Acute Kidney Injury | Acute Renal Failure
Acute Kidney Injury is the newer term for acute renal failure. The publications cited below will discuss the evaluation, causes and treatment of AKI (ARF).
Shai Efrati, Sylvia Berman, Ramzia Abu Hamad, Yariv Siman-Tov, Eduard Ilgiyaev, Ilia Maslyakov, and Joshua Weissgarten
Nephrol. Dial. Transplant. first published online June 16, 2011 doi:10.1093/ndt/gfr256 |
Ion D Bucaloiu, H Lester Kirchner, Evan R Norfolk, James E Hartle and Robert M Perkins
Kidney International , (7 December 2011) | doi:10.1038/ki.2011.405 |
Author Interview: Dr. Ian J. Stewart
Association of AKI with Adverse Outcomes in Burned Military Casualties
Ian J. Stewart, Molly A. Tilley, Casey L. Cotant, James K. Aden, Christopher Gisler, Hana K. Kwan
Jeffery McCorcle, Evan M. Renz, and Kevin K. Chung
CJASN CJN.04420511; published ahead of print December 8, 2011
doi:10.2215/CJN.04420511 |
Author Interview: Dr. Antonio Santoro
Is time on cardiopulmonary bypass during cardiac surgery associated with acute kidney injury requiring dialysis?
Elena MANCINI, Fabio CARAMELLI, Marco RANUCCI, Diego SANGIORGI,
Letizia Bacchi REGGIANI, Guido FRASCAROLI, Annalisa ZUCCHELLI,
Antonio BELLASI, Antonio SANTORO
Nephrology, Dialysis and Hypertension Unit, Policlinico S.Orsola-Malpighi, Bologna, Italy;
Cardiosurgery Intensive Care Unit, Policlinico S.Orsola-Malpighi,
Bologna, Italy; Department of Cardiothoracic-Vascular Anesthesia and Intensive Care, IRCCS Policlinico S. Donato, Milan, Italy; Institute of Cardiology, Policlinico S.Orsola-Malpighi, Bologna, Italy; Nephrology and Dialysis, Unit, Azienda Ospedaliera S. Anna,
Ospedale S. Anna, Como, Italy |
Author Interview: Dr. Julie Ho
Urinary Hepcidin-25 and Risk of Acute Kidney Injury Following Cardiopulmonary Bypass
Julie Ho, Martina Reslerova, Brent Gali, Ang Gao, Jennifer Bestland, David N. Rush,
Peter W. Nickerson, and Claudio Rigatto
CJASN October 2011 6):(10)2340-2346; published ahead of print September 1, 2011,
doi:10.2215/CJN.01000211 |
Author Interview Claudio Rigatto, MD, FRCPC, MSc
Serum Creatinine Measurement Immediately After Cardiac Surgery and Prediction of Acute Kidney Injury
Julie Ho, Martina Reslerova, Brent Gali, Peter W. Nickerson, David N. Rush
Manish M. Sood, Joe Bueti, Paul Komenda, Edward Pascoe, Rakesh C. Arora,
Claudio Rigatto
American Journal of Kidney Diseases - 04 October 2011 (10.1053/j.ajkd.2011.08.023 |
Severe acute kidney injury not treated with renal replacement therapy: characteristics and outcome
Antoine G. Schneider Shigehiko Uchino and Rinaldo Bellomo
Department of Intensive Care, Austin Health, Heidelberg, Australia Department of Epidemiology and Preventive Medicine, Monash University, the Alfred Center, Melbourne, Australia
3Intensive Care Unit, Department of Anesthesiology, Jikei University School of Medicine, Tokyo, Japan
Nephrol. Dial. Transplant. (2011) doi: 10.1093/ndt/gfr501 |
|
|
|
Acute Kidney Injury (AKI) - Acute Renal Failure (ARF)
Washington, DC (August 12, 2011) — Acute kidney injury (AKI) is a common – but preventable -- complication after surgery that can lead to other complications or even death. The use and development of biomarkers will help physicians diagnose and treat acute kidney injury. Three protein measurements indicate who has a high risk of developing kidney injury after heart surgery, according to two studies appearing in an upcoming issue of the Journal of the American Society of Nephrology.
|
Chien CC, Wang HY, Wang JJ, Kan WC, Chien TW, Lin CY, Su SB.
Department of Nephrology, Chi-Mei Medical Center , Tainan , Taiwan.
Ren Fail. 2011 Jul 22.
|
Author Interview: Dr. Qionghong Xie
The Ratio of CRP to Prealbumin Levels Predict Mortality in Patients with Hospital-acquired Acute Kidney Injury
Xie Q, Zhou Y, Xu Z, Yang Y, Kuang D, You H, Ma S, Hao C, Gu Y, Lin S, Ding F
BMC Nephrol 2011 Jun 29; 12(1):30 |
|
Author Interview: Yung-Ming Chen, M.D.
Outcomes following Dialysis for Acute Kidney Injury among Different Stages of Chronic Kidney Disease
Lee PH, Wu VC, Hu FC, Lai CF, Chen YM, Tsai TJ, Wu KD.
Am J Nephrol. 2011 Jun 17;34(2):95-103.
Renal Division, Department of Internal Medicine, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan, ROC
|
Author Interview: Dr. Sun Woo Kang
Renal kallikrein excretion and epigenetics in human acute kidney injury: Expression, mechanisms and consequences
Sun Woo Kang, Pei-An Betty Shih, Roy O Mathew, Manjula Mahata, Nilima Biswas, Fangwen Rao, Liying Yan, Josee Bouchard, Rakesh Malhotra, Ashita Tolwani, Srikrishna Khandrika, Ravindra L Mehta, Daniel T Oconnor
BMC Nephrol. 2011 Jun 16;12 (1):27 |
Author Interview: Dr. John Kellumx
Plasma neutrophil gelatinase-associated lipocalin predicts recovery from acute kidney injury following community-acquired pneumonia
Kidney Int. 2011 Jun 15. doi: 10.1038/ki.2011.160.
Srisawat N, Murugan R, Lee M, Kong L, Carter M, Angus DC, Kellum JA.
1] The CRISMA (Clinical Research, Investigation, and Systems Modeling of Acute Illness) Center, Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA [2] Division of Nephrology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
|
Author Interview Dr. Chou,
Impact of timing of renal replacement therapy initiation on outcome of septic acute kidney injury.
Chou YH, Huang TM, Wu VC, Wang CY, Shiao CC, Lai CF, Tsai HB, Chao CT, Young GH, Wang WJ, Kao TW, Lin SL, Han YY, Chou A, Lin TH, Yang YW, Chen YM, Tsai PR, Lin YF, Huang JW, Chiang WC, Chou NK, Ko WJ, Wu KD, Tsai TJ, Nsarf Study Group T
Crit Care.2011 Jun 6;15(3):R134 |
Author Interview: Dr.Irit Krause, MD
Impact of dialysis type on outcome of acute renal failure in children: a single-center experience.
Krause I, Herman N, Cleper R, Fraser A, Davidovits M.
Isr Med Assoc J. 2011 Mar;13(3):153-6.
Institute of Pediatric Nephrology, Schneider Children's Medical Center of Israel, Petah Tikva, affiliated with Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Israel. |
|
Author Interview: Dr Clec'h Christophe, MD, PhD
Multiple-center evaluation of mortality associated with acute kidney injury in critically ill patients: a competing risks analysis.
Crit Care. 2011 May 17;15(3):R128.
Clec'h C, Gonzalez F, Lautrette A, Nguile-Makao M, Garrouste-Orgeas M, Jamali S, Goldgran-Toledano D, Descorps-Declere A, Chemouni F, Hamidfar-Roy R, Azoulay E, Timsit JF |
|
BMC Nephrol. 2010 Nov 25;11(1):32.
Fieghen HE, Friedrich JO, Burns KE, Nisenbaum R, Adhikari NK, Hladunewich MA, Lapinsky SE, Richardson RM, Wald R; University of Toronto Acute Kidney Injury Research Group.
Department of Medicine, University of Toronto, Toronto, ON, Canada.
|
|
Contrib Nephrol. 2010;165:263-73.
Cruz DN, et al
Department of Nephrology, Dialysis & Transplantation, International Renal Research Institute, Vicenza, Italy.
|
Contrib Nephrol. 2010;165:244-50
Uchino S.
Intensive Care Unit, Department of Anesthesiology, Jikei University School of Medicine, Tokyo, Japan
|
Hosp Pract (Minneap). 2010 Apr;38(2):67-73.
Shimada M, et al
Division of Renal Diseases and Hypertension, University of Colorado Health Sciences Center, Denver, CO, USA |
Renal Angina
Clin J Am Soc Nephrol 5: 943-949, 2010
Stuart L. Goldstein, and Lakhmir S. Chawla
|
|
| |
|
|
Author Interviews: hemodialysis
- Dialysis - ESRD - CKD |
| Predictors of eGFR Decline in Type 2 Diabetes & Preserved Kidney Function: Dr. Chonchol CJASN |
| Tenecteplase for improvement of blood flow in dysfunctional hemodialysis catheters: Dr. Goldman Clin Neph |
| Religious coping, psychological distress and quality of life in hemodialysis: Dr. Carvalho J Psychosom Res. |
| Effect of captopril on recuperation from ischemia/reperfusion-induced AKI Nephrology Dialysis Transplant |
| Restless legs syndrome in dialysis: comparison of hemodialysis & CAPD: Dr. Merlino Neurol Sci. |
| International practice patterns & non-conventional hemodialysis utilization : Dr. Sood BMC Nephrology |
| Decreased PON1 in hemodialyzed & renal transplanted patients. Dr. Paragh Nephrol. Dial. Transplant |
| Preoperative Proteinuria & Long-Term Progression to Chronic Dialysis & Mortality after CABG: Drs. Chao & Ko : PLoS ONE |
| Creatinine generation is reduced in CVHD & predicts mortality: Dr. Wilson: Nephrology Dialysis Transplant |
Importance of normohydration for the long-term survival in hemodialysis : Dr. Wabel
Nephrology Dialysis Transplant |
| Local Tissue Renin-Angiotensin System Activation in Cardiorenal Metabolic Syndrome & Type 2 Diabetes: Dr.Hayden Cardiorenal Med |
| Group I nonreciprocal inhibition in restless legs syndrome secondary to CKD : Dr. Marconi Parkinsonism & Related Disorders |
Low-Dose ESAs and CV Geometry in CKD: Is Darbepoetin-α More Effective than Expected? Dr. Di Lullo
Cardiorenal Med |
Pharmacotherapy to improve outcomes in vascular access surgery: Dr. Jackson
Nephrology Dialysis Transplant |
| Parathyroidectomy for the attainment of NKF-K/DOQI™ and KDIGO recommended values for bone & mineral metabolism in dialysis with uncontrollable secondary hyperparathyroidism. Langenbecks Arch Surg |
| Bisphosphonate Therapy, Death, and Cardiovascular Events Among Female Patients With CKD: Dr. Perkins |
| Losartan prevents the development of the pro-inflammatory monocytes CD14+CD16+ in hemodialysis : Dr. Merino Nephrology Dialysis Transplant |
| Does Dialysis Modality Influence the Oxidative Stress of Uremia? Dr. Capusa Kidney Blood Press Res |
| Treatment of Periodontal Diseases Reduces Inflammation in Hemodialysis : Dr. Siribamrungwong |
| Declining Rates of Deceased Donor Renal Transplantation in the US Over Successive Years of Listing: Dr. Trivedi |
| When Is the Best Moment to Assess the Ankle Brachial Index: Pre- or Post-Hemodialysis?Dr. RM Elias |
| Role of Race and Poverty on Steps to Kidney Transplantation in the Southeastern US |
| Validity & Reliability of the MUST and MST Nutrition Screening Tools in Renal Inpatients : C. Lawson |
| Target-Orientated Algorithm for Regional Citrate-Calcium Anticoagulation in Extracorporeal Therapies: Dr. Brandl |
| Evaluation of bone microarchitecture by HR-pQCT in hemodialysis : Dr. Negri |
| Erectile Dysfunction in Chronic Hemodialysis : Dr. Strippoli |
| Have Renal Dietitians Successfully Implemented Evidence-Based Guidelines Into Practice? E. Joy |
| Regional Citrate Versus Heparin Anticoagulation for CRRT: Drs. Tam & Wu |
| von Willebrand factor predicts mortality in CRRT : Dr. Péquériaux |
| Clinical Outcome of Twice-Weekly Hemodialysis Patients in Shanghai | Dr. Qian |
| Persistently low intact PTH levels predict aortic arch calcification progression in hemodialysis patients : Dr. Song |
| Lack of Awareness among Future Medical Professionals about the Risk of Consuming Hidden Phosphate-Containing Processed Food & Drinks : Dr. Razzaque |
| 51Cr-EDTA plasma & urinary clearance as a measure of residual renal function in dialysis :Dr. Kjaergaard |
| Obesity and Mortality Risk among Younger Dialysis Patients: Dr. Hoogeveen |
| Solar-Assisted Hemodialysis: Dr. Agar |
| Hydrogen sulfide inhibits high glucose-induced matrix protein synthesis by activating AMP-activated protein kinase in renal epithelial cells Drs. Lee & Kasinath |
| Mineral, bone disorders, survival in hemodialysis with & without PKD : Drs. Molnar & Kalantar-Zadeh |
| Hydrogen sulfide inhibits high glucose-induced matrix protein synthesis by activating AMP-activated protein kinase in renal epithelial cells Drs. Lee & Kasinath |
| Mineral, bone disorders, survival in hemodialysis with & without PKD : Drs. Molnar & Kalantar-Zadeh |
| Downregulation of the renal & hepatic hydrogen sulfide-producing enzymes and capacity in CKD - Dr. Vaziri |
| A predictive algorithm for management of anemia in hemodialysis based on ESA pharmacodynamics : Dr. Lines |
| Factors Associated With Intradialytic Systolic Blood Pressure Variability: Dr. Flythe |
| Safety and predictors of complications of renal biopsy in the outpatient setting : Dr. Jiang |
| Heparin induced antibodies in chronic hemodialysis patients and cardiac surgery patients: Dr. Shavit |
| Atrial Fibrillation in Medicare/Medicaid-eligible dialysis patients: Dr. Wetmore |
| Newly identified anorexigenic adipokine nesfatin-1 in hemodialysis patients: J. Saldanha |
| Correction of Post kidney Transplant Anemia Reduces Progression of Allograft Nephropathy: Dr. Choukrou |
| Mild and moderate pre-dialysis CKD is associated with increased coronary artery calcium: Dr. Budoff |
| Endogenous factors modified by hemodialysis and accuracy of blood glucose-measuring device: Dr. Ogawa |
| Narrow-band UVV increases serum vitamin D levels in hemodialysis patients Dr. Ala-Houhala |
| Predicting hospital cost in CKD patients through blood chemistry values: Dr. Bessette |
| Nutritional vitamin D supplementation in hemodialysis: a potential vascular benefit? D. Mason |
| Volume excess in chronic hemodialysis effects of treatment frequency & treatment spacing : Dr. Schneditz |
| Acid reduction with fruits/veges or bicarb attenuates kidney injury in hypertensive nephropathy with reduced GFR |
Predicting Number of US Medical Graduates Entering Adult Nephrology Fellowships
Using Search Terms Dr. Desai |
| Potential influence of sevelamer hydrochloride on responsiveness to ESAs in hemodialysis patients: Dr. Ikee |
| Anemia Management in Dialysis : ESAs vs Transfusions: Clinical & Economic Consequences :Dr. Naci |
| Increased risk of death and de novo chronic kidney disease following reversible acute kidney injury: Dr. Perkins |
| Filtration Markers May Have Prognostic Value Independent of Glomerular Filtration Rate : Dr. Tangri |
| Stopping Renin-Angiotensin System Inhibitors in Chronic Kidney Disease: Predictors of Response |
| Insights into nephrologist training, clinical practice, and dialysis choice: Dr. Mehrotra |
| Early ACE inhibition in Alport syndrome delays renal failure and improves life expectancy: Dr. Gross |
| Blunted insulinemia using high dialysate glucose concentration during hemodialysis : Dr. Schneditz |
| Prevalence of Inadequate Platelet Inhibition by Clopidogrel in Patients Receiving Hemodialysis: Dr. Alexopoulos |
| Live kidney donation: attitudes towards donor approach, motives and factors promoting donation: Dr. Mazaris |
| High-dose ESAs, inflammatory biomarkers, and soluble erythropoietin receptors : Dr. Inrig |
| Association of AKI with Adverse Outcomes in Burned Military Casualties : Dr. Stewart |
| Sodium Intake, ACE Inhibition, and Progression to ESRD Dr. Ruggenenti |
DOPPS Practice Monitor: Update on Trends in US Hemodialysis Care Following Launch of Bundled Payment System and Revisions to ESA Labels January 6 2011 |
Emerging trends in hemodialysis care through August 2011, based on a sample of US dialysis facilities, are included in the latest update to the DOPPS Practice Monitor (DPM, at http://www.dopps.org/DPM), run by the Dialysis Outcomes and Practice Patterns Study (DOPPS) at Arbor Research Collaborative for Health.
Ongoing Changes in the US Dialysis Environment – Recent changes in dialysis payment and regulatory guidance are expected to affect hemodialysis practice. In January 2011, the Centers for Medicare & Medicaid Services (CMS) launched a new Prospective Payment System (PPS) with the intent to control dialysis costs through bundled payments. In June 2011, the FDA approved revised prescribing information for erythropoiesis-stimulating agents (ESAs), used to treat anemia in most dialysis patients. Previously, the label recommended a hemoglobin target range of 10-12 g/dL. The June 2011 update removed the target range, advising instead to start ESA therapy for dialysis patients at hemoglobin less than 10 g/dL, and to reduce or interrupt the dose when the hemoglobin approaches or exceeds 11 g/dL.
Most Recent Trends in Care – Over the August 2010 to August 2011 time period, many hemodialysis practices have remained stable; examples include nutrition measures and hemodialysis treatment time and dose. There have been notable trends in the following practice areas:
- Anemia: Hemoglobin levels have decreased since the June 2011 ESA label update. While the mean hemoglobin level declined by 0.12 g/dL over 12 months from August 2010 to July 2011, it declined in August 2011 by another 0.10 g/dL to 11.26 g/dL. The percentage of patients with hemoglobin levels greater than 12 g/dL declined sharply (from 28% to 23%) in July/August 2011, while the percentage with hemoglobin levels less than 10 g/dL increased slightly from 8.5% to 10% and the percentage with hemoglobin levels less than 9 g/dL remained under 3%.
Mean prescribed epoetin dose (among patients receiving epoetin) decreased by 15%, from 21,100 units/wk to 17,900 units/wk, from August 2010 to August 2011, with the greatest decline in June-August 2011. Epoetin doses at the higher end of the dose range have decreased most notably. IV iron use increased from August 2010 to August 2011 though has recently stabilized. In keeping with greater IV iron use, serum ferritin levels (indicative of iron stores) continue to rise. Serum ferritin concentration exceeded 500 ng/mL in 65% of patients, 800 ng/mL in 34% of patients, and 1,200 ng/mL in 11% of patients in August 2011.
- Mineral & Bone Disorder: In our last report, we noted a 29% increase in serum parathyroid hormone (PTH) levels through April 2011, and differences by race were described. Since then, PTH levels have remained stable or declined slightly in both black and non-black patients. In August 2011, 22% of black patients and 12% of non-black patients had very high PTH values (defined here as PTH >600 pg/mL). The percentage of hemodialysis patients for whom PTH is measured has declined slightly since August 2010. There have been no clear changes in serum calcium or serum phosphorus levels.
- Clinical Outcomes: Preliminary data indicate that the 30-day hospitalization rate has increased somewhat from August 2010 to August 2011. The DPM does not report yet on trends in red blood cell transfusions, as dialysis units are often unaware of transfusions occurring in the inpatient setting. Additional efforts to comprehensively monitor trends in transfusions are warranted. To date mortality rate has not changed appreciably, though further follow-up time is necessary as we continue to track this outcome.
Future monitoring of these trends, confirmation with national data when eventually available, and understanding their effect on clinical outcomes, if any, is required.
DPM data are aggregated across dialysis organizations and facilities. Aggregated trends may not reflect trends in individual dialysis organizations or facilities, and are not intended to provide oversight of performance in individual dialysis organizations or facilities.
Read the rest of the DOPPS Practice Monitor: Update on Trends in US Hemodialysis Care Following Launch of Bundled Payment System and Revisions to ESA Labels Press Release |
| |
|
|
| |
Hemodialysis Research Interview of the Week |
Author Interview: Dr. Len Usvyat PhD
Clinical Systems Database Senior Analyst
Renal Research Institute
|
Seasonal Variations in Mortality, Clinical, and Laboratory Parameters in Hemodialysis Patients: A 5-Year Cohort Study.
Usvyat LA, Carter M, Thijssen S, Kooman JP, van der Sande FM, Zabetakis P,
Balter P, Levin NW, Kotanko P.
Clin J Am Soc Nephrol. 2011 Nov 17.
|
What are the main findings of the study? |
We found that mortality of hemodialysis patients followed a seasonal pattern over a five year period with the highest mortality in the winter and lowest mortality in the summer months.
We also observed that many clinical and laboratory parameters follow a seasonal pattern in our patient population.
For example, pre-dialysis systolic blood pressures are highest in winter and lowest in summer months; pre-dialysis body temperatures are highest in summer and lowest in winter months.
Neutrophils are highest in winter and lowest in summer suggesting higher inflammatory markers in the winter.
This phenomena was observed in various geographic regions in US.
|
Were any of the findings unexpected? |
It has been previously shown that mortality follows seasonal trends in healthy population however these findings were never extended to dialysis patients.
While it was shown that blood pressures tend to follow a seasonal pattern, to the best of our knowledge, it has not been shown that neutrophils or interdialytic weight gains also follow a seasonal pattern.
Additionally, we applied a cosinor analysis to show whether these patterns are statistically significant.
|
What should clinicians and patients take away from this study? |
These findings are particularly important in designing studies -- taking season into account is key.
|
What recommendations do you have for future studies as a result of your study? |
Further research into understanding the biologic factors that contribute to this seasonality is important.
|
|
|
|
hemodialysis Keywords | hemodialysis Tags | hemodialysis Keyword Cloud
|
|
|
