scholarly journals Clinical Outcomes of Dialysis-Treated Acute Kidney Injury Patients at the University of Port Harcourt Teaching Hospital, Nigeria

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Pedro Chimezie Emem-Chioma ◽  
Datonye Dennis Alasia ◽  
Friday Samuel Wokoma
Keyword(s):  
Acute Kidney Injury ◽  
Hospital Mortality ◽  
Clinical Outcomes ◽  
Teaching Hospital ◽  
Kidney Injury ◽  
Developed Countries ◽  
High Morbidity ◽  
Acute Glomerulonephritis ◽  
Study Objective ◽  
The University

Background. Acute kidney injury in adults is a common cause of hospitalization, associated with high morbidity and mortality especially in developing countries. In spite of RRT the in-hospital mortality rates remain high even in the developed countries. Though a proportion of our patients receive renal replacement therapy as part of their management, data on outcomes are sparse. Study Objective. To determine the clinical outcomes of dialysis-treated AKI in our hospital. Methods. A retrospective analysis of the clinical data of all adult AKI patients treated with haemodialysis at the University of Teaching Hospital during an interrupted six-year period was conducted. Analysis was done using SPSS version 17.0. Results. 34 males and 28 females with mean age of 41.3 ± 18.5 years were studied. The leading causes of AKI were sepsis (22.7%), acute glomerulonephritis (20.5%), acute gastroenteritis (15.9%), and toxic nephropathies (11.4%) and presented with mean e-GFR of 14.7±5.8 mls/min/1.73 m2. Of the 62 patients, 29 (46.8%) were discharged from the hospital, 27 (43.5%) died in hospital, while 6 (9.7%) absconded from treatment. Survivors had better Rifle grade than those who died (P<0.001). Conclusion. Hospital mortality rate of dialysis-treated AKI patients is high and the severity of renal damage at presentation may be an important factor.

scholarly journals Acute peritoneal dialysis in children with acute kidney injury at the University of Abuja Teaching Hospital, Abuja, Nigeria: a report of 12 months experience in a developing country

2020 ◽  
Vol 20 (1) ◽  
pp. 314-323
Author(s):  
Emmanuel A Anigilaje ◽  
Andrew P Fashie ◽  
Babatunde Odeyemi ◽  
Alfa Yakubu
Keyword(s):  
Acute Kidney Injury ◽  
Peritoneal Dialysis ◽  
Developing Country ◽  
Teaching Hospital ◽  
Kidney Injury ◽  
Acute Glomerulonephritis ◽  
Dialysis Access ◽  
Klebsiella Species ◽  
Nasogastric Tubes ◽  
The University

Background: Acute peritoneal dialysis (APD) is becoming a common modality of renal support in children with acute kidney injury (AKI) in developing countries. Objectives: To describe the details of APD among children with AKI at the University of Abuja Teaching Hospital, Abuja, Nigeria Methods: A retrospective review of children with AKI that had manual APD with an improvised nasogastric tubes from Jan- uary to December 2017 Results: Forty-three AKI cases were managed in the study period out of which 19 were treated with APD (dialysis access rate of 100%). Ten (52.6%) were males. Causes of AKI included sepsis in 9 (47.3%), hypovolaemia from diarrhoea in 4 (21.1%), acute glomerulonephritis in 3 (15.8%) and acute tubular necrosis from severe malaria fever in 3 (15.8%). Their ages ranged from 1 month to 72 months with a mean age of 30.9 months and a mean weight of 10.9 kilograms. Peri-catheter leakages (9, 47%), outflow obstruction (6, 31.6%), peritonitis (5, 26.3%), hyperglycaemia (4, 21.1%) and hypokalaemia (4, 21.1%) were the complications seen. Klebsiella species (4) and Staphylococcus aureus (1) were the bacteria isolated. Five of the 19 children died giving a mortality rate of 26.3%. Conclusion: APD remains a lifesaving, cheap and affordable mode of renal replacement therapy in a developing country like Nigeria. Fortunately, complications from APD are also manageable and they should not discourage its use. Keywords: Manual acute peritoneal dialysis; improvised acute peritoneal catheter; resource constrained setting. 

Association of Acute Kidney Injury with Outcomes in Patients Undergoing Transcatheter Mitral Valve Repair

Cardiology ◽  
2021 ◽  
pp. 1-7
Author(s):  
Salik Nazir ◽  
Keerat Rai Ahuja ◽  
Dhaval Kolte ◽  
Tanush Gupta ◽  
Sahil Khera ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Renal Function ◽  
Mitral Valve ◽  
Hospital Mortality ◽  
Clinical Outcomes ◽  
Kidney Injury ◽  
Valve Repair ◽  
Transcatheter Mitral Valve Repair ◽  
Increased Risk

<b><i>Introduction:</i></b> Although transcatheter mitral valve repair (TMVr) is a contrast-free procedure, prior single-center studies have demonstrated a high incidence of acute kidney injury (AKI) following TMVr. The main objective of this study was to examine risk factors for AKI, and its association with outcomes in patients undergoing TMVr. <b><i>Methods:</i></b> We queried the National Readmission Database to identify TMVr procedures performed between January 2014 and December 2017. Complex samples multivariable logistic and linear regression models were used to identify risk factors associated with AKI, as well as to determine the association between AKI and clinical outcomes (in-hospital mortality, index length of stay (LOS), 30-day all-cause readmissions, and 30-day heart failure [HF] readmissions). <b><i>Results:</i></b> Of 14,623 patients who underwent TMVr during the study period, 2,001 (13.6%) had a diagnosis of AKI. HF, chronic kidney disease, chronic liver disease, fluid/electrolyte disorder, weight loss, nonelective admission, cardiogenic shock, and bleeding/transfusion were independently associated with an increased risk of AKI. In patients undergoing TMVr, AKI was associated with an increased risk of in-hospital mortality (adjusted odds ratio [aOR], 4.94; 95% confidence interval [CI], 2.92–8.34), 30-day all-cause readmissions (aOR, 1.91; 95% CI, 1.49–2.46), 30-day HF readmissions (aOR, 2.30; 95% CI, 1.38–3.84), and longer index LOS (adjusted parameter estimate, 5.78; 95% CI, 5.26–6.41). <b><i>Conclusion:</i></b> AKI in the setting of TMVr is common and is associated with worse clinical outcomes. Further studies are needed to determine if optimizing renal function prior to TMVr may improve outcomes, as well as to understand the impact of TMVr itself on renal function.

Associations between early thiamine administration and clinical outcomes in critically ill patients with acute kidney injury

2021 ◽  
pp. 1-27
Author(s):  
Xunliang Li ◽  
Hong Luan ◽  
Hui Zhang ◽  
Chenyu Li ◽  
Quandong Bu ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Hospital Mortality ◽  
Clinical Outcomes ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Medical Information ◽  
Kidney Injury ◽  
Term Survival ◽  
Stage 1 ◽  
Thiamine Treatment

Abstract Background: The effects of early thiamine use on clinical outcomes in critically ill patients with acute kidney injury (AKI) are unclear. The purpose of this study was to investigate the associations between early thiamine administration and clinical outcomes in critically ill patients with AKI. Methods: The data of critically ill patients with AKI within 48 hours after ICU admission were extracted from the Medical Information Mart for Intensive Care III (MIMIC III) database. Propensity score matching (PSM) was used to match patients early receiving thiamine treatment to those not early receiving thiamine treatment. The association between early thiamine use and in-hospital mortality due to AKI was determined using a logistic regression model. Results: A total of 15,066 AKI patients were eligible for study inclusion. After PSM, 734 pairs of patients who did and did not receive thiamine treatment in the early stage were established. Early thiamine use was associated with lower in-hospital mortality (OR 0.65; 95% CI 0.49-0.87; P < 0.001) and 90-day mortality (OR 0.58; 95% CI 0.45-0.74; P < 0.001), and it was also associated with the recovery of renal function (OR 1.26; 95% CI 1.17-1.36; P < 0.001). In the subgroup analysis, early thiamine administration was associated with lower in-hospital mortality in patients with stage 1 to 2 AKI. Conclusions: Early thiamine use was associated with improved short-term survival in critically ill patients with AKI. It was possible beneficial role in patients with stage 1 to 2 AKI according to the KDIGO criteria.

scholarly journals Association between Latent Trajectories of Fluid Balance and Clinical Outcomes in Critically Ill Patients with Acute Kidney Injury: A Prospective Multicenter Observational Study

2021 ◽  
pp. 1-11
Author(s):  
Meiping Wang ◽  
Bo Zhu ◽  
Li Jiang ◽  
Xuying Luo ◽  
Na Wang ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Logistic Regression ◽  
Hospital Mortality ◽  
Clinical Outcomes ◽  
Critically Ill ◽  
Fluid Balance ◽  
Critically Ill Patients ◽  
Kidney Injury ◽  
Icu Mortality ◽  
Increased Risk

<b><i>Introduction:</i></b> We aimed to identify different trajectories of fluid balance (FB) and investigate the effect of FB trajectories on clinical outcomes in intensive care unit (ICU) patients with acute kidney injury (AKI) and the dose-response association between fluid overload (FO) and mortality. <b><i>Methods:</i></b> We derived data from the Beijing Acute Kidney Injury Trial (BAKIT). A total of 1,529 critically ill patients with AKI were included. The primary outcome was 28-day mortality, and hospital mortality, ICU mortality and AKI stage were the secondary outcomes. A group-based trajectory model was used to identify the trajectory of FB during the first 7 days. Multivariable logistic regression was performed to examine the relationship between FB trajectories and clinical outcomes. A logistic regression model with restricted cubic splines was used to examine the dose relationship between FO and 28-day mortality. <b><i>Results:</i></b> Three distinct trajectories of FB were identified: low FB (1,316, 86.1%), decreasing FB (120, 7.8%), and high FB (93, 6.1%). Compared with low FB, high FB was associated with increased 28-day mortality (odds ratio [OR] 1.94, 95% confidence interval [CI] 1.17–3.19) and AKI stage (OR 2.04, 95% CI 1.23–3.37), whereas decreasing FB was associated with a reduction in 28-day mortality by approximately half (OR 0.53, 95% CI 0.32–0.87). Similar results were found for the outcomes of ICU mortality and hospital mortality. We observed a J-shaped relationship between maximum FO and 28-day mortality, with the lowest risk at a maximum FO of 2.8% L/kg. <b><i>Conclusion:</i></b> Different trajectories of FB in critically ill patients with AKI were associated with clinical outcomes. An FB above or below a certain range was associated with an increased risk of mortality. Further studies should explore this relationship and search for the optimal fluid management strategies for critically ill patients with AKI.

scholarly journals Incidence and Outcomes of Acute Kidney Injury in Patients Admitted to Hospital With COVID-19: A Retrospective Cohort Study

2021 ◽  
Vol 8 ◽  
pp. 205435812110277
Author(s):  
Tyler Pitre ◽  
Angela (Hong Tian) Dong ◽  
Aaron Jones ◽  
Jessica Kapralik ◽  
Sonya Cui ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Acute Kidney Injury ◽  
Cohort Study ◽  
Hospital Mortality ◽  
Disease Severity ◽  
Retrospective Cohort Study ◽  
Odds Ratio ◽  
Retrospective Cohort ◽  
Kidney Injury ◽  
Icu Admission

Background: The incidence of acute kidney injury (AKI) in patients with COVID-19 and its association with mortality and disease severity is understudied in the Canadian population. Objective: To determine the incidence of AKI in a cohort of patients with COVID-19 admitted to medicine and intensive care unit (ICU) wards, its association with in-hospital mortality, and disease severity. Our aim was to stratify these outcomes by out-of-hospital AKI and in-hospital AKI. Design: Retrospective cohort study from a registry of patients with COVID-19. Setting: Three community and 3 academic hospitals. Patients: A total of 815 patients admitted to hospital with COVID-19 between March 4, 2020, and April 23, 2021. Measurements: Stage of AKI, ICU admission, mechanical ventilation, and in-hospital mortality. Methods: We classified AKI by comparing highest to lowest recorded serum creatinine in hospital and staged AKI based on the Kidney Disease: Improving Global Outcomes (KDIGO) system. We calculated the unadjusted and adjusted odds ratio for the stage of AKI and the outcomes of ICU admission, mechanical ventilation, and in-hospital mortality. Results: Of the 815 patients registered, 439 (53.9%) developed AKI, 253 (57.6%) presented with AKI, and 186 (42.4%) developed AKI in-hospital. The odds of ICU admission, mechanical ventilation, and death increased as the AKI stage worsened. Stage 3 AKI that occurred during hospitalization increased the odds of death (odds ratio [OR] = 7.87 [4.35, 14.23]). Stage 3 AKI that occurred prior to hospitalization carried an increased odds of death (OR = 5.28 [2.60, 10.73]). Limitations: Observational study with small sample size limits precision of estimates. Lack of nonhospitalized patients with COVID-19 and hospitalized patients without COVID-19 as controls limits causal inferences. Conclusions: Acute kidney injury, whether it occurs prior to or after hospitalization, is associated with a high risk of poor outcomes in patients with COVID-19. Routine assessment of kidney function in patients with COVID-19 may improve risk stratification. Trial registration: The study was not registered on a publicly accessible registry because it did not involve any health care intervention on human participants.

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