Outcomes of renal  function in elderly patients with acute kidney injury

Li, Qinglin; Zhao, Meng; Du, Jing; Wang, Xiaodan

doi:10.2147/cia.s121823

Cited by 14 publications

(9 citation statements)

References 33 publications

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“…Then a personalized probability of renal function recovery after AKI requiring RRT was obtained diabetes. 23,30 In the univariate analysis, the rate of patients with diabetes in the non-recovery group was higher than that in the recovery group, which was consistent with the medical common sense. However, diabetes was not selected in the final model.…”

Section: Discussionsupporting

confidence: 72%

Prospective model for predicting renal recovery in cardiac surgery patients with acute kidney injury requiring renal replacement therapy

Song

Liang

et al. 2021

Nephrology

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Aim: To develop a model for predicting renal recovery in cardiac surgery patients with acute kidney injury (AKI) requiring renal replacement therapy (RRT).Methods: Data from a prospective randomized controlled trial, conducted in a tertiary hospital to compare the survival effect of two dosages of hemofiltration for continuous RRT in cardiac surgery patients between 20 March 2012 and 9 August 2015, were used to develop the model. The outcome was renal recovery defined as alive and dialysis-free 90 days after RRT initiation. Multivariate logistic regression with a stepwise backward selection of variables based on Akaike Information Criterion was applied to develop the model, which was internally validated using bootstrapping.Model discrimination, calibration and clinical value were assessed using the concordance index (C-Index), calibration plots and decision curve analysis, respectively.Results: Totally, 211 patients with AKI requiring RRT (66.8% male) with median age of 57 years were included. The incidence of renal recovery was 33.2% (n = 70). The model included six variables: body mass index stratification, baseline estimated glomerular filtration rate, hypertension, sepsis, mean arterial pressure and mechanical ventilation. The C-Index for this model was 0.807 (95% CI, 0.744-0.870). After correction by the bootstrap, the C-Index was 0.780 (95% CI, 0.720-0.845). The calibration plots indicated good consistency between actual observations and model prediction of renal recovery. Decision curve analysis demonstrated the model was clinical usefulness. Conclusion:We developed and validated a model to predict the chance of renal recovery in cardiac surgery patients with AKI requiring RRT.

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Section: Discussionsupporting

confidence: 72%

Prospective model for predicting renal recovery in cardiac surgery patients with acute kidney injury requiring renal replacement therapy

Song

Liang

et al. 2021

Nephrology

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“…Moreover, AKI development is per se an independent risk factor of long-term mortality in older patients. Bagshaw et al [166,170] clearly showed that older age was independently associated with increased in-hospital and 1-year mortality in patients with AKI and severe AKI.…”

Section: Outcomementioning

confidence: 99%

Molecular Mechanisms of AKI in the Elderly: From Animal Models to Therapeutic Intervention

Infante

Franzin

Madio

et al. 2020

JCM

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Acute kidney injury (AKI), a critical syndrome characterized by a sudden reduction of renal function, is a common disorder among elderly patients particularly in Intensive Care Unit (ICU). AKI is closely associated with both short- and long-term mortality and length of hospital stay and is considered a predictor of chronic kidney disease (CKD). Specific hemodynamic, metabolic, and molecular changes lead to increased susceptibility to injury in the aged kidney; therefore, certain causes of AKI such as the prerenal reduction in renal perfusion or vascular obstructive conditions are more common in the elderly; moreover, AKI is often multifactorial and iatrogenic. Older patients present several comorbidities (diabetes, hypertension, heart failure) and are exposed to multiple medical interventions such as the use of nephrotoxic contrasts media and medications, which can also trigger AKI. Considering the emerging relevance of this condition, prevention and treatment of AKI in the elderly should be crucial in the internist and emergency setting. This review article summarizes the incidence, the risk factors, the pathophysiology, the molecular mechanisms and the strategies of prevention and treatment of AKI in elderly patients.

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“…Uremia syndrome can be defined as the terminal clinical manifestation of renal failure. The levels of BUN and SCr allow for the estimation of renal function [ 23 , 24 ]. Meanwhile, it has been reported that weight loss is a common symptom of uremia, and weight loss induced by bariatric surgery, physical exercise, or low-calorie diets is usually accompanied by a significant antiproteinuric effect [ 25 ].…”

Section: Discussionmentioning

confidence: 99%

Effects of RNA interference-mediated gene silencing of VEGF on the ultrafiltration failure in a rat model of peritoneal dialysis

Wang

Liu

et al. 2017

Bioscience Reports

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We investigated the effects of RNAi-mediated gene silencing of vascular endothelial growth factor (VEGF) on ultrafiltration failure (UFF) in rats with peritoneal dialysis (PD). Sprague–Dawley (SD) male rats were classified into normal, sham operation, and uremic model groups. Uremic rats were subcategorized into uremia, PD2, VEGF shRNA-2, vector-2, PD2 + Endostar, PD4, VEGF shRNA-4, Vector-4, and PD4 + Endostar groups. Peritoneal Equilibration Test (PET) was conducted to assess ultrafiltration volume (UFV) and mass transfer of glucose (MTG). mRNA and protein expressions of VEGF were detected using quantitative real-time PCR (qRT-PCR) and Western blotting. Immunohistochemistry was performed to detect microvessel density (MVD). Compared with the normal group, decreased UFV and increased MTG were observed in rest of the groups. Compared with the uremia group, UFV decreased, while MTG, expression of VEGFs, and number of new blood capillaries increased in the PD2, Vector-2, PD4, and Vector-4 groups. The PD4 and Vector-4 groups exhibited lower UFV and higher MTG than the PD2 group. In the VEGF shRNA-2, PD2 + Endostar, VEGF shRNA-4, and in PD4 + Endostar group increased UFV, reduced MTG and expression of VEGF, and decreased number of new blood capillaries were detected. Compared with the PD4 group, in the VEGF shRNA-4 and PD4 + Endostar groups, UFV increased, MTG and expression of VEGF decreased, and number of new blood capillaries reduced. VEGF expression was negatively correlated with UFV, but positively correlated with MTG. The results obtained in the study revealed that down-regulation of VEGF by RNAi could be a novel target approach for the treatment of UFF.

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Outcomes of renal function in elderly patients with acute kidney injury

Cited by 14 publications

References 33 publications

Prospective model for predicting renal recovery in cardiac surgery patients with acute kidney injury requiring renal replacement therapy

Prospective model for predicting renal recovery in cardiac surgery patients with acute kidney injury requiring renal replacement therapy

Molecular Mechanisms of AKI in the Elderly: From Animal Models to Therapeutic Intervention

Effects of RNA interference-mediated gene silencing of VEGF on the ultrafiltration failure in a rat model of peritoneal dialysis

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