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Nephrology Nursing Journal : Journal of... 2021The occurrence of acute kidney injury (AKI) during COVID infection is associated with increased morbidity and mortality of patients. AKI can occur at any stage of... (Review)
Review
The occurrence of acute kidney injury (AKI) during COVID infection is associated with increased morbidity and mortality of patients. AKI can occur at any stage of COVID-19 infection; clinical judgment and the consideration of AKI risk factors along with early detection and diagnosis are essential to prevent short- and long-term complications. A review of the literature found that pre-existing chronic kidney disease, obesity, and the severe presentation of the illness appear to be risk factors; people who develop AKI during acutely severe disease may have slightly worse outcomes than patients without COVID-19 who develop AKI; and finally, certain genetic susceptibilities may play a role in developing COVID-19-related AKI. Nurses can assist in detecting, preventing, and treating AKI in patients with COVID-19. Nursing interventions can be implemented to optimize care for individuals and their families in the context of COVID-19 and kidney injury. Finally, discoveries from this critical situation can help health care facilities plan resources and prepare for the increased health care burden of survivors of AKI associated with COVID-19. This article discusses recent data about how the virus causes kidney injury and suggests nursing solutions to optimize care for patients with AKI.
Topics: Acute Kidney Injury; COVID-19; Humans; Renal Insufficiency, Chronic; Retrospective Studies; Risk Factors; SARS-CoV-2
PubMed: 34756004
DOI: No ID Found -
Lancet (London, England)This seminar covers the most recent information on definition, epidemiology, and clinical causes of acute renal failure. The mechanisms of acute prerenal failure and the... (Review)
Review
This seminar covers the most recent information on definition, epidemiology, and clinical causes of acute renal failure. The mechanisms of acute prerenal failure and the potential interference by commonly used drugs of autoregulation of renal blood flow are discussed. We summarise some basic and recent insights into the haemodynamic and cellular pathophysiological mechanisms, mainly of postischaemic acute renal failure. Recent findings on the repair mechanisms of renal injury and the potential future therapeutic possibilities are discussed. We provide some differential diagnostic approaches for patients with acute renal failure and summarise prevention of the disorder and management of critically ill patients by dialysis and by other means. Finally, some information on the influence of gene polymorphisms on the prognosis of acute renal failure is given.
Topics: Acute Kidney Injury; Biomarkers; Humans; Kidney; Kidney Tubules; Prognosis; Renal Circulation; Renal Replacement Therapy
PubMed: 15680458
DOI: 10.1016/S0140-6736(05)17831-3 -
Journal of Veterinary Emergency and... 2015To review the unique pathophysiology of sepsis-induced acute kidney injury (AKI) and highlight the relevant aspects of the Kidney Disease: Improving Global Outcomes... (Review)
Review
OBJECTIVE
To review the unique pathophysiology of sepsis-induced acute kidney injury (AKI) and highlight the relevant aspects of the Kidney Disease: Improving Global Outcomes (KDIGO) Clinical Practice Guideline for Acute Kidney Injury that may apply to veterinary patients.
DATA SOURCES
Electronic search of MEDLINE database.
HUMAN DATA SYNTHESIS
Sepsis-induced AKI is diagnosed in up to 47% of human ICU patients and is seen as a major public health concern associated with increased mortality and increased progression to chronic kidney disease (CKD). Consensus criteria for the definition and classification of AKI has allowed for accurate description of the epidemiology of patients with AKI. AKI develops from a complex relationship between the initial insult and activation of inflammation and coagulation. In contrast to the traditional view, clinical and experimental data dispute the role of renal ischemia-reperfusion in the development of sepsis-induced AKI. Renal tubular dysfunction with activation of the tubuloglomerular feedback mechanism appears to be a crucial contributor to sepsis-induced AKI. Furosemide and n-acetylcysteine (NAC) do not appear to be helpful in the treatment of AKI. Hydroxyethyl starches (HES), dopamine, and supraphysiological concentrations of chloride are harmful in patients with AKI.
VETERINARY DATA SYNTHESIS
Community and hospital-acquired AKI is a significant factor affecting survival in critical ill patients. Sepsis-induced AKI occurs in 12% of dogs with abdominal sepsis and is an important contributor to mortality. Early detection of AKI in hospitalized patients currently offers the best opportunity to improve patient outcome. The use of urinary biomarkers to diagnose early AKI should be evaluated in critical care patients.
CONCLUSION
Veterinary clinical trials comparing treatment choices with the development of AKI are needed to make evidence-based recommendations for the prevention and treatment of AKI.
Topics: Acute Kidney Injury; Animals; Biomarkers; Critical Care; Critical Illness; Dog Diseases; Dogs; Humans; Hydroxyethyl Starch Derivatives; Practice Guidelines as Topic; Sepsis; Veterinary Medicine
PubMed: 25845505
DOI: 10.1111/vec.12297 -
American Family Physician Oct 2012Acute kidney injury is characterized by abrupt deterioration in kidney function, manifested by an increase in serum creatinine level with or without reduced urine...
Acute kidney injury is characterized by abrupt deterioration in kidney function, manifested by an increase in serum creatinine level with or without reduced urine output. The spectrum of injury ranges from mild to advanced, sometimes requiring renal replacement therapy. The diagnostic evaluation can be used to classify acute kidney injury as prerenal, intrinsic renal, or postrenal. The initial workup includes a patient history to identify the use of nephrotoxic medications or systemic illnesses that might cause poor renal perfusion or directly impair renal function. Physical examination should assess intravascular volume status and identify skin rashes indicative of systemic illness. The initial laboratory evaluation should include measurement of serum creatinine level, complete blood count, urinalysis, and fractional excretion of sodium. Ultrasonography of the kidneys should be performed in most patients, particularly in older men, to rule out obstruction. Management of acute kidney injury involves fluid resuscitation, avoidance of nephrotoxic medications and contrast media exposure, and correction of electrolyte imbalances. Renal replacement therapy (dialysis) is indicated for refractory hyperkalemia; volume overload; intractable acidosis; uremic encephalopathy, pericarditis, or pleuritis; and removal of certain toxins. Recognition of risk factors (e.g., older age, sepsis, hypovolemia/shock, cardiac surgery, infusion of contrast agents, diabetes mellitus, preexisting chronic kidney disease, cardiac failure, liver failure) is important. Team-based approaches for prevention, early diagnosis, and aggressive management are critical for improving outcomes.
Topics: Acute Kidney Injury; Humans; Prognosis
PubMed: 23062091
DOI: No ID Found -
Deutsche Medizinische Wochenschrift... Mar 2022
Topics: Acute Kidney Injury; Female; Humans; Internal Medicine; Male; Pyridones
PubMed: 35226919
DOI: 10.1055/a-1468-6599 -
Medwave Jun 2020Acute kidney injury is a syndrome characterized by a sudden, sustained, and potentially reversible decrease in glomerular filtration rate and tubular function, which... (Review)
Review
Acute kidney injury is a syndrome characterized by a sudden, sustained, and potentially reversible decrease in glomerular filtration rate and tubular function, which globally impacts renal function. It comprises of a series of events starting with the presence of risk factors, then evolving towards acute kidney injury progression, characterized by stress, injury, and renal failure, culminating with either the use of renal replacement therapy or death. Currently, the use of biomarkers that differentiate between the initial functional deterioration and late-onset structural damage of the kidney enables the clinician to perform an early diagnosis and indicate treatment before the stages of acute kidney injury progression are established, thus increasing survival rates.
Topics: Acute Kidney Injury; Biomarkers; Disease Progression; Early Diagnosis; Humans; Renal Replacement Therapy; Survival Rate
PubMed: 32544152
DOI: 10.5867/medwave.2020.05.7928 -
Der Internist Mar 2001
Review
Topics: Acute Kidney Injury; Autoimmune Diseases; Calcium Channel Blockers; Cardiotonic Agents; Diagnosis, Differential; Diuretics; Drug Hypersensitivity; Humans; Kidney Diseases; Renal Dialysis; Ureteral Obstruction
PubMed: 11277024
DOI: 10.1007/s001080050765 -
Nefrologia 2022
Topics: Humans; COVID-19; Acute Kidney Injury; SARS-CoV-2
PubMed: 36681518
DOI: 10.1016/j.nefroe.2021.06.008 -
Archives of Pediatrics & Adolescent... Sep 2002Acute kidney failure in children is a catastrophic, life-threatening event. (Review)
Review
BACKGROUND
Acute kidney failure in children is a catastrophic, life-threatening event.
OBJECTIVE
To compare and contrast 2 decades of data, analyzing the underlying causes, associated multiple organ system failures, outcome of dialysis procedures, and other variables of interest.
DESIGN
Retrospective examination of clinical data collected between January 1, 1979, and December 31, 1998.
SETTING
Regional health care center in the mid-Atlantic area.
PARTICIPANTS
Two hundred twenty-eight patients, aged from 1 day to 18 years, had acute kidney failure and were referred to a pediatric nephrology service.
MAIN OUTCOME MEASURES
Characteristics, percentage of mortality, intensive care unit admission, procedures, and other variables and causes of acute renal failure.
RESULTS
The total number of cases analyzed represented 7% of all patients presented to the pediatric nephrology service. Sex distribution, ethnicity, and survival statistics were unchanged between both decades. The overall survival rate was 73%. One hundred fifty-four patients (68%) were admitted to the pediatric intensive care unit. The following 106 acute extracorporeal procedures were performed on 93 patients (41%): 12 patients received extracorporeal membrane oxygenation, 52 patients underwent peritoneal dialysis, 32 underwent hemodialysis, 3 patients received continuous venovenous hemofiltration, and 7 patients received continuous arteriovenous hemofiltration. Sepsis and burns, other leading causes of acute renal failure in the first decade, are replaced in the second decade by hematologic-oncologic complications and pulmonary failure.
CONCLUSIONS
Acute kidney failure following repair of cardiac lesions remains unchanged as a leading risk factor of mortality in both decades. Three organ system failures were associated with more than a 50% mortality rate. Predialysis low serum albumin concentrations emerged as a significant copredictor of mortality.
Topics: Acute Kidney Injury; Adolescent; Child; Child, Preschool; Female; Humans; Infant; Infant, Newborn; Male; Renal Replacement Therapy; Retrospective Studies; Risk Factors; Serum Albumin; Survival Analysis; Virginia
PubMed: 12197796
DOI: 10.1001/archpedi.156.9.893 -
Swiss Medical Weekly 2012The term acute kidney injury (AKI) has been recently coined by a large panel of international experts in place of the former expression "acute renal failure". This... (Review)
Review
The term acute kidney injury (AKI) has been recently coined by a large panel of international experts in place of the former expression "acute renal failure". This change has been motivated by a double intention: first it served to definitely find a conventional definition for acute changes of renal function, previously lacking in the medical community. In fact, any attempt to compare scientific papers and different centres experiences on AKI was essentially impossible. The second aim was to remark that this syndrome is characterised by a spectrum of progressive damage, from mild creatinine increase to renal injury to a more severe form, failure: this important concept should increase clinicians awareness to every form of renal dysfunction, even milder ones, in order to improve epidemiologic analyses, potentially preventing eventual AKI progression and finally helping standardisation of medical and supportive therapy. This review will describe such "new era" of critical care nephrology by presenting current literature (and its many controversies) about AKI diagnosis, physiopathology and management.
Topics: Acute Kidney Injury; Critical Care; Humans
PubMed: 22923149
DOI: 10.4414/smw.2012.13662