2010 Mar - Acute kidney injury in non-severe pneumonia is associated with an increased immune response and lower survival

Raghavan Murugan, Vijay Karajala-Subramanyam, Minjae Lee, Sachin Yende, Lan Kong, Melinda Carter, Derek C Angus and John A Kellum on behalf of the Genetic and Inflammatory Markers of Sepsis (GenIMS) Investigators; Kidney Int 2010:  77: 527-535
While sepsis is a leading cause of acute kidney injury in critically ill patients, the relationship between immune response and acute kidney injury in less severely ill patients with infection is not known. Here we studied the epidemiology, 1-year mortality, and immune response associated with acute kidney injury in 1836 hospitalized patients with community-acquired severe and non-severe pneumonia.

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2009 Regional Citrate Anticoagulation for Intermittent Predilution Online Hemofiltration

Jakob Gubenšek, Jadranka Buturović-Ponikvar, Nataša Škofic, and Rafael Ponikvar. Therapeutic Apheresis and Dialysis. Volume 13 Issue 4, Pages 306 - 309. Published Online: 31 Jul 2009
There is no consensus on the optimal renal replacement treatment in intensive care units. Among intermittent dialysis methods, hemofiltration (HF) is preferred by some because of better hemodynamic stability and cytokine removal. We report our experience with regional citrate anticoagulation for intermittent predilution online HF.

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2009 Nov - Outcomes of Chronic Dialysis Patients Admitted to the Intensive Care Unit.

Strijack B, Mojica J, Sood M, Komenda P, Bueti J, Reslerova M, Roberts D, Rigatto C.; J Am Soc Nephrol 20: 2441-2447.
Admission rates and outcomes of patients who have ESRD and are admitted to an intensive care unit (ICU) are not well defined. We conducted a historical cohort study using a prospective regional ICU database that captured all 11 adult ICUs in Winnipeg, Canada. Between 2000 and 2006, there were 34,965 total admissions to the ICU, 1173 (3.4%) of which were patients with ESRD.

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2009 Nov - Is it cerebral or renal salt wasting?

Maesaka JK, Imbriano LJ, Ali NM, Ilamathi E.; Kidney Int. 2009 Nov;76(9):934-8. Epub 2009 Jul 29.
Cerebral salt-wasting (CSW), or renal salt-wasting (RSW), has evolved from a misrepresentation of the syndrome of inappropriate secretion of antidiuretic hormone (SIADH) to acceptance as a distinct entity. Challenges still confront us as we attempt to differentiate RSW from SIADH, ascertain the prevalence of RSW, and address reports of RSW occurring without cerebral disease.

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2009 Oct Acetylcysteine and non-ionic isosmolar contrast-induced nephropathy--a randomized controlled study.

Ferrario F, Barone MT, Landoni G, Genderini A, Heidemperger M, Trezzi M, Piccaluga E, Danna P, Scorza D.; Nephrol Dial Transplant. 2009 Oct;24(10):3103-7. Epub 2009 Jun 23.
INTRODUCTION: Intravenous administration of saline and non-ionic isosmolar contrast media significantly reduces the incidence of contrast-induced nephropathy, one of the most common causes of acute renal failure. Results with oral N-acetylcysteine are conflicting. The aim of our study was to evaluate the prophylactic role of N-acetylcysteine in patients with stable chronic renal failure undergoing coronary and/or peripheral angiography and/or angioplasty.

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2009 Oct - Sodium bicarbonate plus isotonic saline versus saline for prevention of contrast-induced nephropathy in patients undergoing coronary angiography: a randomized controlled trial.

Vasheghani-Farahani A, Sadigh G, Kassaian SE, Khatami SM, Fotouhi A, Razavi SA, Mansournia MA, Yamini-Sharif A, Amirzadegan A, Salarifar M, Sadeghian S, Davoodi G, Borumand MA, Esfehani FA, Darabian S.; Am J Kidney Dis. 2009 Oct;54(4):610-8. Epub 2009 Jul 19.
BACKGROUND: There is controversy about the prophylactic measures proposed for the prevention of contrast-induced nephropathy (CIN). We aim to compare the efficacy of the combination of sodium bicarbonate and isotonic saline and that of isotonic saline alone in preventing CIN.

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2009 Oct - Forced euvolemic diuresis with mannitol and furosemide for prevention of contrast-induced nephropathy in patients with CKD undergoing coronary angiography: a randomized controlled trial.

Majumdar SR, Kjellstrand CM, Tymchak WJ, Hervas-Malo M, Taylor DA, Teo KK.; Am J Kidney Dis. 2009 Oct;54(4):602-9. Epub 2009 Jun 17.
BACKGROUND: Contrast-induced nephropathy is common in patients with coronary angiography. Mechanistically, forced euvolemic diuresis with mannitol and furosemide ought to prevent contrast-induced nephropathy. Our objectives are to: (1) undertake a randomized trial testing this hypothesis, and (2) conduct a meta-analysis of our findings with 2 earlier studies.

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2009 Sep - A comparison of observed versus estimated baseline creatinine for determination of RIFLE class in patients with acute kidney injury

Bagshaw SM, Uchino S, Cruz D, Bellomo R, Morimatsu H, Morgera S, Schetz M, Tan I, Bouman C, Macedo E, Gibney N, Tolwani A, Oudemans-van Straaten HM, Ronco C, Kellum JA; Beginning and Ending Supportive Therapy for the Kidney (BEST Kidney) Investigators.; Nephrol Dial Transplant. 2009 Sep;24(9):2739-44. Epub 2009 Apr 6.

BACKGROUND: The RIFLE classification scheme for acute kidney injury (AKI) is based on relative changes in serum creatinine (SCr) and on urine output. The SCr criteria, therefore, require a pre-morbid baseline value. When unknown, current recommendations are to estimate a baseline SCr by the MDRD equation. However, the MDRD approach assumes a glomerular filtration rate of approximately 75 mL/min/1.73 m(2). This method has not been validated.

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2009 Aug - Fluid accumulation, survival and recovery of kidney function in critically ill patients with acute kidney injury

Bouchard J, Soroko SB, Chertow GM, Himmelfarb J, Ikizler TA, Paganini EP, Mehta RL; Program to Improve Care in Acute Renal Disease (PICARD) Study Group. ; Kidney Int. 2009 Aug;76(4):422-7. Epub 2009 May 13.
Fluid accumulation is associated with adverse outcomes in critically ill patients. Here, we sought to determine if fluid accumulation is associated with mortality and non-recovery of kidney function in critically ill adults with acute kidney injury.

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009 Sep - Biofilm in bicarbonate-based replacement fluid circuits in CVVH

Nigel S Kanagasundaram, Iain Moore and Nicholas A Hoenich; Kidney Int Sept 2009,  76: 682
Bacterial contamination and biofilm formation are well recognized in the setting of intermittent hemodialysis and have led to the development of well-defined requirements for water and dialysate purity. The standards are even more stringent in the setting of intermittent hemodiafiltration because of the need for systemic infusion of the replacement fluid. Until lately, little attention had been paid to the microbial integrity of the continuous renal replacement therapies (CRRTs) used in critically ill patients. However, recently published work has revealed evidence of widespread microbial contamination of both bicarbonate-based dialysate and replacement fluid circuits in CRRTs....

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2009 High-volume hemofiltration in sepsis and SIRS: current concepts and future prospects

Honore PM, Joannes-Boyau O, Boer W, Collin V. ; Blood Purif. 2009;28(1):1-11. Epub 2009 Mar 27.

In recent years, a number of techniques have been studied and developed in the field of renal replacement therapy in the septic patient. Manipulation of ultrafiltrate dose, membrane porosity, mode of clearance, and combinations of techniques have yielded promising findings. However, at present, conclusive evidence based on well-designed, randomized controlled trials remains scarce, limiting the practical implementation of many techniques in daily practice outside the context of a study.

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2009 Long-term risk of mortality and other adverse outcomes after acute kidney injury: a systematic review and meta-analysis

Recommended by Dr SHUM Hoi Ping, ICU, PYNEH, Hong Kong, on 30 May 2009. Coca SG, Yusuf B, Shlipak MG, Garg AX, Parikh CR. Am J Kidney Dis. 2009 Jun;53(6):961-73. Epub 2009 Apr 5.

BACKGROUND: Acute kidney injury (AKI) is common in hospitalized patients. The impact of AKI on long-term outcomes is controversial.

STUDY DESIGN: Systematic review and meta-analysis.


SELECTION CRITERIA FOR STUDIES: MEDLINE and EMBASE databases were searched from 1985 through October 2007. Original studies describing outcomes of AKI for patients who survived hospital discharge were included. Studies were excluded from review when participants were followed up for less than 6 months.

PREDICTOR: AKI, defined as acute changes in serum creatinine level or acute need for renal replacement therapy. OUTCOMES: Chronic kidney disease (CKD), cardiovascular disease, and mortality.

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2009 Sodium Bicarbonate Therapy for Prevention of Contrast-Induced Nephropathy: A Systematic Review and Meta-analysis

Am J Kidney Dis 2009 Apr; 53 (4), 617-627. Sankar D. Navaneethan, Sonal Singh, Suresh Appasamy, Richard E. Wing, Ashwini R. Sehgal

Optimal hydration measures to prevent contrast-induced nephropathy are controversial.

Study Design

We conducted a systematic review and meta-analysis using the MEDLINE database (1966 to January 2008), EMBASE (January 2008), and abstracts from conference proceedings.

Setting & Population

Adult patients undergoing contrast procedures.

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