Acute Kidney Injury

Alkhunaizi, Ahmed M.

doi:10.5772/intechopen.80625

Cited by 3 publications

(1 citation statement)

References 133 publications

(149 reference statements)

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“…Tissue inhibitor of metalloproteinase 2 (TIMP2) and insulin-like growth factor-binding protein 7 (IGFBP7) are two proteins that are involved in cell cycle arrest during the G1 phase, which occurs if cellular DNA damage is detected. They are considered indicators of cellular stress and are expressed throughout the body-notably also in the tubular cells of the kidneys [8][9][10]. Crucially, urinary concentrations of TIMP2 and IGFBP7 were found to have peaked 18 h after the initial decline in glomerular filtration rate (GFR), responding much faster than serum creatinine (sCr) [8].…”

Section: Introductionmentioning

confidence: 99%

Kinetics of the Cell Cycle Arrest Biomarkers (TIMP2 and IGFBP7) for the Diagnosis of Acute Kidney Injury in Critically Ill COVID-19 Patients

et al. 2023

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Background: Acute kidney injury (AKI) is highly prevalent in critical COVID-19 patients. The diagnosis and staging of AKI are based on serum creatinine (sCr) and urinary output criteria, with limitations in the functional markers. New cell-cycle arrest biomarkers [TIMP2]*[IGFBP7] have been proposed for early detection of AKI, but their role in critically ill COVID-19 patients is poorly understood. Methods: We conducted an observational study to assess the performance of [TIMP2]*[IGFBP7] for the detection of AKI in critical COVID-19 patients admitted to our intensive care unit (ICU). We sampled urinary [TIMP2]*[IGFBP7] levels at ICU admission, 12 h, 24 h, and 48 h, and compared the results to the development of AKI, as well as baseline and laboratory data. Results: Forty-one patients were enrolled. The median age was 66 years [57–72] and most were males (85%). Thirteen patients (31.7%) developed no/mild stage AKI, 19 patients (46.3%) moderate AKI, and nine patients (22.0%) severe AKI. The ICU mortality was 29.3%. sCr levels in the Emergency Department or at ICU admission were not significantly different according to AKI stage. [TIMP-2]*[IGFBP-7] urinary levels were elevated in severe AKI at 12 h after ICU admission, but not at ICU admission or 24 h or 48 h after ICU admission. Conclusion: Urinary biomarkers [TIMP-2]*[IGFBP-7] were generally increased in this population with a high prevalence of AKI, and were higher in patients with severe AKI measured at 12 h from ICU admission. Further studies are needed to evaluate the best timing of these biomarkers in this population.

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Section: Introductionmentioning

confidence: 99%

Kinetics of the Cell Cycle Arrest Biomarkers (TIMP2 and IGFBP7) for the Diagnosis of Acute Kidney Injury in Critically Ill COVID-19 Patients

et al. 2023

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Acute Kidney Injury

Murphy

2024

Principles of Specialty Nursing

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Developing A Decision Aid for Critically Ill Patients Requiring Renal Replacement Therapy: A User-Centered Approach for Rapid Prototyping (Preprint)

Zheng¹,

Yin²,

Cao³

et al. 2022

Preprint

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BACKGROUND Renal replacement therapy (RRT) is increasingly being adopted as a treatment method for critically ill patients suffering from acute kidney injury, followed by inevitably high rates of morbidity and mortality. Whether or not to choose RRT for critically ill patients is a significant concern for surrogate decision makers and is associated with anxiety and decision dilemmas. While evidence suggests that decision aids (DAs) help to improve the quality of medical decision making, few supports exist in the decision-making process for surrogates when their loved ones in the ICU face the possibility of RRT. OBJECTIVE The objective of this study was to develop a web-based DA to help surrogates make better-informed decisions for critically ill patients requiring RRT. METHODS To develop the DA, we utilized a systematic process to create a user-centered design by following four steps: (1) competitive analysis — identify existing DAs through a systematic environmental scan; (2) users’ needs assessment — explore surrogates’ decisional needs through semi-structured interviews; (3) user persona development — develop a typical user persona through a manual characterization of users’ expectations for DAs; (4) evidence synthesis — synthesize clinical evidence on RRT decision making according to the above requirements. This process was implemented to efficiently solve design issues before the development began, thereby helping developers to determine their goals more readily and to focus on the needs of target users. RESULTS The rapid prototyping of the DA was accomplished through a systematic process and conceiving a user-centered design. (1) Sixteen available DAs related to RRT were identified in the areas of: end-of-life issues (N=2), end stage renal disease (N=5), and chronic kidney disease (N=9). Design decisions for a DA pertaining to RRT for critically ill AKI patients were informed by these methods. (2) Fifteen family surrogates with RRT decision-making experience in an ICU setting were interviewed for the purpose of needs assessment. Users’ potential needs were identified within the domains of professional support, role guidance, information needs, and values clarification. (3) A typical user persona was constructed to help understand users’ needs and to further inform design choices. (4) 27 sources were selected and a total of 21 items were extracted as evidence to augment the content of the prototype. Finally, the DA prototype was designed to include a user guide and a four-step decision guide. CONCLUSIONS We have created a novel approach for the rapid prototyping of a web-based DA that is targeted at family surrogates making decisions about RRT for their loved ones in ICU. Future studies are warranted to evaluate the usability, feasibility, and comprehensibility of the DA through iterative refinement. CLINICALTRIAL ChiCTR2000031613

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Acute Kidney Injury

Cited by 3 publications

References 133 publications

Kinetics of the Cell Cycle Arrest Biomarkers (TIMP2 and IGFBP7) for the Diagnosis of Acute Kidney Injury in Critically Ill COVID-19 Patients

Kinetics of the Cell Cycle Arrest Biomarkers (TIMP2 and IGFBP7) for the Diagnosis of Acute Kidney Injury in Critically Ill COVID-19 Patients

Acute Kidney Injury

Developing A Decision Aid for Critically Ill Patients Requiring Renal Replacement Therapy: A User-Centered Approach for Rapid Prototyping (Preprint)

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