Archivi categoria: AKI
Delayed versus early initiation of renal replacement therapy for severe acute kidney injury: a systematic review and individual patient data meta-analysis of randomised clinical trials – The Lancet
The timing of RRT initiation does not affect survival in critically ill patients with severe acute kidney injury in the absence of urgent indications for RRT. Delaying RRT initiation, with close patient monitoring, might lead to a reduced use of RRT, thereby saving health resources.
Sorgente: Delayed versus early initiation of renal replacement therapy for severe acute kidney injury: a systematic review and individual patient data meta-analysis of randomised clinical trials – The Lancet
Novel coronavirus disease (COVID-19) is a newly discovered contagious disease caused by SARS-CoV-2 virus, primarily manifesting as an acute respiratory illness with interstitial and alveolar pneumonia, but can affect multiple organs such as kidney, heart, digestive tract, blood and nervous system1. The rapidly spreading outbreak which first emerged in Wuhan, Hubei Province in China in December 2019 has raised concerns about a global pandemic. To date (2 March 2020), 88,948 cases of COVID-19 have been reported worldwide in 65 countries (and a cruise ship) and 79,842 in mainland China, with 3,043 deaths worldwide (mainland China 2,915 deaths).
Post–Acute Kidney Injury Proteinuria and Subsequent Kidney Disease Progression: The Assessment, Serial Evaluation, and Subsequent Sequelae in Acute Kidney Injury (ASSESS-AKI) Study | Acute Kidney Injury | JAMA Internal Medicine | JAMA Network
This cohort study quantifies whether proteinuria after hospital discharge is associated with future loss of renal function among patients who had acute kidney injury during hospitalization.
Sorgente: Post–Acute Kidney Injury Proteinuria and Subsequent Kidney Disease Progression: The Assessment, Serial Evaluation, and Subsequent Sequelae in Acute Kidney Injury (ASSESS-AKI) Study | Acute Kidney Injury | JAMA Internal Medicine | JAMA Network
The Controversy of Contrast-Induced Nephropathy With Intravenous Contrast: What Is the Risk? – American Journal of Kidney Diseases
Contrast-induced nephropathy (CIN) has long been observed in both experimental and clinical studies. However, recent observational studies have questioned the prevalence and severity of CIN following intravenous contrast exposure. Initial studies of acute kidney injury following intravenous contrast were limited by the absence of control groups or contained control groups that did not adjust for additional acute kidney injury risk factors, including prevalent chronic kidney disease, as well as accepted prophylactic strategies.
Timing of Recovery From Moderate to Severe AKI and the Risk for Future Loss of Kidney Function – American Journal of Kidney Diseases
The extent of recovery of kidney function following acute kidney injury (AKI) is known to be associated with future chronic kidney disease. Less is known about how the timing of recovery affects the rate of future loss of kidney function.
Association of Acute Increases in Plasma Creatinine after Renin-Angiotensin Blockade with Subsequent Outcomes | American Society of Nephrology
Background and objectives Data from observational and interventional studies provide discordant results regarding the relationship between creatinine increase after renin-angiotensin system inhibition (RASi) and adverse outcomes. We compared health outcomes among patients with different categories of increase in creatinine upon initiation of RASi in a large population-based cohort. Design, setting, participants, & measurements We performed a retrospective analysis of the Stockholm CREAtinine Measurements database, which contains complete information on diagnoses, medication dispensation claims, and laboratory test results for all Stockholm citizens accessing health care. Included were 31,951 adults initiating RASi during 2007–2011 with available pre- and postinitiation creatinine monitoring. Multivariable Cox regression was used to compare mortality, cardiovascular and ESKD events among individuals with different ranges of creatinine increases within 2 months after starting treatment. Results In a median follow-up of 3.5 years, acute increases in creatinine were associated with mortality (3202 events) in a graded manner: compared with creatinine increases <10%, a 10%–19% increase
Individuals taking a certain number of NSAIDs each month had greater risks of acute kidney injury and chronic kidney disease.
Uno studio firmato da un team dell’Università di Firenze e dell’ospedale pediatrico Meyer rivoluziona le conoscenze sul danno renale acuto (fino a qualche anno fa definito insufficienza renale acuta),
Intravascular iodinated contrast has historically been considered a risk factor for acute kidney injury (AKI), particularly among individuals with underlying chronic kidney disease (1). Recent studies, however, have suggested that incidence of contrast-induced nephropathy (CIN) may not be as frequent as previously thought (2,3). In this commentary, we argue that contrast material can often be safely used without increased risk of AKI, even among individuals with underlying kidney disease.
Myocardial infarction patients who underwent percutaneous coronary intervention had an AKI rate similar to those who did not have the procedure.
Early and late initiation of renal replacement therapy for AKI in critically ill patients are associated with similar long-term risks.
Sorgente: European Nephrology Portal
piu’ attenzione da parte di tutti, coinvolgimento dei nefrologi
Noi lo diciamo da anni, ma soprattutto gli Hospitalists non ne tengono conto. E’ necessario implementare follow-up seriali di pazienti con AKI.
Spesso AKI non riconosciuta, se riconosciuta non seguita dopo la dimissione. Un problema sociale.
Se eletto, mi impegno ad affrontare il problema attuando i dettami del decreto cronicità’ sulla istituzione di un registro dei malati cronici