scholarly journals Potensi Ekstrak Bunga Telang (Clitoria ternatea) Sebagai Pencegah Acute Kidney Injury (AKI)

2020 ◽  
Vol 1 (2) ◽  
pp. 92-100
Author(s):  
Ersalita Rahmadhani Pratiwi ◽  
Sukma Oktavia Aulia Rahmandani ◽  
Achmad Rivaldy Ibrahim ◽  
Isbandiyah Isbandiyah
Keyword(s):  
Acute Kidney Injury ◽  
Literature Search ◽  
Ornamental Plants ◽  
Kidney Injury ◽  
Good Alternative ◽  
Antioxidant Compounds ◽  
Toxic Substances ◽  
Clitoria Ternatea ◽  
Incidence And Mortality ◽  
Butterfly Pea

Introduction: Butterfly pea (Clitoria ternatea) is a vine that has various colors such as pink, light blue, white, and purple. This plant is commonly used as a food coloring and ornamental plants. Butterfly pea has pharmacological potential, among others, as high antioxidants. The antioxidants of the butterfly pea show much higher activity than other flowers. Antioxidants are substances that can prevent the occurrence of Acute Kidney Injury (AKI), which is currently increasing in incidence and mortality due to AKI reaching 23.9% in adults and 13.8% in children. Aim of study: This article aims to discuss the potential of butterfly pea extract (Clitoria ternatea) as a preventative for Acute Kidney Injury (AKI). Method: The research method used is the literature search technique on 20 articles from the Google Scholar database. Results and Discussion: The results of the literature search show that the butterfly pea (Clitoria ternatea) has antioxidant compounds that have the potential to prevent the occurrence of acute kidney injury (AKI). Butterfly pea extract has the potential to reduce levels of urea, serum creatinine, reduce levels of malondialdehyde (MDA) and increase levels of glutathione, catalase, and superoxide dismutase (SOD). The antioxidant activity of flavonoids and tannins in butterfly pea extract was found to have a nephroprotective effect against exposure to toxic substances. Conclusion: The conclusion from this literature search is that the antioxidant content contained in butterfly pea extract can be a good alternative as a nephroprotector to prevent AKI.

The Significance of “Fractional Excretion of Urea” in The Differential Diagnosis of Acute Kidney Injury in Cirrhotic Patients

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Sameh Mohamed Ghaly ◽  
Moataz Serry Seyam ◽  
Mohamed Osama Aly ◽  
Ahmed Mohamed Hesham Abdelfattah ◽  
Ahmed R. Mashaal
Keyword(s):  
Acute Kidney Injury ◽  
Differential Diagnosis ◽  
Kidney Injury ◽  
Fractional Excretion ◽  
Final Diagnosis ◽  
Good Alternative ◽  
Decompensated Cirrhosis ◽  
Eligibility Criteria ◽  
Significant Difference ◽  
Cirrhotic Patients

Abstract Background Patients with cirrhosis are more susceptible to develop AKI than the non-cirrhotic individuals. AKI has an estimated prevalence of approximately 20% to 50% among hospitalized patients with cirrhosis. Physicians caring for patients with cirrhosis should recognize the acute or chronic character of renal disease, the causes of renal injury, the clinical conditions leading concomitantly to AKI and liver dysfunction, and the prognostic factors associated with the progression of AKI. Hypovolemia (due to diuretics, hemorrhage and diarrhea), acute tubular necrosis (ATN), sepsis, nephrotoxic agents (such as nonsteroidal anti-inflammatory drugs, aminoglycosides and/or radiological contrasts) and hepatorenal syndrome (HRS)-type 1 are the most common causes of AKI in cirrhotic patients. Objective To evaluate the sensitivity of fractional excretion of urea (FEUrea) vas a diagnostic biomarker for different causes of acute kidney injury in liver cirrhosis. Patients and Methods This study was conducted in co-operation between Tropical Medicine Department, Ain-Shams University and the Gastroenterology and Hepatology Department, Theodor Bilharz Research Institute between July 2019 to January 2020. It included 70 adult Egyptian patients admitted for treatment of complications of cirrhosis who fulfilled the eligibility criteria and compared to 10 cirrhotic patients without renal impairment. All patients were subjected to; full history taking, thorough clinical examination, laboratory investigations, Child-Pugh score was calculated for admission and urine samples were collected for urinary urea and creatinine levels to calculate FEUrea. Results Concerning the gender distribution in this study, male to female percent was 40 (57.10%) males and 30 (42.90%) females for gender, respectively. As regards to the causes of AKI, there were 24 (34.30%) PRA, 7 (10.00%) HRS and 39 (55.70%) ATN for final diagnosis. In the current study, there was significant difference (P = 0.0001; P < 0.05) in FE urea % among PRA, HRS and ATN groups (26.28±2.89, 11.76±3.44, and 47.37±10.53, respectively). Findings showed a higher FEUrea cut-off for ATN (>33%) compared to lower cut-off values for PRA (<33% and >21%) and HRS (<21%). Conclusion FEUrea was found to be an excellent simple tool for the differential diagnosis of AKI in patients with decompensated cirrhosis and ascites. FEUrea has also proven to be a useful “tubular injury” marker by differentiating ATN from non-ATN with high diagnostic accuracy (Sensitivity and Specificity exceeding >90%). FEUrea was found to be a good alternative and noninvasive tool for differentiating causes of AKI in cirrhotic patients instead of other non-available or expensive markers.

scholarly journals MO371TIME AND THE ETIOLOGY OF ACUTE KIDNEY INJURY DEFINE PROGNOSIS IN THE COURSE OF COVID-19

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Ahmet Murt ◽  
Mevlut Tamer Dincer ◽  
Cebrail Karaca ◽  
Sinan Trabulus ◽  
Nurhan Seyahi ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Hospital Admissions ◽  
Inflammatory Marker ◽  
Kidney Injury ◽  
Disease Stage ◽  
Immunologic Response ◽  
Electrolyte Disturbances ◽  
Incidence And Mortality ◽  
Depth Analysis ◽  
D Dimer

Abstract Background and Aims Kidneys are among the affected organs in COVID-19 and there may be different etiologies resulting in acute kidney injury (AKI) in different stages of the disease. There have been previous studies focusing on incidence and mortality of AKI in COVID-19 but none has made in depth analysis in relation to the background pathophysiology. Based on previous observations, we hypothesized that all AKIs seen in COVID-19 are not uniform and we aimed to analyze the etiologies and prognosis of AKI among hospitalized COVID-19 patients in relation to the time of AKI during different phases of the disease. Method A total of 1056 patients were admitted to the designated COVID-19 clinics from March to July in 2020. 77 Patients who were younger than 18 years old and 7 kidney transplant patients were excluded from the study. 427 of the remaining patients were confirmed by real time polymerase chain reaction (RT-PCR) test.). As eGFR below 60 mL/min/1,73 m2 was already shown to be related to mortality, these patients (44) were also excluded. As immunologic response is generally accepted to start with the second week of COVID-19 course, patients were classified into three groups, those who had AKI on admission, those who developed AKI in the first week and those who developed AKI starting from 7th day. Initial lymphocyte counts, creatinine levels, electrolytes, acid-base status and changes in the inflammatory markers were compared between the groups. A comparison between patients who survived and who died was also performed. Results 89 of the 383 included COVID-19 patients developed AKI. 24% of those who developed AKI died. Patients who developed AKI later had higher peak CRP and D-dimer levels with lower nadir lymphocyte counts (p=0,000, 0,004 and 0,003 respectively). Additionally, patients who died had higher initial inflammatory marker levels and lower lymphocyte counts than those who survived. Mortality of patients who had AKI on hospital admission (13%) was similar to the overall COVID-19 mortality for inpatients, however it was as high as 44% for those who developed AKI after 7th day. Early AKI was related to pre-renal causes and had a milder course. However, later AKIs were more related to immunologic response and had significantly higher mortality. Patients who died had significantly higher ferritin and d-dimer levels upon their hospital admissions (p=0,000). Electrolyte disturbances, metabolic acidosis and mortality were also higher in patients who developed AKI later. Hypernatremia (OR: 6,5, 95% CI: 3 – 13,9) and phosphorus disturbances (both hyperphosphatemia (OR: 3,3; 95%CI: 1,6 – 6,9) and hypophosphatemia (OR: 3,9; 95% CI: 2,0-7,9)) were related to mortality. Conclusion Findings of this study suggest that AKI in COVID-19 is not of one kind. When developed, AKI should be evaluated in conjunction with the disease stage and possible etiologies

scholarly journals Acute Kidney Injury in Patients Undergoing Cardiac Transplantation: A Meta-Analysis

Medicines ◽  
2019 ◽  
Vol 6 (4) ◽  
pp. 108 ◽  
Author(s):  
Charat Thongprayoon ◽  
Ploypin Lertjitbanjong ◽  
Panupong Hansrivijit ◽  
Anthony Crisafio ◽  
Michael Mao ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Mortality Risk ◽  
Cardiac Transplantation ◽  
Patient Survival ◽  
Meta Analysis ◽  
Solid Organ Transplantation ◽  
Kidney Injury ◽  
Solid Organ ◽  
Short Term ◽  
Incidence And Mortality

Background: Acute kidney injury (AKI) is a common complication following solid-organ transplantation. However, the epidemiology of AKI and mortality risk of AKI among patients undergoing cardiac transplantation is not uniformly described. We conducted this study to assess the incidence of AKI and mortality risk of AKI in adult patients after cardiac transplantation. Methods: A systematic review of EMBASE, MEDLINE, and Cochrane Databases was performed until June 2019 to identify studies evaluating the incidence of AKI (by standard AKI definitions), AKI requiring renal replacement therapy (RRT), and mortality risk of AKI in patients undergoing cardiac transplantation. Pooled AKI incidence and mortality risk from the included studies were consolidated by random-effects model. The protocol for this study is registered with PROSPERO (no. CRD42019134577). Results: 27 cohort studies with 137,201 patients undergoing cardiac transplantation were identified. Pooled estimated incidence of AKI and AKI requiring RRT was 47.1% (95% CI: 37.6–56.7%) and 11.8% (95% CI: 7.2–18.8%), respectively. The pooled ORs of hospital mortality and/or 90-day mortality among patients undergoing cardiac transplantation with AKI and AKI requiring RRT were 3.46 (95% CI, 2.40–4.97) and 13.05 (95% CI, 6.89–24.70), respectively. The pooled ORs of 1-year mortality among patients with AKI and AKI requiring RRT were 2.26 (95% CI, 1.56–3.26) and 3.89 (95% CI, 2.49–6.08), respectively. Conclusion: Among patients undergoing cardiac transplantation, the incidence of AKI and severe AKI requiring RRT are 47.1% and 11.8%, respectively. AKI post cardiac transplantation is associated with reduced short term and 1-year patient survival.

P6438Trends of acute kidney injury following percutaneous coronary interventions

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
A Karrthik ◽  
M Gad ◽  
N Bazarbashi ◽  
K Ahuja ◽  
M Kaur ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Length Of Stay ◽  
Temporal Trends ◽  
Kidney Injury ◽  
Study Patient ◽  
Categorical Variables ◽  
Percutaneous Coronary Interventions ◽  
Coronary Interventions ◽  
Incidence And Mortality ◽  
Percutaneous Coronary

Abstract Introduction Acute kidney injury (AKI) is a significant in-hospital complication in patients undergoing percutaneous coronary interventions (PCI) and has been shown to be associated with poor outcomes. Prior studies have shown an upward trend of AKI post PCI which may be related to a multitude of factors. In this study, we aim to discern whether the recent changes in AKI definition, awareness of risk calculators, and preventive measures have been effective in changing the inclining trend. Methods Patients who underwent PCI during hospitalization were identified retrospectively in the Nationwide Readmission Database (NRD) from January 2010 to December 2014. All patients older than 18 years were included in the current study. Patient demographics and comorbidities were identified using appropriate ICD-9 codes. The primary outcome is the temporal trends of AKI following PCI and secondary outcomes are temporal trends in mortality, length of stay and hospitalization cost in patients with AKI. Continuous variables were expressed as means ± standard deviation or median (IQR), and categorical variables were expressed as percentages (%). All statistical tests were two-sided. Results Among the 2,712,473 patients who underwent PCI from 2010 to 2014, 162,286 (6%) patients developed AKI post PCI. Mean age was 69.22±12.34 years and 65% of them were males. The percentage of cases with AKI rose almost twofold from 2010 to 2014 (4.8% to 8.1%, p-value <0.005), despite the lack of a significant change in patient's demographics and comorbidities over the years. Among patients with a history of Chronic Kidney Disease (CKD) the incidence of AKI increased from 20.3% to 24.2%, and in patients without CKD history the incidence of AKI almost doubled (2.6% to 5.0%) from 2010 to 2014. There was a slight decrease in in-hospital mortality (9.4% to 8.8%) and median length of stay (7 days to 5 days), and a slight increase in the mean cost of hospitalization ($124,755.1 to $133,902.17) from 2010 to 2014. AKI Incidence and mortality trend Conclusion This large cohort study shows a consistent uptrend of AKI in patients undergoing PCI from 2010 to 2014. Despite this, the mortality and length of stay are decreasing while the cost of hospitalization only slightly increased in patients with AKI. Thus, future drives to implement renal protective measures and advanced studies to identify new preventive therapies are needed to reduce the incidence of AKI post-PCI.

Incidence- and Mortality-Related Risk Factors of Acute Kidney Injury Requiring Hemofiltration Treatment in Patients Undergoing Cardiac Surgery: A Single-Center 6-Year Experience

2011 ◽  
Vol 25 (4) ◽  
pp. 619-624 ◽  
Author(s):  
Maciej M. Kowalik ◽  
Romuald Lango ◽  
Katarzyna Klajbor ◽  
Violetta Musiał-Świa̢tkiewicz ◽  
Magdalena Kołaczkowska ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Cardiac Surgery ◽  
Kidney Injury ◽  
Single Center ◽  
Related Risk ◽  
Incidence And Mortality

scholarly journals Butterfly Pea (Clitoria ternatea L.: Fabaceae) and Its Morphological Variations in Bali

2021 ◽  
Vol 6 (2) ◽  
pp. 63013
Author(s):  
I Wayan Suarna ◽  
I Made Saka Wijaya
Keyword(s):  
Ornamental Plants ◽  
Morphological Characterization ◽  
Primary Data ◽  
Natural Food ◽  
Herbaceous Plant ◽  
Clitoria Ternatea ◽  
Morphological Variations ◽  
Perennial Herbaceous Plant ◽  
Wide Range ◽  
Butterfly Pea

Butterfly pea (Clitoria ternatea L.) is an important perennial herbaceous plant with a range of uses as ornamental plants, fodder crops, medicine, and sources of natural food colorant and antioxidants. The leaves and pods are commonly used as a source of protein in fodder, while the flowers are usually dried and processed as a high antioxidant-containing tea. The blue variant of butterfly pea was the most commonly used variety, although there are quite diverse butterfly pea varieties. The present study aimed to observe the morphological variations among the 26 butterfly pea accessions that originated from a wide range of areas in Bali. The explorative method was used to obtain diverse specimens (accessions) of butterfly pea in Bali, and subsequently, morphological characterization of the accessions was performed. The primary data of morphological traits that were recorded included stems, leaves, flower structures, flower colors, pods, and seeds. The data were analyzed descriptively to determine the morphological variations between accessions. The results showed three major morphological variations: (i) the colour of the flower (corolla), (ii) the corolla structure, and (iii) the stamen structure. The colour of corolla has four variations: white, mauve, light blue, and dark blue; while the corolla structure has two variations: normal and multiple layered corollas. The stamen character showed a correlation with the structure of the corolla. The normal corolla has diadelphous stamens, while the multiple layered corollas have solitary stamens. These morphological variations are the genetic richness of Indonesia’s biodiversity and should be protected and conserved.

scholarly journals Epidemiological profile of acute kidney injury in critically ill patients admitted to intensive care units: A Prospective Brazilian Cohort

2021 ◽  
Author(s):  
Antônio José Inda-Filho ◽  
Heitor Siqueira Ribeiro ◽  
Edilene Almeida Vieira ◽  
Aparecido Pimentel Ferreira
Keyword(s):  
Acute Kidney Injury ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Meta Analysis ◽  
Kidney Injury ◽  
Federal District ◽  
Incidence And Mortality ◽  
Epidemiological Profile ◽  
Stage 1 ◽  
Disease Stages

Abstract Introduction Acute kidney injury (AKI) is a frequent syndrome affecting patients admitted to intensive care units (ICU), and it is associated with poor clinical outcomes. The aim of the present study was to understand the epidemiological profile of patients with AKI admitted to ICUs. Methods Prospective cohort study, carried out in three ICUs in the Federal District, Brazil. Between October/2017 and December/2018, 8,131 patients were included in the cohort. AKI was defined according to the KDIGO criteria. The main outcomes assessed were AKI development and mortality within 28 days of hospitalization. Results Of the 8,131 patients followed up, 1,728 developed AKI (21.3%). Of the 1,728 patients with AKI, 1,060 (61.3%) developed stage 1, while stages 2 and 3 represented 154 (8.9%) and 514 (29.7%), respectively. Of these, 459 (26.6%) underwent renal replacement therapy. The mortality was 25.7% for those with AKI, and 4.9% for those without AKI. Discussion Patients with AKI had higher mortality rates when compared to those without AKI. Likewise, among patients with AKI, higher disease stages were associated with higher death occurrences. AKI incidence (21.3%) and mortality (25.7%) in our study is in line with the largest meta-analysis ever conducted, in which incidence and mortality of 21.6 and 23.9% were observed, respectively. These findings confirm the importance of establishing the KDIGO guideline for the definition and management of AKI in Brazilian ICUs.

scholarly journals Analysis of chemical characteristics and antioxidant activity test of kombucha black tea and butterfly pea flower (Clitoria ternatea L.) based on fermentation time

2021 ◽  
Vol 4 (1) ◽  
pp. 27-32
Author(s):  
Putu Rima Sintyadewi ◽  
I Gusti Agung Yogi Rabani RS ◽  
Nadya Treesna Wulansari
Keyword(s):  
Antioxidant Activity ◽  
Sugar Content ◽  
Black Tea ◽  
Reducing Sugar ◽  
Antioxidant Compounds ◽  
Chemical Characteristics ◽  
Fermentation Time ◽  
Clitoria Ternatea ◽  
High Antioxidant Activity ◽  
Butterfly Pea

Free radicals are one of the triggering factors for degenerative diseases. Free radical activity can be minimized or prevented in the presence of antioxidant compounds. The butterfly pea flower (Clitoria ternatea L.) has long been used as a traditional medicine to cure various diseases. Previous research has shown that the Butterfly pea flower has bioactive compounds, one of which is flavonoids, which act as antioxidants. Butterfly pea flower can be used as another substitute in making black tea-based kombucha drinks. Kombucha fermentation can increase the benefits of Butterfly pea flower with the presence of organic acids, minerals, and vitamins produced during the fermentation process. This study aims to determine the effect of fermentation time on chemical characteristics including pH, reducing sugar content, and antioxidant activity. Based on analysis of variance ANOVA showed that the length of time fermentation had a very significant effect (P>0.01) on pH, reducing sugar content and antioxidant activity of black tea and Butterfly pea flower kombucha. The longer the fermentation time, the lower the pH and sugar content in the medium. Optimum antioxidant activity occurred on the 8th day of fermentation in the variation of treatment P3 (3:3) which was 89.74%. These results indicate that black tea kombucha and Butterfly pea flower are categorized as having high antioxidant activity at the interval of 68.45% to 89.74%.

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