kidney Injury ◽  
Urinary Tract Infection ◽  
Risk Factor ◽  
Urinary Tract ◽  
Tract Infection ◽  
Care Setting ◽  
Ureteral Stone ◽  
Multivariate Logistic Regression Analysis ◽  
Kidney Injury ◽  
Increased Risk

AbstractTo identify whether urolithiasis with or without hydronephrosis has an impact on acute kidney injury (AKI) in patients with urinary tract infection (UTI). This study aimed to identify whether urolithiasis with or without hydronephrosis has an impact on AKI in patients with UTI. This retrospective study enrolled hospitalized UTI patients who underwent imaging in an acute care setting from January 2006 to April 2019. Of the 1113 participants enrolled, 191 (17.2%) had urolithiasis and 76 (6.8%) had ureteral stone complicated with hydronephrosis. Multivariate logistic regression analysis showed that in UTI patients with urolithiasis, the presence of ureteral stone with concomitant hydronephrosis was an independent risk factor for AKI (odds ratio [OR] 2.299, 95% confidence interval [CI] 1.112–4.755, P = 0.025). In addition, urolithiasis was associated with an increased risk for AKI (OR 2.451, 95% CI 1.369–4.389, P = 0.003) in UTI patients without hydronephrosis. The presence of ureteral stone with hydronephrosis increases the risk for AKI of UTI patients with urolithiasis, and urolithiasis remains a risk factor of AKI in UTI patients without hydronephrosis.

scholarly journals Impact of urolithiasis and hydronephrosis on acute kidney injury in patients with urinary tract infection

2020 ◽  
Author(s):  
Chih-Yen Hsiao ◽  
Tsung-Hsien Chen ◽  
Yi-Chien Lee ◽  
Ming-Cheng Wang
Keyword(s):  
Acute Kidney Injury ◽  
Urinary Tract Infection ◽  
Risk Factor ◽  
Urinary Tract ◽  
Tract Infection ◽  
Ureteral Stone ◽  
Urinary Tract Obstruction ◽  
Multivariate Logistic Regression Analysis ◽  
Kidney Injury ◽  
Increased Risk

AbstractBackgroundUrolithiasis is a common cause of urinary tract obstruction and urinary tract infection (UTI). This study aimed to identify whether urolithiasis with or without hydronephrosis has an impact on acute kidney injury (AKI) in patients with UTI.Methods and findingsThis retrospective study enrolled hospitalized UTI patients who underwent imaging in an acute care setting from January 2006 to April 2019. Of the 1113 participants enrolled, 191 (17.2%) had urolithiasis and 76 (6.8%) had ureteral stone complicated with hydronephrosis. Multivariate logistic regression analysis showed that in UTI patients with urolithiasis, the presence of ureteral stone with concomitant hydronephrosis was an independent risk factor for AKI (odds ratio [OR] 2.345, 95% confidence interval [CI] 1.128–4.876, P = 0.023). In addition, urolithiasis was associated with an increased risk for AKI (OR 2.484, 95% CI 1.398–4.415, P = 0.002) in UTI patients without hydronephrosis.ConclusionThe presence of ureteral stone with hydronephrosis increases the risk for AKI of UTI patients with urolithiasis, and urolithiasis remains a risk factor of AKI in UTI patients without hydronephrosis.

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