Analyzing Chinese Patients with Post-Operative Acute Kidney Injury

Zhang, Wen; Shen, Ping; Chen, Yongxi; Zhu, Ping; Shi, Hao; Li, Xiao; Xu, Yu; Ren, Hong; Chen, Nan

doi:10.3109/0886022x.2011.601827

Cited by 4 publications

(4 citation statements)

References 36 publications

(34 reference statements)

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“…Risk factors for AKI, including sepsis [33] , type of surgery [6] , contrast media exposure, and cardiorenal syndrome [14,15,23,34] were collected using standard definitions. Both serum creatinine and hourly urine output data were used to identify AKI, based on the AKI network definition [35] .…”

Section: Predisposing Conditionsmentioning

confidence: 99%

Incidence of Adverse Events during Continuous Renal Replacement Therapy

Akhoundi¹,

Singh²,

Vela³

et al. 2015

Blood Purif

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Background/Aims: The incidence of adverse events (AEs) in adults who receive continuous renal replacement therapy (CRRT) is unknown. We report the incidence of mechanical, metabolic, and hemodynamic CRRT AEs. Methods: This is a retrospective study of all consecutive adult patients (≥18 years) who underwent CRRT from January 1, 2007 to December 31, 2009. Results: Out of 595 patients who underwent CRRT, 366 (62%) were male and 500 (84%) were Caucasian. Regional citrate anticoagulation was used in 98.6% of all patients. The most common clinically significant electrolyte derangements were ionized hypocalcemia (22%), ionized hypercalcemia (23%), and hyperphosphatemia (44%). Almost all (97%) patients had at least one additional AE including new onset hypotension (within the first hour after CRRT initiation) (43%), hypothermia (44%), new onset arrhythmias (29%), new onset anemia (31%) and thrombocytopenia (40%). Conclusions: ICU patients who require CRRT have a high incidence of AEs. Although the extent to which these complications are attributable to CRRT is not known, clinicians need to be cautious and aware of their high prevalence in this patient population.

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Section: Predisposing Conditionsmentioning

confidence: 99%

Incidence of Adverse Events during Continuous Renal Replacement Therapy

Akhoundi¹,

Singh²,

Vela³

et al. 2015

Blood Purif

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“…The definition of AKI encompasses the whole spectrum of the syndrome from minor changes in renal function to requirement for renal replacement therapy [1,2,3]. AKI is a common complication for hospitalized patients and recent studies demonstrate that the incidence of AKI is rapidly increasing [4,5,6]. Despite the advances in treatment of AKI, many patients still progress to end-stage renal disease and depend on dialysis.…”

Section: Introductionmentioning

confidence: 99%

Identification of Nestin as a Urinary Biomarker for Acute Kidney Injury

Zhang

Chen

et al. 2014

Am J Nephrol

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Objectives: Acute kidney injury (AKI) is a common complication in hospitalized patients and the incidence of AKI is rapidly increasing. Despite the advances in treatment of AKI, many patients still progress to end-stage renal disease and depend on dialysis. Therefore, early diagnosis and adequate treatment of AKI could improve prognosis. Methods: We established rat models of AKI induced by cisplatin nephrotoxicity and renal ischemia-reperfusion (I/R). Urine samples were collected, labeled with isobaric tags for relative and absolute quantification agents, and then subjected to nano-LC-MS/MS-based proteomic analysis. Results of the proteomic study were confirmed by Western blot. We also performed RNAi to silence nestin and investigate its role in renal I/R injury. We then validated its clinical application by studying urine nestin levels in AKI patients with cardiovascular surgeries. Results: Our proteomic analysis showed that fetuin-A, nestin, hamartin and T-kininogen were differentially expressed in the urine samples of rats after cisplatin or I/R treatment. Western blot confirmed the differential expression of these proteins in animal models and ELISA confirmed the differential expression of nestin in human urine samples. To explore the expression of nestin in the development of AKI, our results showed that nestin was primarily detected in the glomeruli and barely detected in tubular cells but increased in tubular cells during I/R- and cisplatin-induced AKI. The urine nestin-to-creatinine ratio increased earlier than serum creatinine in AKI patients with postcardiovascular surgeries. The role of nestin in AKI might be related to the p53 signaling pathway. Conclusions: Thus, our results demonstrated that urinary nestin could be a urinary biomarker for patients with AKI and its role in AKI might be related to the p53 signaling pathway.

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“…Therapeutic intervention and renal replacement therapy have minimal impact on the AKI. Resources should focus on renal risk stratification and preventing AKI in the elderly in the perioperative settings (41, 49, 50). Clinicians should be able to anticipate AKI on the basis of patients’ clinical characteristics and minimize the morbidities occurring with postoperative renal failure (51).…”

Section: Discussionmentioning

confidence: 99%

Predictors of Acute Kidney Injury in Geriatric Patients Undergoing Total Knee Replacement Surgery

Sehgal¹,

Bajwa²,

Sehgal³

et al. 2014

Int J Endocrinol Metab

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Background:Few studies have focused on patients’ characteristics that affects acute kidney injury (AKI) after total knee replacement surgery (TKR).Objectives:The primary objective of this retrospective study was to identify patients’ characteristics associated with AKI after TKR.Patients and Methods:Between January 2008 and December 2009, 659 patients with a mean age of 67.1 years (range, 39-99) underwent TKA at Regional Hospital Knee and Hip Institute. Retrospective chart review was done to identify patients’ characteristics that were associated with AKI after TKR. Logistic regression was used to evaluate AKI.Results:AKI occurred in 21.9% of patients. AKI risk decreased between 2008 and 2009 (odds ratio, 0.55; 95% CI, -0.37 to 0.82) but increased with age (P < 0.001), diabetes mellitus (DM), and angiotensin converting enzyme inhibitors (ACEI)/angiotensin receptor blockers (ARB) use (OR, -1.6; 95% CI, -1.0 to 2.5; and OR, -1.5, 95% CI, -1.0 to 2.3, respectively). However, the effects of DM and ACEI/ARB use were not independent; when both were included in the regression model, neither was statistically significant, and both ORs were smaller than combined OR.Conclusions:When examined separately, both DM and preoperative ACEI/ARB use increased the risk of AKI; however these factors were correlated and were not independent predictors of significantly increased risk. Patients with DM have higher tendency to develop AKI and hence, preoperative renal risk stratification should be done in all patients with DM.

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Analyzing Chinese Patients with Post-Operative Acute Kidney Injury

Cited by 4 publications

References 36 publications

Incidence of Adverse Events during Continuous Renal Replacement Therapy

Incidence of Adverse Events during Continuous Renal Replacement Therapy

Identification of Nestin as a Urinary Biomarker for Acute Kidney Injury

Predictors of Acute Kidney Injury in Geriatric Patients Undergoing Total Knee Replacement Surgery

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