scholarly journals Biomarker Rule-in or Rule-out in Patients With Acute Diseases for Validation of Acute Kidney Injury in the Emergency Department (BRAVA): A Multicenter Study Evaluating Urinary TIMP-2/IGFBP7

2022 ◽  
Vol 42 (2) ◽  
pp. 178-187
Hyun Suk Yang ◽  
Mina Hur ◽  
Kyeong Ryong Lee ◽  
Hanah Kim ◽  
Hahn Young Kim ◽  
2020 ◽  
Vol 5 (11) ◽  
pp. 1982-1992
Jacob S. Stevens ◽  
Katherine Xu ◽  
Alexa Corker ◽  
Tejashree S. Gopal ◽  
Osman R. Sayan ◽  

2011 ◽  
Vol 39 (6) ◽  
pp. 1493-1499 ◽  
Simon Li ◽  
Catherine D. Krawczeski ◽  
Michael Zappitelli ◽  
Prasad Devarajan ◽  
Heather Thiessen-Philbrook ◽  

2021 ◽  
Vol 50 (Supplement_1) ◽  
pp. i12-i42
C McCann ◽  
A Hall ◽  
J Min Leow ◽  
A Harris ◽  
N Hafiz ◽  

Abstract Background Acute kidney injury (AKI) in hip fracture patients is associated with morbidity, mortality, and increased length of stay. To avoid this our unit policy recommends maintenance crystalloid IV fluids of >62.5 mL/Hr for hip fracture patients. However, audits have shown that many patients still receive inadequate IV fluids. Methods Three prospective audits, each including 100 consecutive acute hip fracture patients aged >55, were completed with interventional measures employed between each cycle. Data collection points included details of IV fluid administration and pre/post-operative presence of AKI. Interventions between cycles included a revised checklist for admissions with a structured ward round tool for post-take ward round and various educational measures for Emergency Department, nursing and admitting team staff with dissemination of infographic posters, respectively. Results Cycle 1: 64/100 (64%) patients received adequate fluids. No significant difference in developing AKI post operatively was seen in patients given adequate fluids (2/64, 3.1%) compared to inadequate fluids (4/36, 11.1%; p = 0.107). More patients with pre-operative AKI demonstrated resolution of AKI with appropriate fluid prescription (5/6, 83.3%, vs 0/4, 0%, p < 0.05) Cycle 2: Fewer patients were prescribed adequate fluids (54/100, 54%). There was no significant difference in terms of developing AKI post operatively between patients with adequate fluids (4/54, 7.4%) or inadequate fluids (2/46, 4.3%; p = 0.52). Resolution of pre-operative AKI was similar in patients with adequate or inadequate fluid administration (4/6, 67% vs 2/2, 100%). Cycle 3: More patients received adequate fluids (79/100, 79%, p < 0.05). Patients prescribed adequate fluids were less likely to develop post-operative AKI than those receiving inadequate fluids (2/79, 2.5% vs 3/21, 14.3%; p < 0.05). Discussion This audit demonstrates the importance of administering appropriate IV fluid in hip fracture patients to avoid AKI. Improving coordination with Emergency Department and ward nursing/medical ward staff was a critical step in improving our unit’s adherence to policy.

2020 ◽  
pp. 102490792091339
Seda Dağar ◽  
Emine Emektar ◽  
Hüseyin Uzunosmanoğlu ◽  
Şeref Kerem Çorbacıoğlu ◽  
Özge Öztekin ◽  

Background: Despite its risks associated with renal injury, intravenous contrast media increases diagnostic efficacy and hence the chance of early diagnosis and treatment, which leaves clinicians in a dilemma regarding its use in emergency settings. Objective: The aim of this study was to determine the risk and predictors of contrast-induced acute kidney injury following intravenous contrast media administration for computed tomography in the emergency department. Methods: All patients aged 18 years and older who had a basal creatinine measurement within the last 8 h before contrast-enhanced computed tomography and a second creatinine measurement within 48–72 h after computed tomography scan between 1 January 2015 and 31 December 2017 were included in the study. Characteristics of patients with and without contrast-induced acute kidney injury development were compared. Multivariate regression analysis was used to assess the predictors for contrast-induced acute kidney injury. Results: A total of 631 patients were included in the final statistical analysis. After contrast media administration, contrast-induced acute kidney injury developed in 4.9% ( n = 31) of the patients. When the characteristics of patients are compared according to the development of contrast-induced acute kidney injury, significant differences were detected for age, initial creatinine, initial estimated glomerular filtration rate, and all acute illness severity indicators (hypotension, anemia, hypoalbuminemia, and need for intensive care unit admission). A multivariate logistic regression analysis was performed. The need for intensive care unit admission (odds ratio: 6.413 (95% confidence interval: 1.709–24.074)) and hypotension (odds ratio: 5.575 (95% confidence interval: 1.624–19.133)) were the main factors for contrast-induced acute kidney injury development. Conclusion: Our study results revealed that hypotension, need for intensive care, and advanced age were associated with acute kidney injury in patients receiving contrast media. Therefore, we believe that to perform contrast-enhanced computed tomography in emergency department should not be decided only by checking for renal function tests and that these predictors should be taken into consideration.

2018 ◽  
Vol 19 (1) ◽  
Paulo Ricardo Gessolo Lins ◽  
Wallace Stwart Carvalho Padilha ◽  
Carolina Frade Magalhaes Giradin Pimentel ◽  
Marcelo Costa Batista ◽  
Aécio Flávio Teixeira de Gois

2011 ◽  
Vol 70 (2) ◽  
pp. 203-207 ◽  
Asad I Mian ◽  
Yue Du ◽  
Harsha K Garg ◽  
A Chantal Caviness ◽  
Stuart L Goldstein ◽  

2021 ◽  
Vol 29 (1) ◽  
pp. 82-84
Gregor Lindner ◽  
Adrian Wolfensberger ◽  
Aristomenis K. Exadaktylos ◽  
Christoph Schwarz ◽  
Georg-Christian Funk ◽  

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