The nephrotoxic drugs have been responsible for about 20% of AKI episodes in inpatients and outpatients. The cisplatin nephrotoxicity is a major limiting factors in 20% of patients who have received the drug, triggering injuries in renal tubular epithelial cells. Cisplatin toxicity is determined by the target tissue and cells accumulation besides the interaction with various subcellular structures and macromolecules. Cisplatin accumulates and interferes with the functioning of different organelles such as mitochondria, lysosomes, endoplasmic reticulum, nuclei and cell membranes, causing inflammation and cell death. This review aims to define the pathophysiology and biochemistry of the cisplatin nephrotoxicity, reviewing the main molecular mechanisms that lead to tubular cisplatin toxicity.

The incidence and mortality of AKI in ICU were high in this study, despite the advances that have been emerging in their management.

Creatinine remains the standard for laboratory diagnosis of AKI. Efforts to prevent nephrotoxicity have been harmed by the delay in the diagnosis of AKI criteria by using only the creatinine as a marker, therefore there is great interest in identifying early reliable biomarkers. Moreover, early treatment of ARF can be correlated with a better prognosis and identification of biomarkers for early diagnosis would improve the efficacy of a therapeutic strategy. Thus, it becomes imperative to find biomarkers that can stratify correctly the extent of renal damage that each patient has suffered and the risk of developing chronic kidney disease (CKD). Here, we review the main features of emerging biomarkers in nephrology.

To our knowledge, this report was the first available study of the equipment and human resources utilized for RRT in AKI patients in Latin America.

Currently, partial hepatectomy is the treatment of choice for a wide variety of liver and biliary conditions. Among the possible complications of partial hepatectomy, acute kidney injury (AKI) should be considered as an important cause of increased morbidity and postoperative mortality. Difficulties in the data analysis related to postoperative AKI after liver resections are mainly due to the multiplicity of factors to be considered in the surgical patients, moreover, there is no consensus of the exact definition of AKI after liver resection in the literature, which hampers comparison and analysis of the scarce data published on the subject. Despite this multiplicity of risk factors for postoperative AKI after partial hepatectomy, there are main factors that clearly contribute to its occurrence. First factor relates to large blood losses with renal hypoperfusion during the operation, second factor relates to the occurrence of post-hepatectomy liver failure with consequent distributive circulatory changes and hepatorenal syndrome. Eventually, patients can have more than one factor contributing to post-operative AKI, and frequently these combinations of acute insults can be aggravated by sepsis or exposure to nephrotoxic drugs.

AIMTo identify risk factors for the occurrence of acute kidney injury (AKI) in the postoperative period of partial hepatectomies.METHODSRetrospective analysis of 446 consecutive resections in 405 patients, analyzing clinical characteristics, preoperative laboratory data, intraoperative data, and postoperative laboratory data and clinical evolution. Adopting the International Club of Ascites criteria for the definition of AKI, potential predictors of AKI by logistic regression were identified.RESULTSOf the total 446 partial liver resections, postoperative AKI occurred in 80 cases (17.9%). Identified predictors of AKI were: Non-dialytic chronic kidney injury (CKI), biliary obstruction, the Model for End-Stage Liver Disease (MELD) score, the extent of hepatic resection, the occurrence of intraoperative hemodynamic instability, post-hepatectomy haemorrhage, and postoperative sepsis.CONCLUSIONThe MELD score, the presence of non-dialytic CKI and biliary obstruction in the preoperative period, and perioperative hemodynamics instability, bleeding, and sepsis are risk factors for the occurrence of AKI in patients that underwent partial hepatectomy.

SUMMARY INTRODUCTION Acute kidney injury (AKI) is a frequent event among critically ill patients hospitalized in intensive care units (ICU) and represents a global public health problem, being imperative an interdisciplinary approach. OBJECTIV To investigate, through literature review, the AKI epidemiology in ICUs. METHODS: Online research in Medline, Scientific Electronic Library Online, and Latin American and Caribbean Literature in Health Sciences databases, with analysis of the most relevant 47 studies published between 2010 and 2017. RESULTS Data of the 67,033 patients from more than 300 ICUs from different regions of the world were analyzed. The overall incidence of AKI ranged from 2.5% to 92.2%, and the mortality from 5% to 80%. The length of ICU stay ranged from five to twenty-one days, and the need for renal replacement therapy from 0.8% to 59.2%. AKI patients had substantially higher mortality rates and longer hospital stays than patients without AKI. CONCLUSION AKI incidence presented high variability among the studies. One of the reasons for that were the different criteria used to define the cases. Availability of local resources, renal replacement therapy needs, serum creatinine at ICU admission, volume overload, and sepsis, among others, influence mortality rates in AKI patients.

ObjectiveTo evaluate the prevalence of metabolic disorders associated with nephrolithiasis in a female population.MethodsA retrospective study on 1,737 patients with evidence of recent formation of renal stones, being 54% females. The laboratory investigation consisted of at least two samples of blood and 24-hour urine to assess calcium, uric acid, citrate and creatinine levels, qualitative cystinuria, urinary pH following fasting and 12-hour water restriction, urine culture, serum creatinine and parathyroid hormone.ResultsThe most frequent alterations were hypercalciuria (40.9%), urinary tract infection (23.2%), hypocitraturia (22.4%), low urinary volume (20.5%) and hyperuricosuria (16%).ConclusionThe most frequent metabolic alterations in females were hypocitraturia, urinary tract infection, low urinary volume and hyperuricosuria.