Background. Aging is associated with a high risk of acute kidney injury (AKI), and the elderly with AKI show a higher mortality rate than those without AKI. In this study, we compared AKI outcomes between elderly and nonelderly patients in a university hospital in a developing country. Materials and Methods. This retrospective cohort study included patients with AKI who were admitted to the medical intensive care unit (ICU) between January 1, 2012, and December 31, 2017. The patients were divided into the elderly (eAKI; age ≥65 years; n = 158) and nonelderly (nAKI; n = 142) groups. Baseline characteristics, comorbidities, principle diagnosis, renal replacement therapy (RRT) requirement, hospital course, and in-hospital mortality were recorded. The primary outcome was in-hospital mortality. Results. The eAKI group included more females, patients with higher Acute Physiology and Chronic Health Evaluation II scores, and patients with more comorbidities than the nAKI group. The etiology and staging of AKI were similar between the two groups. There were no significant differences in in-hospital mortality (p=0.338) and RRT requirement (p=0.802) between the two groups. After adjusting for covariates, the 28-day mortality rate was similar between the two groups (p=0.654), but the 28-day RRT requirement was higher in the eAKI group than in the nAKI group (p=0.042). Conclusion. Elderly and nonelderly ICU patients showed similar survival outcomes of AKI, although the elderly were at a higher risk of requiring RRT.

Background: Post contrast acute kidney injury (PC-AKI) following coronary procedures is a common cause of renal impairment in hospitalized patients, curcuminoids exert anti-inflammatory and antioxidant actions and have shown positive effects on renal hemodynamic protection The objective of this study was to evaluate the role of curcuminoids in the prevention of PC-AKI in chronic kidney disease (CKD) patients. Methods: This study was a single-center, prospective, double-blind, randomized, placebo-controlled trial in patients with CKD undergoing elective coronary angiography (CAG) at Vajira Hospital from October 2018 to March 2019. Patients were randomized to receive curcuminoids at 1500 mg per day 3 days before and 2 days after the procedure or placebo. The primary outcome was the development of PC-AKI, and the secondary outcomes were overall acute kidney injury (AKI) incidence within 7 days after CAG, changes in estimated glomerular filtration rate (eGFR), interleukin-6 (IL-6), high sensitivity C-reactive protein (hs-CRP), and other adverse events. Results: Sixty patients were enrolled in this study (30 in the curcuminoid group and 30 in the control group). AKI developed in 5 patients in the control group but not in the curcuminoid group (16.67% vs 0%, P = .052). that curcuminoids could preserve changes in eGFR compared to the placebo group (-1.5 vs 2.5 mL/min/1.73 m 2 , P value <.001 within 48 hours and -4 vs 1 mL/min/1.73 m 2 , P value 0.002 within 7 days). However, the hs-CRP and IL-6 levels did not differ between the groups. No serious adverse events were observed in either of the groups. Conclusion: Prophylactic administration of curcuminoids, in addition to standard treatment, reduces the incidence of PC-AKI in patients with CKD undergoing elective CAG.

setting where a proportion of neonates do not receive TH, we conducted this study with the following objectives a) to compare the incidence and severity of AKI in neonates with perinatal asphyxia who receive therapeutic hypothermia (TH+) to those who don't receive it (TH-) b) compare the levels of urinary biomarkers in those with AKI to those without AKI. Methods: A prospective observational study was conducted in the neonatal intensive care of a tertiary referral hospital from March 2018 to November 2019. Neonates (inborn and outborn) >35 completed weeks gestational age with perinatal asphyxia and moderate to severe hypoxic ischemic encephalopathy using the Sarnat and Sarnat classification were included. TH using whole body cooling was administered in all babies who were admitted within 6 hours of life for 72 hours with 18 hours of re-warming. The incidence and severity of AKI was compared between TH+ and TH-. Urinary biomarkers like neutrophil gelatinase associated lipocalin (NGAL), cystatin C (ucysC) and beta 2 microglobulin (B2m) were tested on day 1 of life using a Luminex based assay and were compared between those who had and did not have AKI.Results: Among 39 neonates, 29 (74%) received therapeutic hypothermia. Thirty (76%) were males and 25 (64%) were inborn babies, 10 (25%) were preterm. The median birth weight was 2.3 (2.1, 2.7) kg. The incidence of AKI was 5/10 (50%) in TH-group when compared to 5/29 (18%) in TH+ group (p=0.04). In the TH+ group, 80% had stage 1 AKI, 20% had stage 2 AKI when compared to 20% stage 1, 60% stage 2 AKI and 20% stage 3 in TH-group (p=0.15). None of neonates required dialysis. After adjusting for other risk factors for AKI like shock, ventilation and sepsis, TH+ was associated with a significantly lower incidence of AKI (p=0.03). The urinary levels of NGAL were higher in neonates with AKI (210 (66, 473) ng/ml) when compared to those without AKI (140 (42, 556) ng/ml) (p=0.65) while levels were comparable for B2m (p=0.11) and ucysC (p=0.45) . Conclusions: Therapeutic hypothermia is associated with a significantly lower incidence of AKI in neonates with perinatal asphyxia. Urinary NGAL is a useful biomarker for the diagnosis of AKI in neonates with perinatal asphyxia.