The Relationship of Mean Perfusion Pressure (MPP) With Acute Kidney Injury (AKI) on Patients in Intensive Care Unit (ICU) at Haji Adam Malik General Hospital Medan

Acute Kidney Injury (AKI) is a common complication in patients with critical illness or multiple comorbid conditions who are hospitalized, especially at the Intensive Care Unit (ICU). AKI is associated with increased in short and long term mortality and morbidity. The connection between MAP and CVP on alteration of AKI causes researcher interested to investigate the correlation between Mean Perfusion Pressure (MPP) as a difference between MAP and CVP on the progression of AKI.  Methods: Forty-two patients treated in the ICU who met inclusion criteria (ages 18-65 years and signed informed consent) and exclusion criteria (chronic kidney disease, refused to have Central Venous Catheters (CVC) installed, and heart disease). After CVC installation, we perform hemodynamic examination, MAP and CVP measurements, and serum creatinine examination after installation, 6 hours, 12 hours, and 48 hours after installation.  Results: Significant differences were obtained during 12- hour observation between MPP values in the AKI group with lower values than the non-AKI group (p=0.009) and also obtained a significant difference during 48- hours observation between MPP values in the AKI group with a lower value than the non-AKI group (p=0.001). MAP values showed a significant difference at 12-hour observation time with creatinine serum in the MAP group<65mmHg higher than the MAP 65mmHg group (p=0.035). MPP values showed significant differences 12-hours observation with creatinine serum in the MPP group<55mmHg was higher than the MPP group 55mmHg (p=0.044). In addition, there was a correlation between creatinine serum increase with MPP decrease (r=-0.476; p=0.001).  Conclusion: Lower MPP tend to increase AKI occurence contrary higher MPP decrease AKI occurence at the observation. The mean MPP of AKI group was 90.6 ( 24.2) mmHg at T0, 78.2 ( 22.6) mmHg at T1, 67.2 ( 20.9) mmHg at T3, and 57, 0 ( 20,2) mmHg at T4 observation.

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Incidence, Risk Factors, and Outcome of Acute Kidney Injury in the Intensive Care Unit: A Single-Center Study from Jordan

Critical Care Research and Practice ◽

10.1155/2020/8753764 ◽

2020 ◽

Vol 2020 ◽

pp. 1-7

Author(s):

Ashraf O. Oweis ◽

Sameeha A. Alshelleh ◽

Suleiman M. Momany ◽

Shaher M. Samrah ◽

Basheer Y. Khassawneh ◽

...

Keyword(s):

Risk Factors ◽

Intensive Care Unit ◽

Acute Kidney Injury ◽

Intensive Care ◽

Kidney Injury ◽

Tertiary Hospital ◽

Acute Kidney Injury Network ◽

Apache Ii Score ◽

Mortality And Morbidity ◽

Incidence Risk

Background. Acute kidney injury (AKI) is a common serious problem affecting critically ill patients in intensive care unit (ICU). It increases their morbidity, mortality, length of ICU stay, and long-term risk of chronic kidney disease (CKD). Methods. A retrospective study was carried out in a tertiary hospital in Jordan. Medical records of patients admitted to the medical ICU between 2013 and 2015 were reviewed. We aimed to identify the incidence, risk factors, and outcomes of AKI. Acute kidney injury network (AKIN) classification was used to define and stage AKI. Results. 2530 patients were admitted to medical ICU, and the incidence of AKI was 31.6%, mainly in stage 1 (59.4%). In multivariate analysis, increasing age (odds ratio (OR) = 1.2 (95% CI 1.1–1.3), P = 0.0001) and higher APACHE II score (OR = 1.5 (95% CI 1.2–1.7), P = 0.001) were predictors of AKI, with 20.4% of patients started on hemodialysis. At the time of discharge, 58% of patients with AKI died compared to 51.3% of patients without AKI (P = 0.05). 88% of patients with AKIN 3 died by the time of discharge compared to patients with AKIN 2 and 1 (75.3% and 61.2% respectively, P = 0.001). Conclusion. AKI is common in ICU patients, and it increases mortality and morbidity. Close attention for earlier detection and addressing risk factors for AKI is needed to decrease incidence, complications, and mortality.

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Clinical Course of Cancer Patients with COVID-19: A Retrospective Cohort Study

JNCI Cancer Spectrum ◽

10.1093/jncics/pkaa085 ◽

2020 ◽

Author(s):

Naomi Alpert ◽

Joseph L Rapp ◽

Bridget Marcellino ◽

Wil Lieberman-Cribbin ◽

Raja Flores ◽

...

Keyword(s):

Intensive Care Unit ◽

Acute Kidney Injury ◽

Intensive Care ◽

Venous Thromboembolism ◽

Cancer Patients ◽

Kidney Injury ◽

Adverse Outcomes ◽

Cancer Treatments ◽

Patients With Cancer ◽

Significant Difference

Abstract Background Complications in cancer patients with COVID-19 have not been examined. This analysis aimed to compare characteristics of COVID-19 patients with and without cancer, and assess whether cancer is associated with COVID-19 morbidity or mortality. Methods COVID-19 positive patients with an inpatient or emergency encounter at the Mount Sinai Health System between March 1, 2020 and May 27, 2020 were included, and compared across cancer status on demographics and clinical characteristics. Multivariable logistic regressions were used to model the associations of cancer with sepsis, venous thromboembolism, acute kidney injury, intensive care unit admission, and all-cause mortality. Results There were 5,556 COVID-19 positive patients included; 421 (7.6%) with cancer (325 solid, 96 non-solid). Those with cancer were statistically significantly older, more likely to be non-Hispanic Black and to be admitted to the hospital during their encounter, and had more comorbidities than non-cancer COVID-19 patients. Cancer patients were statistically significantly more likely to develop sepsis (adjusted odds ratio [ORadj]=1.31, 95% confidence interval [CI]=1.06-1.61) and venous thromboembolism (ORadj=1.77, 95% CI = 1.01-3.09); there was no statistically significant difference in acute kidney injury (ORadj=1.10, 95% CI = 0.87-1.39), intensive care unit admissions (ORadj=1.04, 95% CI = 0.80-1.34), or mortality (ORadj=1.02, 95% CI = 0.81-1.29). Conclusions COVID-19 patients with cancer may have a higher risk for adverse outcomes. Although there was no statistically significant difference in mortality, COVID-19 patients with cancer have significantly higher risk of thromboembolism and sepsis. Further research is warranted into the potential effects of cancer treatments on inflammatory and immune responses to COVID-19, and on the efficacy of anticoagulant therapy in these patients.

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Acute kidney injury and continuous renal replacement therapy: A nursing perspective for my shift today in the intensive care unit

Seminars in Dialysis ◽

10.1111/sdi.12992 ◽

2021 ◽

Author(s):

Ian Baldwin ◽

Theresa Mottes

Keyword(s):

Intensive Care Unit ◽

Acute Kidney Injury ◽

Intensive Care ◽

Renal Replacement Therapy ◽

Continuous Renal Replacement Therapy ◽

Replacement Therapy ◽

Kidney Injury

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POS-007 MAGNITUDE AND ASSOCIATED RISK FACTORS OF NEONATAL ACUTE KIDNEY INJURY IN THE NEONATAL INTENSIVE CARE UNIT OF TIKUR ANBESSA SPECIALIZED HOSPITAL, ADDIS ABABA, ETHOPIA

Kidney International Reports ◽

10.1016/j.ekir.2021.03.013 ◽

2021 ◽

Vol 6 (4) ◽

pp. S3

Author(s):

H. Nida ◽

A. Demtse ◽

B.A. Bekele

Keyword(s):

Risk Factors ◽

Intensive Care Unit ◽

Acute Kidney Injury ◽

Intensive Care ◽

Neonatal Intensive Care ◽

Addis Ababa ◽

Kidney Injury ◽

Specialized Hospital ◽

Tikur Anbessa Specialized Hospital ◽

Associated Risk Factors

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POS-004 HYPOALBUMINEMIA AND ACUTE KIDNEY INJURY IN PATIENTS ADMITTED TO INTENSIVE CARE UNIT

Kidney International Reports ◽

10.1016/j.ekir.2021.03.010 ◽

2021 ◽

Vol 6 (4) ◽

pp. S2

Author(s):

A. BACA ◽

M. Carmoma Antonio ◽

M. Wasung ◽

P. Visoso ◽

M. Sebastian Alberto

Keyword(s):

Intensive Care Unit ◽

Acute Kidney Injury ◽

Intensive Care ◽

Kidney Injury

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Influence of volume administration on Doppler-based renal resistive index, renal hemodynamics and renal function in medical intensive care unit patients with septic-induced acute kidney injury: a pilot study

International Urology and Nephrology ◽

10.1007/s11255-016-1312-1 ◽

2016 ◽

Vol 48 (8) ◽

pp. 1327-1334 ◽

Cited By ~ 9

Author(s):

Tobias Lahmer ◽

Sebastian Rasch ◽

Christopher Schnappauf ◽

Roland M. Schmid ◽

Wolfgang Huber

Keyword(s):

Intensive Care Unit ◽

Acute Kidney Injury ◽

Renal Function ◽

Intensive Care ◽

Pilot Study ◽

Medical Intensive Care Unit ◽

Resistive Index ◽

Kidney Injury ◽

Renal Resistive Index ◽

Medical Intensive Care

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Dosing of daptomycin in intensive care unit patients with acute kidney injury undergoing extended dialysis--a pharmacokinetic study

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfp704 ◽

2009 ◽

Vol 25 (5) ◽

pp. 1537-1541 ◽

Cited By ~ 51

Author(s):

J. T. Kielstein ◽

C. Eugbers ◽

S. M. Bode-Boeger ◽

J. Martens-Lobenhoffer ◽

H. Haller ◽

...

Keyword(s):

Intensive Care Unit ◽

Acute Kidney Injury ◽

Intensive Care ◽

Pharmacokinetic Study ◽

Kidney Injury

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Intensive care unit physician-delivered point of care renal tract ultrasound in acute kidney injury is feasible

Journal of the Intensive Care Society ◽

10.1177/1751143718762685 ◽

2018 ◽

Vol 19 (4) ◽

pp. 313-318 ◽

Cited By ~ 1

Author(s):

Prashant Parulekar ◽

Ed Neil-Gallacher ◽

Alex Harrison

Keyword(s):

Intensive Care Unit ◽

Acute Kidney Injury ◽

Intensive Care ◽

Critically Ill ◽

Critically Ill Patients ◽

Point Of Care ◽

Kidney Injury ◽

Diagnostic Quality ◽

The Core ◽

Low Incidence

Acute kidney injury is common in critically ill patients, with ultrasound recommended to exclude renal tract obstruction. Intensive care unit clinicians are skilled in acquiring and interpreting ultrasound examinations. Intensive Care Medicine Trainees wish to learn renal tract ultrasound. We sought to demonstrate that intensive care unit clinicians can competently perform renal tract ultrasound on critically ill patients. Thirty patients with acute kidney injury were scanned by two intensive care unit physicians using a standard intensive care unit ultrasound machine. The archived images were reviewed by a Radiologist for adequacy and diagnostic quality. In 28 of 30 patients both kidneys were identified. Adequate archived images of both kidneys each in two planes were possible in 23 of 30 patients. The commonest reason for failure was dressings and drains from abdominal surgery. Only one patient had hydronephrosis. Our results suggest that intensive care unit clinicians can provide focussed renal tract ultrasound. The low incidence of hydronephrosis has implications for delivering the Core Ultrasound in Intensive Care competencies.

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