scholarly journals Association between Caffeine Citrate and Incidence of Acute Kidney Injury in Preterms

2021 ◽  
pp. 189-199
Author(s):  
Halah Tarek Mohammed Mansour ◽  
Hamed Mohamed Mohamed Elsharkawy ◽  
Sahar Mohey Eldin Hazzaa ◽  
Mohammed Abd-Ellatif Nassar
Keyword(s):  
Acute Kidney Injury ◽  
Serum Creatinine ◽  
Serum Albumin ◽  
Urine Output ◽  
Kidney Injury ◽  
Preterm Neonates ◽  
P Value ◽  
Significant Difference ◽  
Caffeine Citrate ◽  
Group A

Background: As a result of prematurity, Acute kidney injury (AKI) occurs commonly in preterm neonates and is associated with increased morbidity and mortality. (AKI) is defined as a rapid, potentially reversible deterioration in renal functions sufficient to result in accumulation of nitrogenous wastes in the body. Aim of the Study: the aim of this study was to determine whether preterm neonates who took caffeine citrate from the first day after birth were less likely to AKI within the first 7 days. Patients and Methods: This case control study was conducted on 100 preterm neonates at Neonatal Intensive Care Units (NICUS), Pediatric Department, Tanta University with gestational age less than (30 weeks) were grouped into group A and B. Group A 50 preterm neonates who received caffeine citrate from the first day after birth with dose (20 mg/kg) loading dose, and (5 mg/kg/dose) every 24hrs of maintenance dose, given as slow intravenous infusion over twenty to thirty minutes for a week. Group B 50 preterm neonates who did not receive caffeine citrate. Inclusion Criteria: all preterms <30 weeks admitted within first 24 hours after birth presented by respiratory distress according to Downes score. Exclusion Criteria: newborns with congenital heart disease except non-significant PDA, neonatal mortality < 48 h of life, clinical signs suggest chromosomal anomalies, newborns with congenital renal anomalies. Hematological Investigations: serum albumin, serum creatinine, blood urea. Urinary Investigations: measuring urine output. Results: There was a statistically significant difference between the two studied groups as regard serum creatinine in day (5,7) (p<0.001), urea in day 7 (p value <0.001), serum albumin in day (5,7) (p value ≤ 0.05), urine output in day (4,5,6,7) (p value ≤0.05), AKI incidence (p value <0.001). Conclusion: Caffeine Citrate administration in preterm neonates from the first day of life for one week was associated with reduced occurrence and severity of AKI.

scholarly journals A Study on the Effect of N-Acetylcysteine on Acute Kidney Injury due to Falciparum Malaria

2021 ◽  
Author(s):  
Gurupada Das ◽  
Bibhu Prasad Behera ◽  
Purna Chandra Karua ◽  
Rama Chandra Sethy
Keyword(s):  
Acute Kidney Injury ◽  
Serum Creatinine ◽  
Falciparum Malaria ◽  
General Medicine ◽  
Kidney Injury ◽  
Tubular Secretion ◽  
P Value ◽  
Not Given ◽  
Mean Values ◽  
Significant Difference

Introduction: Acute Kidney Injury (AKI) occurs most commonly in Plasmodium falciparum infection. Next to cerebral malaria and anaemia, AKI is the third most common complication of falciparum malaria. N-Acetylcysteine (NAC) has been shown to decrease serum creatinine without affecting the Glomerular Filtration Rate (GFR) by activating creatinine kinase and possibly by increasing tubular secretion. Aim: To study the effect of NAC on improvement and deterioration of falciparum malarial AKI. Materials and Methods: This prospective observational study was undertaken on 100 patients of falciparum malaria with AKI who were admitted to the Department of General Medicine ward, VSSIMSAR, Burla, Odisha from November 2014 to October 2016. Patients who were treated with NAC were considered as NAC group (n=50) and those who were not given were considered as Non N-Acetylcysteine (NNAC) group (n=50). In both the groups serum creatinine level and urine output were compared on day 1, day 3 and on day 5 of the study. Graph pad instat version-3 for windows was used for various statistical analyses. The numerical value was compared by Chi-square test. The comparison of mean values among the NAC and NNAC groups was performed by student t-test. The p-value less than 0.05 was considered statistically significant. Results: A total of 63 males and 37 females were included in the study. Most of the cases were present in 15-34 years age group in both NAC and NNAC groups. The mean age of the patients for NAC group was 33.3±12.8 years and for NNAC group was 33.2±12.1 years with majority being males in both the groups. Out of 50 cases who were given NAC 600 mg twice daily for five days, 28 (56%) cases improved in AKI on day 5 as compared to day 1 of the study in NAC group. Similarly, out of 50 cases who were not given NAC, 26 (52%) cases improved in AKI on day 5 as compared to day 1 of the study in NNAC group. There was no difference in patients showing improvement in AKI after NAC therapy compared to patients with NNAC (χ2, 0.04; p=0.841). Conclusion: In NAC group, improvement of falciparum malarial AKI after five days was found to be little bit more as compared to the NNAC group, though it did not reach statistically significant difference.

Acute Kidney Injury in Perinatal Asphyxia: Comparison Between Term and Preterm Neonates

2018 ◽  
Vol 32 (2-3) ◽  
pp. 50-59
Author(s):  
Preeti Malhotra ◽  
Simran Kaur Syal ◽  
Ankush Singh ◽  
Karuna Thapar
Keyword(s):  
Acute Kidney Injury ◽  
Serum Creatinine ◽  
Renal Injury ◽  
Perinatal Asphyxia ◽  
Kidney Injury ◽  
Preterm Neonates ◽  
Acute Renal Injury ◽  
Sodium Potassium ◽  
Significant Difference ◽  
Ischemic Encephalopathy

Objective: To investigate asphyxiated neonates for acute kidney injury, compare the occurrence between preterms and terms and to correlate the severity and type of renal injury with the degree of asphyxia and hypoxic ischemic encephalopathy (HIE) grading. Materials and Methods: Renal functions were assessed using urine output and biochemical parameters such as blood urea, serum creatinine, serum sodium, potassium, and calcium. These were evaluated on alternate days till day 7 or recovery or death. Results: Total 108 asphyxiated neonates were enrolled: 63 term and 45 preterm. A total of 28 (25.9%) developed acute kidney injury: 9 (32.1%) had oliguric acute renal injury and the rest 19 (67.8%) had nonoliguric acute renal injury. A total of 77.7% neonates had a prerenal cause and the other 22.2% had an intrinsic cause for the kidney injury. Levels of blood urea and serum creatinine were maximally elevated on day 5 of life. Biochemical derangements correlated well with the Apgar score at birth and severity of HIE. No statistically significant difference was observed in the incidence of renal injury between preterm and term asphyxiated neonates. Conclusion: Perinatal asphyxia is an important cause of renal injury in neonates. A majority of neonates had nonoliguric and pre renal type of acute kidney injury. The more severe the degree of asphyxia, the more prone they were to develop renal complications.

Neutrophil gelatinase associated lipocalin, an early biomarker for diagnosis of acute kidney injury after percutaneous coronary intervention

2017 ◽  
Vol 43 (1) ◽  
pp. 15-21 ◽  
Author(s):  
Nakhshab Choudhry ◽  
Amna Ihsan ◽  
Sadia Mahmood ◽  
Fahim Ul Haq ◽  
Aamir Jamal Gondal
Keyword(s):  
Acute Kidney Injury ◽  
Percutaneous Coronary Intervention ◽  
Serum Creatinine ◽  
Kidney Injury ◽  
Coronary Intervention ◽  
Diagnostic Biomarker ◽  
Elective Percutaneous Coronary Intervention ◽  
Percutaneous Coronary ◽  
Significant Difference ◽  
The Mean

AbstractObjectives:This study was designed to find the reliability of serum NGAL as an early and better diagnostic biomarker than that of serum creatinine for acute kidney injury after percutaneous coronary intervention in Pakistani population.Materials and methods:One hundred and fifty-one patients undergoing elective percutaneous coronary intervention were included and demographic data were recorded. Blood was drawn by venipuncture in clot activator vacutainers and serum was separated and stored at 4°C. Sample was drawn before the percutaneous procedure and subsequently sampling was done serially for 5 days.Results:The mean±SD serum NGAL pre-PCI (39.92± 10.35 μg/L) and 4 h post-PCI (100.42±26.07 μg/L) showed highly significant difference (p<0.001). The mean±SD serum creatinine pre-PCI (70.1±11.8 μmol/L) and post-PCI (71.2±11.6 μmol/L) showed significant difference (p=0.005) on day 2 onwards but mean microalbumin showed insignificant results (p=0.533). The serum NGAL predicted CI-AKI with sensitivity of 95.8% and specificity of 97.6% for a cut off value of 118 μg/L.Conclusion:Our results suggest that NGAL is an excellent early diagnostic biomarker for acute kidney injury in patients undergoing elective percutaneous coronary intervention.

scholarly journals Comparison of In-Hospital Outcomes Between Patients With or Without Acute Kidney Injury Developed After Hospitalization Following Acute Coronary Syndrome

2020 ◽  
Vol 16 (1) ◽  
pp. 3-10
Author(s):  
Md Sajjad Safi ◽  
Msi Tipu Chowdhury ◽  
Tanjima Parvin ◽  
Khurshed Ahmed ◽  
Md Ashraf Uddin Sultana ◽  
...  
Keyword(s):  
Heart Failure ◽  
Acute Kidney Injury ◽  
Serum Creatinine ◽  
Cardiogenic Shock ◽  
Hospital Stay ◽  
Kidney Injury ◽  
Duration Of Hospital Stay ◽  
Group A ◽  
Hospital Stays ◽  
Group B

Background: Acute Kidney Injury (AKI), a common complication of acute coronary syndromes (ACS), is associated with higher mortality and longer hospital stays. ACS patients with renal impairment during hospitalization are associated with adverse in-hospital outcomes in the form of heart failure, cardiogenic shock, arrhythmia, dialysis requirement and mortality. Objective: To compare the in-hospital adverse outcomesof patients with ACS with or without AKI. Materials and Methods: This prospective comparative study was conducted in the Department of Cardiology, BSMMU, Dhaka, during the period of August 2017 to July 2018. A total of 70 eligible patients were included in this study of which 35 patients were included in group A (ACS with AKI) and 35 patients were included in group B (ACS without AKI). AKI was diagnosed, on the basis of increased serum creatinine level 0.3mg/dL from baseline within 48 hours after hospitalization. They were subjected to electrocardiography, blood test for serum creatinine (on admission, 12 hours, 48 hours and at the time of discharge), lipid profile, 2-D echocardiography along with serum troponin, CK MB and electrolytes. Results: It was observed that mean age was 58.0±8.5 years in group A and 55.6±12.3 years in group B. Heart failure was more common in group A than in Group B (74.3% vs 34.2% p=0.001 respectively) and arrhythmia was more common in group A than in Group B (100% vs 74.2% respectively). 7(20%) patients of group A required dialysis. The mean duration of hospital stay was significantly higher in Group A than in the Group B (9.4±2.3 vs 7.2±0.6; p=0.001) days. Multiple logistic regression analysis revealed that heart failure, cardiogenic shock, duration of hospital stay were found to be the independently significant predictors of outcome of the patients with AKI with odds ratio being 5.53 (p=0.001), 4.353 (p=0.001) and 6.92 (p=0.001) Conclusion: This study shows that, heart failure, cardiogenic shock, arrhythmia, dialysis requirement, were more common in the patients with AKI (group A) than in the patients without AKI (group B). The duration of hospital stays were longer in patients with AKI (group A) than in the patients without AKI (group B). Therefore, an important research target is the identification of high-risk patients with ACS experiencing AKI, thereby appropriate medication and follow-up should be implemented. University Heart Journal Vol. 16, No. 1, Jan 2020; 3-10

Definition and Diagnosis of Acute Kidney Injury in Cirrhosis

2015 ◽  
Vol 33 (4) ◽  
pp. 539-547 ◽  
Author(s):  
Florence Wong
Keyword(s):  
Acute Kidney Injury ◽  
Serum Creatinine ◽  
Urine Output ◽  
Negative Impact ◽  
Kidney Injury ◽  
Acute Kidney Injury Network ◽  
Severe Form ◽  
Loss Of Function ◽  
Baseline Serum ◽  
Advanced Cirrhosis

Background: Acute kidney injury (AKI) is a common complication of advanced cirrhosis. Type 1 hepatorenal syndrome is the best-known and most severe form of AKI, and it has a precise definition and a set of specific diagnostic criteria. More recently, it has become recognized that milder degrees of renal dysfunction also have a negative impact on patient outcome in various patient populations. Key Messages: Several definitions and criteria for staging the severity of AKI have been proposed, including the RIFLE (Risk, Injury, Failure, Loss of Function and End-Stage Renal Disease) group, the Acute Kidney Injury Network (AKIN), and the Kidney Disease: Improving Global Outcome (KDIGO) group. All of them incorporate some changes of serum creatinine and urine output in the definition and staging of AKI. The hepatology community has mostly embraced the AKIN diagnostic and staging criteria and has applied them in the prognostication of patients with advanced cirrhosis. However, the AKIN criteria have not been strictly applied in all studies on cirrhosis. This is partly related to the fact that changes in urine output are difficult to assess in advanced cirrhosis, and partly related to the difficulty in defining the baseline serum creatinine from which the change in serum creatinine is calculated. This has led to some confusion in the interpretation of results of the various studies on AKI in cirrhosis. More recently, some investigators have suggested incorporating the AKIN criteria with setting a lower limit of serum creatinine of 1.5 mg/dl in determining the diagnosis and prognosis of AKI in cirrhosis. Conclusions: This is an ongoing debate as to how best to define AKI in cirrhosis. In the near future there should be prospective clinical trials that will clarify which diagnostic and staging criteria of AKI will best serve the cirrhotic population.

scholarly journals Comparison of urine and serum neutrophil gelatinase-associated lipocalin after open and endovascular thoraco-abdominal aortic surgery and their meaning as indicators of acute kidney injury

VASA ◽  
2019 ◽  
Vol 48 (1) ◽  
pp. 79-87 ◽  
Author(s):  
Alexander Gombert ◽  
Lukas Martin ◽  
Ann Christina Foldenauer ◽  
Clara Krajewski ◽  
Andreas Greiner ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Serum Creatinine ◽  
Kidney Injury ◽  
Aortic Aneurysms ◽  
Urine Ngal ◽  
Neutrophil Gelatinase Associated Lipocalin ◽  
Abdominal Aortic ◽  
Potential Biomarker ◽  
Significant Difference ◽  
Neutrophil Gelatinase

Abstract. Background: Neutrophil gelatinase-associated lipocalin (NGAL) has been described as a potential biomarker of acute kidney injury (AKI) in different settings, but its behaviour under influence of open and endovascular repair of thoraco-abdominal aortic aneurysms (TAAA) has not been assessed yet. In this study, the course of NGAL was observed and differences of serum- (sNGAL) and urine-NGAL (uNGAL) levels following TAAA repair, especially with regard to AKI, were evaluated. Patients and methods: In this retrospective single centre study, 52 patients (mean age 64.5 years, [43–85 years]), including 39 (75 %) men, were enrolled (2014–2015, 13.2 months mean follow-up). Levels of sNGAL and uNGAL were measured perioperatively for 48 hours on intensive care unit. Twenty-three patients were treated by endovascular and 29 by open TAAA-repair. Results: Logistic regression revealed an increase in NGAL (sNGAL p = 0.0263, uNGAL p = 0.0080) corresponding with an increase in serum creatinine within the first 48 hours. Fourteen patients (26.9 %) developed AKI and 11 (21.1 %) required dialysis. The course of NGAL differed significantly (uNGAL p < .0001, sNGAL p = 0.0002) between patients suffering from AKI requiring dialysis and patients without AKI. The predictive power of uNGAL was three times higher than that of sNGAL (estimate of the regression slope 0.1382 vs. 0.0460). No significant difference between patients undergoing open or endovascular TAAA repair regarding the perioperative course of sNGAL and uNGAL was observed. Conclusion: serum-NGAL and urine-NGAL correlate with serum creatinine levels and AKI requiring dialysis. Furthermore, the postoperative course of sNGAL and uNGAL after open and endovascular TAAA repair is not significantly different. Taken together, the results indicate that uNGAL and, to a lesser extent, sNGAL could be considered biomarkers for early detection of perioperative AKI after open and endovascular TAAA surgery.

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