Sepsis and Acute Kidney Injury

Bilgili, Beliz; Haliloğlu, Murat; Cinel, İsmail

doi:10.5152/tjar.2014.83436

Cited by 28 publications

(21 citation statements)

References 65 publications

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“…Multiple inflammatory mediators and enzymes participate in organism damage; however, the kidney is the most sensitive organ in sepsis infection [1]. Acute kidney injury (AKI) is a clinical syndrome caused by a variety of pathogens, leading to morbidity and mortality in patients [2]. The pathogenesis is complicated, including pro-inflammatory cytokines, ROS, and cell apoptosis [3][4][5].…”

Section: Introductionmentioning

confidence: 99%

Protopine Protects Mice against LPS-Induced Acute Kidney Injury by Inhibiting Apoptosis and Inflammation via the TLR4 Signaling Pathway

Zhang

Zeng

et al. 2019

Molecules

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Corydalis humosa Migo is a traditional Chinese medicine that clears away damp heat, relieves sore. Protopine (PRO) is an alkaloid component isolated from C. humosa Migo. However, the role of protopine in acute kidney injury (AKI) has not yet been reported. This study aims to investigate the effect and mechanism of protopine isolated from C. humosa Migo on lipopolysaccharide (LPS)-induced AKI in mice. Inflammation accumulation was assessed by small animal living imaging. The blood urea nitrogen (BUN), and serum creatinine (Scr) were measured to assess the effects of protopine on renal function in LPS-induced AKI. The levels of tumor necrosis factor (TNF), interleukin-2 (IL-2), interferon-γ (IFN-γ), and (interleukin-10) IL-10 in serum were detected by cytometric bead array. Flow cytometry was used to detect the levels of reactive oxygen species (ROS) in primary kidney cells. The proportions of granulocytes, neutrophils, and macrophages in peripheral blood were examined to evaluate the effect of protopine on immune cells in mice with AKI. Toll-like receptor (TLR4) and apoptotic signaling pathway were detected by Western blot analysis. The results showed that protopine markedly improved the renal function, relieve inflammation, reversed inflammatory cytokines, transformed apoptosis markers, and regulated the TLR4 signaling pathway in mice with AKI induced by LPS. The protopine isolated from C. humosa Migo protected mice against LPS-induced AKI by inhibiting apoptosis and inflammation via the TLR4 signaling pathway, thus providing a molecular basis for a novel medical treatment of AKI.

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Section: Introductionmentioning

confidence: 99%

Protopine Protects Mice against LPS-Induced Acute Kidney Injury by Inhibiting Apoptosis and Inflammation via the TLR4 Signaling Pathway

Zhang

Zeng

et al. 2019

Molecules

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“…The predictors that determine AKI in our study were comparable to previous studies. For instance, patient age [8,24,27], sepsis at ICU admission [9], SOFA non-renal score [1,28], emergency surgery [8,24], and perioperative blood lost [29].…”

Section: Discussionmentioning

confidence: 99%

Acute kidney injury risk prediction score for critically-ill surgical patients

et al. 2020

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Background: There has been a global increase in the incidence of acute kidney injury (AKI), including among critically-ill surgical patients. AKI prediction score provides an opportunity for early detection of patients who are at risk of AKI; however, most of the AKI prediction scores were derived from cardiothoracic surgery. Therefore, we aimed to develop an AKI prediction score for major non-cardiothoracic surgery patients who were admitted to the intensive care unit (ICU). Methods: The data of critically-ill patients from non-cardiothoracic operations in the Thai Surgical Intensive Care Unit (THAI-SICU) study were used to develop an AKI prediction score. Independent prognostic factors from regression analysis were included as predictors in the model. The outcome of interest was AKI within 7 days after the ICU admission. The AKI diagnosis was made according to the Kidney Disease Improving Global Outcomes (KDIGO)-2012 serum creatinine criteria. Diagnostic function of the model was determined by area under the Receiver Operating Curve (AuROC). Risk scores were categorized into four risk probability levels: low (0-2.5), moderate (3.0-8.5), high (9.0-11.5), and very high (12.0-16.5) risk. Risk of AKI was presented as likelihood ratios of positive (LH+). Results: A total of 3474 critically-ill surgical patients were included in the model; 333 (9.6%) developed AKI. Using multivariable logistic regression analysis, older age, high Sequential Organ Failure Assessment (SOFA) non-renal score, emergency surgery, large volume of perioperative blood loss, less urine output, and sepsis were identified as independent predictors for AKI. Then AKI prediction score was created from these predictors. The summation of the score was 16.5 and had a discriminative ability for predicting AKI at AuROC = 0.839 (95% CI 0.825-0.852). LH+ for AKI were: low risk = 0.117 (0.063-0.200); moderate risk = 0.927 (0.745-1.148); high risk = 5.190 (3.881-6.910); and very high risk = 9.892 (6.230-15.695), respectively. Conclusions: The function of AKI prediction score to predict AKI among critically ill patients who underwent noncardiothoracic surgery was good. It can aid in early recognition of critically-ill surgical patients who are at risk from ICU admission. The scores could guide decision making for aggressive strategies to prevent AKI during the perioperative period or at ICU admission.

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“…The authors stated that medications that have long been successful in animals for the treatment of ARF have unfortunately not been similarly effective in most people experiencing sepsis and sepsis shock in intensive care units. They further suggested that sepsis is a common cause of death and that this necessitated new investigations into the diagnosis and treatment of sepsis-related ARF [31]. On the other hand, Souza et al [32] stated that exposure to P. aeruginosa may cause septic shock, especially in patients with chronic renal failure.…”

Section: Discussionmentioning

confidence: 99%

Statistical analysis of the relationship between mortality and nosocomial factors in patients with septicemia and the importance of Pseudomonas aeruginosa

Dülger¹

2020

Turk J Vet Anim Sci

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The ongoing evolution of sepsis as a condition constitutes a global health concern and necessitates continuous monitoring and investigation of incidence rates, mortality factors, and disease patterns. This study sought to elucidate the frequency of bacterial cultures in patients with septicemia at our hospital and identify the factors influencing mortality. Zoonotic risk factors with reference to the literature were also taken into account.Independent variables of all patients diagnosed with sepsis were retrospectively screened to reveal factors affecting mortality. Incomplete or unclear data were not included. Continuous variables are represented as means and standard deviations, whereas binary variables are represented as percentages and frequency values. The distribution was evaluated using the Kolmogorov-Smirnov test. Separately, the Student's t-test or Mann-Whitney U test was used to compare differences for continuous variables between independent groups according to distribution status. Dichotomous variables were evaluated using the chi-squared or Fisher's exact test. Significant results found during univariate analysis were reevaluated using linear and binary logistic regression. Neither the length of hospital stay nor patient age was statistically significant, for mortality. Among dichotomous variables, sex also did not impact the mortality rate. Meanwhile, Salmonella, Shigella, and Pseudomonas aeruginosa infections were found to cause mortality. During the final statistical analysis using multiple logistic regression, only P. aeruginosa was a factor influencing the mortality rate. P. aeruginosa is an important pathogen that contributes to increased risks of mortality and zoonotic transmission among patients with sepsis.

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Sepsis and Acute Kidney Injury

Cited by 28 publications

References 65 publications

Protopine Protects Mice against LPS-Induced Acute Kidney Injury by Inhibiting Apoptosis and Inflammation via the TLR4 Signaling Pathway

Protopine Protects Mice against LPS-Induced Acute Kidney Injury by Inhibiting Apoptosis and Inflammation via the TLR4 Signaling Pathway

Acute kidney injury risk prediction score for critically-ill surgical patients

Statistical analysis of the relationship between mortality and nosocomial factors in patients with septicemia and the importance of Pseudomonas aeruginosa

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