Acute Kidney Injury: Not Just Acute Renal Failure Anymore?

Dirkes, Susan

doi:10.4037/ccn2011946

Cited by 31 publications

(32 citation statements)

References 152 publications

(145 reference statements)

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“…(9,17) Scientific studies such as the present one have showed that older age and overweight were factors present in the sample who developed AKI. (10,25) The high APACHE II score can be considered a risk factor for death in patients with acute kidney injury, as well as risk for requiring dialysis (6) -a reality observed in this study.…”

Section: Discussionmentioning

confidence: 83%

“…(5) Acute kidney injury is a critical problem in severely ill patients and is usually predictive of increased morbidity and mortality. (6) It affects between 5 and 30% of patients in the postoperative period of cardiac surgery. (7,8) Renal dysfunction can be identified in the postoperative period of cardiac surgery, both in patients with pre-existing renal damage and in those without previous renal impairment.…”

Section: Introductionmentioning

confidence: 99%

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Lesão renal aguda no pós-operatório de cirurgia cardíaca

Nascimento

Aguiar²,

Silva

et al. 2015

Acta paul. enferm.

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Objective: To identify the occurrence of acute kidney injury (AKI) in the postoperative period of cardiac surgery. Methods: A prospective cohort study including 51 patients exposed to coronary artery bypass surgery, valve replacement, or combined surgery (bypass surgery and valve replacement) without history of kidney disease and kidney transplant, and who were followed from the preoperative period until 72 hours after surgery. Acute renal failure was defined as baseline creatinine increase of 0.3 mg/dL in 48 hours or less, or its increase from 1.5 to 1.9-fold, or a reduction in urine flow <0.5mL/kg/h for 6 hours. The Kidney Disease: Improving Global Outcomes (KDIGO) classification was used. Results: The KDIGO classification showed that 92.2% of patients had renal impairment. The urinary flow criterion of this classification alone showed that 31.4% of patients had renal dysfunction in stage of risk, 33.3% in stage of renal injury, and 21.6% in stage of renal failure. By the serum creatinine criterion, 27.5% were identified in the stage of risk, 3.9% in stage of injury and another 3.9% in stage of kidney failure. Conclusion: A high percentage of patients in the postoperative period of cardiac surgery (coronary artery bypass surgery and valve replacement) progressed to acute kidney injury. ResumoObjetivo: Identificar a ocorrência de lesão renal aguda em pós-operatório de cirurgia cardíaca. Métodos: Estudo de coorte prospectivo que incluiu 51 pacientes expostos a cirurgia de revascularização do miocárdio, troca valvar ou cirurgia combinada (revascularização do miocárdio e troca valvar), sem antecedentes de doença renal e de transplante renal e que foram acompanhados desde o pré-operatório até 72 horas de pós-operatório. Foi definido como lesão renal aguda o aumento de 0,3mg/dL em tempo menor ou igual a 48 horas ou aumento de 1,5 a 1,9 vez da creatinina basal, ou ainda redução do fluxo urinário <0,5mL/kg/h por 6 horas. Foi utilizada a classificação Kidney Disease: Improving Global Outcomes (KDIGO). Resultados: A classificação KDIGO sinalizou 92,2% dos pacientes com disfunção renal. O critério fluxo urinário dessa classificação isoladamente mostrou que 31,4% dos pacientes apresentaram disfunção renal no estágio de risco, 33,3% no estágio de lesão renal, e 21,6% no estágio de falência renal. Pelo critério creatinina sérica, foram identificados 27,5% no estágio de risco e, nos estágios de lesão e falência renal, foram identificados 3,9% pacientes em cada. Conclusão: Um percentual elevado de pacientes em pós-operatório de cirurgia cardíaca (revascularização miocárdica e troca valvar) progrediu com lesão renal aguda.

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Section: Discussionmentioning

confidence: 83%

Section: Introductionmentioning

confidence: 99%

Lesão renal aguda no pós-operatório de cirurgia cardíaca

Nascimento

Aguiar²,

Silva

et al. 2015

Acta paul. enferm.

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“…El término de Insuficiencia Renal Aguda ha cambiado a FRA, para reflejar un continuum de la enfermedad y no como un solo evento (3,4,5). Se define el FRA como un proceso progresivo y reversible, producido por causas hemodinámicas o tóxicas, que abarca desde el desarrollo de lesiones subletales de las células renales identificables por biomarcadores (fase de lesión renal aguda) al daño estructural caracterizado por la necroaptosis de las células tubulares, necrosis tubular aguda, en el que se constata elevación de la creatinina sérica y descenso de la tasa de filtrado glomerular (3) .…”

Section: Fracaso Renal Agudo: Definición Y Etiologíaunclassified

Revisión de conocimientos sobre el fracaso renal agudo en el contexto del paciente crítico

Romero-García

Hito

Ariza

2013

Enfermería Intensiva

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ResumenEl fracaso renal agudo afecta entre un 1% y un 25% de los pacientes ingresados en unidades de cuidados intensivos, cifras que varían según la población y criterios estudiados.Las complicaciones derivadas del fracaso renal agudo (hipervolemia, acidosis metabólica, hiperpotasemia, hemorragias) se tratan pero la mortalidad sigue siendo elevada a pesar de los avances tecnológicos de los últimos años ya que, habitualmente, el fracaso renal agudo está asociado a sepsis, insuficiencia respiratoria, heridas graves, complicaciones quirúrgicas o coagulopatías de consumo. El rango de mortalidad va desde un 30% a un 90%.Aunque no disponemos de una definición universalmente aceptada, la clasificación RIFLE aporta una herramienta operativa tanto para definir el grado de fracaso renal agudo como para homogeneizar el inicio de las Técnicas de Depuración Extrarrenal y evaluar los resultados obtenidos.En consecuencia, las enfermeras que trabajan en una unidad de cuidados intensivos deben estar familiarizadas con esta patología, con su tratamiento (farmacológico o sustitutivo) y con la prevención de las posibles complicaciones. De igual manera han de ser capaces de detectar las manifestaciones de dependencia de cada una de las necesidades básicas e identificar los problemas de colaboración para conseguir un plan de cuidados individualizado.Palabras clave: Cuidados intensivos, Atención de Enfermería, Proceso de Enfermería, Lesión Renal Aguda, Terapéutica. AbstractAcute renal failure affects between 1% to 25% of patients admitted to intensive care units, figures vary depending on the population studied and criteria.Complications of Acute renal failure (fluid overload, metabolic acidosis, hyperkalaemia, bleeding) are treated but the mortality remains high despite technological advances in recent years because the acute renal failure is usually associated with sepsis, respiratory failure, serious injury, complications surgical or consumption coagulopathy. Mortality ranges from 30% to 90%. RIFLE classification gives us both an operational tool to define the degree of acute renal failure and to standardize the start of renal replacement techniques and evaluate the results. We therefore consider that nurses working at intensive care unit should be familiar with this disease, with treatment (drug or alternative) and the prevention of possible complications. Must likewise be able to detect unmet needs depending on the manifestations of dependency, identify problems collaboratively to achieve individualized care plan.

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“…The risk of CIN is greatest in patients with GFR <30 mL/mins. 11,12 The diagnostic criteria for CIN include 13 exposure to contrast agent, increase in serum level of creatinine of 0.5 mg/dL or 25%> baseline, increase in serum level of creatinine occurs 48-72 hrs after administration of contrast agent and persists for 2-5 days with other alternative major injuries ruled out.…”

Section: Males 74mentioning

confidence: 99%