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Critical Care Clinics Oct 2015Acute kidney injury (AKI) is a common and often lethal complication that is also associated with severe morbidity in hospitalized patients. During the last decade, the... (Review)
Review
Acute kidney injury (AKI) is a common and often lethal complication that is also associated with severe morbidity in hospitalized patients. During the last decade, the standardization of AKI diagnostic criteria has helped to facilitate several large-scale investigations of biomarkers of AKI. These studies have led to the international clinical implementation of several biomarkers of renal injury. This review summarizes the results of many of these multicenter investigations and discusses the clinical utility and interpretation of several of these new clinical tests. The merits of combining biomarkers of kidney function is also discussed.
Topics: Acute Kidney Injury; Acute-Phase Proteins; Albuminuria; Azotemia; Biomarkers; Cardiovascular Surgical Procedures; Creatinine; Cystatin C; Early Diagnosis; Emergency Service, Hospital; Humans; Insulin-Like Growth Factor Binding Proteins; Interleukin-18; Lipocalin-2; Lipocalins; Proto-Oncogene Proteins; Sepsis; Tissue Inhibitor of Metalloproteinase-2
PubMed: 26410134
DOI: 10.1016/j.ccc.2015.06.002 -
Journal of Veterinary Internal Medicine 2010Hyperthyroidism complicates the diagnosis of chronic kidney disease (CKD) as it increases glomerular filtration rate. No practical and reliable means for identifying...
BACKGROUND
Hyperthyroidism complicates the diagnosis of chronic kidney disease (CKD) as it increases glomerular filtration rate. No practical and reliable means for identifying those cats that will develop azotemia after treatment for hyperthyroidism has been identified. Hyperthyroidism is associated with proteinuria. Proteinuria has been correlated with decreased survival of cats with CKD and with progression of CKD.
HYPOTHESIS
Proteinuria and other clinical parameters measured at diagnosis of hyperthyroidism will be associated with the development of azotemia and survival time.
ANIMALS
Three hundred client owned hyperthyroid cats treated in first opinion practice.
METHODS
Retrospective, cohort study relating clinical parameters in hyperthyroid cats at diagnosis to the development of azotemia within 240 days of diagnosis and survival time (all cause mortality). Multivariable logistic regression analysis was used to identify factors that were predictive of the development of azotemia. Multivariable Cox regression analysis was used to identify factors associated with survival.
RESULTS
Three hundred cats were eligible for survival analysis and 216 cats for analysis of factors associated with the development of azotemia. The median survival time was 417 days, and 15.3% (41/268) cats developed azotemia within 240 days of diagnosis of hyperthyroidism. Plasma concentrations of urea and creatinine were positively correlated with the development of azotemia. Plasma globulin concentration was negatively correlated with the development of azotemia. Age, urine protein:creatinine ratio, and the presence of hypertension were significantly correlated with decreased survival time. Urine specific gravity and PCV were significantly correlated with increased survival time.
CONCLUSIONS AND CLINICAL IMPORTANCE
The proteinuria associated with hyperthyroidism is not a mediator of progression of CKD; however, it does correlate with all cause mortality.
Topics: Animals; Azotemia; Cat Diseases; Cats; Female; Hyperthyroidism; Male; Retrospective Studies
PubMed: 20649748
DOI: 10.1111/j.1939-1676.2010.0550.x -
Clinical Obstetrics and Gynecology Dec 2014Acute kidney injury complicates the care of a relatively small number of pregnant and postpartum women. Several pregnancy-related disorders such as preeclampsia and... (Review)
Review
Acute kidney injury complicates the care of a relatively small number of pregnant and postpartum women. Several pregnancy-related disorders such as preeclampsia and thrombotic microangiopathies may produce acute kidney injury. Prerenal azotemia is another common cause of acute kidney injury in pregnancy. This manuscript will review pregnancy-associated acute kidney injury from a renal functional perspective. Pathophysiology of acute kidney injury will be reviewed. Specific conditions causing acute kidney injury and treatments will be compared.
Topics: Acute Kidney Injury; Azotemia; Fatty Liver; Female; Humans; Pre-Eclampsia; Pregnancy; Pregnancy Complications; Thrombotic Microangiopathies
PubMed: 25264696
DOI: 10.1097/GRF.0000000000000069 -
GP Feb 1959
Topics: Azotemia; Uremia; Urologic Diseases
PubMed: 13619967
DOI: No ID Found -
American Journal of Clinical Pathology May 1954
Topics: Azotemia; Blood; Humans; Nitrogen
PubMed: 13158285
DOI: 10.1093/ajcp/24.5.511 -
Intensive Care Medicine Jul 2015
Topics: Azotemia; Humans; Kidney Failure, Chronic; Male; Middle Aged; Skin; Tomography, X-Ray Computed
PubMed: 25626886
DOI: 10.1007/s00134-015-3664-x -
Nephrology, Dialysis, Transplantation :... Jun 2013Recent experimental work suggests a paradox: although uremia evokes systemic toxicities, in the setting of AKI, it can induce intrarenal cytoprotective and...
BACKGROUND
Recent experimental work suggests a paradox: although uremia evokes systemic toxicities, in the setting of AKI, it can induce intrarenal cytoprotective and anti-inflammatory effects. Whether these influences can attenuate post-ischemic kidney disease progression remains unknown.
METHODS
To explore this possibility, male CD-1 mice were subjected to a 30-min unilateral (left) kidney ischemia model, previously shown to reduce renal mass by ∼50% over 2-3 weeks. Stepwise azotemia/acute uremia was superimposed by inducing different lengths of contralateral (right) kidney ischemia (0, 15, 18, 20 min). Subsequent loss of left renal mass (kidney weight) was assessed 2 weeks later and contrasted with the degree of initial azotemia 24-h BUN.
RESULTS
A striking correlation between 24-h BUNs and 2-week left renal mass was observed (r, 0.77; P < 0.001). With 20 min of right kidney ischemia, left kidney size was completely preserved. This preservation did not result from increased tubular cell proliferation or decreased microvascular loss, as gauged by KI-67 and CD-34 immunohistochemistry, respectively. Rather, an early reduction in proximal tubule cell dropout (as judged by renal cortical N-acetyl-glucosaminidase content), with a subsequent preservation of tubule mass, was observed.
CONCLUSIONS
In summary, these findings advance a novel concept: acute uremia can confer early post-ischemic cytoprotection resulting in a slowed progression of post-ischemic kidney disease.
Topics: Acetylglucosaminidase; Animals; Azotemia; Immunoenzyme Techniques; Kidney Diseases; Male; Mice; Renal Circulation; Reperfusion Injury; Uremia
PubMed: 23543590
DOI: 10.1093/ndt/gft040 -
Pediatria Polska Apr 1962
Topics: Azotemia; Child; Humans; Infant; Nitrogen; Uremia; Urologic Diseases
PubMed: 14009720
DOI: No ID Found -
Vie Medicale (Paris, France : 1920) Aug 1954
Topics: Acid-Base Imbalance; Azotemia; Uremia; Urologic Diseases; Water-Electrolyte Imbalance
PubMed: 13196278
DOI: No ID Found -
The American Journal of Hospice &... 2007This paper presents a study of the relationship between prerenal azotemia and rehabilitation outcomes of cancer patients. A retrospective chart review of 70 patients who...
This paper presents a study of the relationship between prerenal azotemia and rehabilitation outcomes of cancer patients. A retrospective chart review of 70 patients who underwent inpatient rehabilitation in a tertiary cancer center was undertaken. Eight patients with creatinine values >1.5 were excluded. The remaining 62 patients were divided into 2 groups according to the blood urea nitrogen/creatinine (BUN/Cr) ratio: 27 (44%) in the prerenal azotemia group (BUN/Cr > or = 20) and 35 (56%) in the non-azotemic group (BUN/Cr < 20). Age, gender, <10 g/dL of hemoglobin, co-morbidity (diabetes mellitus and/or hypertension), discharge destiny and median rehabilitation length of stay were not significantly different in these 2 groups. Prerenal azotemia was present in a significant number of cancer patients, but it did not impact the length of rehabilitation stay or discharge destiny.
Topics: Adult; Aged; Aged, 80 and over; Azotemia; Blood Urea Nitrogen; Chi-Square Distribution; Comorbidity; Creatinine; Dehydration; Diabetes Complications; Female; Hemoglobins; Humans; Hypertension; Length of Stay; Male; Middle Aged; Neoplasms; Patient Discharge; Prealbumin; Rehabilitation Centers; Retrospective Studies; Risk Factors; Statistics, Nonparametric; Texas
PubMed: 17601836
DOI: 10.1177/1049909107302298