Recovery from AKI in the critically ill: potential confounders in the evaluation

Schetz, Miet; Gunst, Jan; Vlieger, Greet De; Berghe, Greet Van den

doi:10.1007/s00134-015-3946-3

Cited by 46 publications

(51 citation statements)

References 43 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In consequence, results concerning the 6-month outcome, especially persistent renal dysfunction, might not be applicable to patients experiencing at least a partial renal recovery allowing discontinuation of RRT in the ICU. Second, eGFR criterion might have overestimated renal recovery due to muscle wasting during ICU stay [38].…”

Section: Discussionmentioning

confidence: 99%

Continuous renal replacement therapy versus intermittent hemodialysis in intensive care patients: impact on mortality and renal recovery

Truche¹,

Darmon²,

Bailly³

et al. 2016

Intensive Care Med

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

Continuous renal replacement therapy versus intermittent hemodialysis in intensive care patients: impact on mortality and renal recovery

Truche¹,

Darmon²,

Bailly³

et al. 2016

Intensive Care Med

View full text Add to dashboard Cite

show abstract

“…However, studies that consider renal recovery as independence from dialysis can show higher recovery rates than those that evaluate patients with AKI based on baseline SCr 25. Additionally, studies using a discharge SCr to assess renal outcome in elderly patients with AKI can overestimate the incidence of renal recovery 26. We used a very restrictive definition of renal recovery (ie, return to eGFR ≥60 mL/min/1.73 m 2 rather than to SCr), because using eGFR enabled us to classify the patients according to their KDIGO stage of chronic disease.…”

Section: Discussionmentioning

confidence: 99%

“…James et al, studying older patients following coronary angiography, observed that the patients who developed AKI were more prone to nonrenal recovery beyond 90 days after the angiography and were more likely to progress toward end-stage renal disease (ESRD) 31. These adverse effects were associated with the severity of AKI 26,31. In our cohort, however, the peak SCr level and the need for dialysis (both indicative of AKI severity) were not independent factors associated with renal nonrecovery in the multivariate regression.…”

Section: Discussionmentioning

confidence: 99%

Outcomes of renal function in elderly patients with acute kidney injury

Li¹,

Zhao²,

Du³

et al. 2017

CIA

View full text Add to dashboard Cite

ObjectivesThe aim of this study was to explore the prognostic impact of clinical factors on the short-term outcomes of renal function (RF) in very elderly patients with acute kidney injury (AKI).Patients and methodsWe carried out a retrospective cohort study of only very elderly patients who developed AKI at the geriatric department of a tertiary medical center during the period 2007–2015. All patients with AKI were followed up for 90 days after AKI diagnosis or until death. Survivors were divided into recovery and nonrecovery groups according to their RF 90 days post-AKI. RF recovery was defined as an estimated glomerular filtration rate (eGFR) of ≥60 mL/min/1.73 m2.ResultsIn total, 668 patients (39.0%) developed AKI, and 652 patients were included in the final analysis. The median age of this population was 87 years, with 95.6% being male. The 90-day mortality rate was 33.6%. Of the 433 survivors, 316 (73.0%) recovered to their baseline eGFR. Body mass index (BMI), baseline eGFR, low mean aortic pressure (MAP), low prealbumin level, hypoalbuminemia, oliguria, blood urea nitrogen (BUN) level, and more severe AKI stage were independent risk factors associated with nonrenal recovery or death. AKI etiology, evaluated by peak serum creatinine (SCr) level and the requirement for dialysis, was not associated with nonrenal recovery.ConclusionRisk factors for the poor outcomes of RF in very elderly patients with AKI were BMI, baseline eGFR, low MAP, low prealbumin level, hypoalbuminemia, oliguria, BUN level, and more severe AKI stage. Identifying risk factors may help to improve patient outcomes.

show abstract

“…However, there is now a trend towards early renal replacement therapy (RRT) in vulnerable patients primarily for fluid management and stabilization of acidosis and humeral response in favor of excessive use of diuretics in high risk patients (17). Recovery from AKI following aortic surgery and critical illness is multifactorial and the long-term prognosis of these patients is often determined by the lack of M A N U S C R I P T A C C E P T E D ACCEPTED MANUSCRIPT 10 full recovery and requirement of ongoing RRT, which in its own right negatively affects long term survival (18).…”

Section: Acute Kidney Injury (Aki)mentioning

confidence: 99%

Postoperative management

Schraag

2016

Best Practice & Research Clinical Anaesthesiology

View full text Add to dashboard Cite

Most patients undergoing major aortic surgery have multiple comorbidities and are at high risk of postoperative complications that affect multiple organ systems. Different aortic pathologies and surgical repair techniques have specific impact on the postoperative course. Ischemia-reperfusion injury is the common denominator in aortic surgery and influences the integrity of end-organ function. Common postoperative problems include hemodynamic instability due to the immediate inflammatory response, renal impairment, spinal cord ischemia, respiratory failure with prolonged mechanical ventilation, and gastrointestinal symptoms such as ileus or mesenteric ischemia. Focused care bundles to establish homeostasis and a team working toward an early functional recovery determine the success of effective rehabilitation and outcomes after aortic surgery.

show abstract

Recovery from AKI in the critically ill: potential confounders in the evaluation

Abstract: These results indicate the need for rigorous description of AKI severity, the included population, definitions, and baseline creatinine handling in reports on AKI recovery.

Cited by 46 publications

References 43 publications

Continuous renal replacement therapy versus intermittent hemodialysis in intensive care patients: impact on mortality and renal recovery

Continuous renal replacement therapy versus intermittent hemodialysis in intensive care patients: impact on mortality and renal recovery

Outcomes of renal function in elderly patients with acute kidney injury

Postoperative management

Contact Info

Product

Resources

About