Comparison of Outcomes of Mild and Severe Community- and Hospital-Acquired Acute Kidney Injury

Medina-Liabres, Kristianne Rachel P.; Jeong, Jong Cheol; Ryu, Jiwon; Kang, Eunjeong; Chin, Ho Jun; Na, Ki Young; Chae, Dong Wan; Kim, Sejoong

doi:10.3349/ymj.2021.0238

Cited by 6 publications

(6 citation statements)

References 29 publications

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“…A similar finding was reported in a regional multicenter Egyptian cohort study conducted in four teaching hospitals in Alexandria, where 39.6% of patients with AKI were referred to intensive care [ 53 ]. On the other hand, a study in Pakistan revealed higher mortality among CA-AKI patients [ 54 ].…”

Section: Aki Stagementioning

confidence: 99%

Characteristics, Risk Factors, and Outcomes in Acute Kidney Injury Patients: A Retrospective Cross-Sectional Study, Palestine

Damin Abukhalil,

Alyazouri,

Alsheikh

et al. 2024

The Scientific World Journal

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Background. Acute kidney injury (AKI) is a major medical problem affecting patients’ quality of life and healthcare costs. Objectives. This study evaluated the severity, risk factors, and outcomes of patients diagnosed with acute kidney injury (AKI), including community-acquired AKI (CA-AKI) and hospital-acquired AKI (HA-AKI), who were admitted to tertiary institutions in Palestine. Methods. This retrospective cross-sectional study was conducted at multiple tertiary care hospitals in Palestine by reviewing patient charts from January 2020 to March 2023. The study included all patients aged ≥18 years who were admitted to the hospital and diagnosed with AKI at admission (CA-AKI) or who developed AKI 48 hours after admission (HA-AKI). Patients with incomplete medical records and those with no reported creatinine levels during their stay, pregnant women, kidney transplant patients, and end-stage renal disease patients were excluded. Data were analyzed using SPSS v22.0. The incidence of AKI in each group was compared using the chi-squared test. Results. This study included 259 participants. HA-AKI was present in 27.3% of the patients, while CA-AKI was 72.7%. The most common stage among patients was stage 3 (55.7%, HA-AKI) (42.9%, CA-AKI), and the most common comorbidity contributing to AKI was CKD. NSAIDs, ACE-I/ARBs, and DIURETICs were the most nephrotoxic drugs contributing to AKI. Patients with hyperphosphatemia, hyperkalemia, severe metabolic acidosis, or stage 3 AKI require renal replacement therapy. In addition, our findings revealed a significant association among AKI mortality, age, and heart disease. Conclusion. CA-AKI was more prevalent than HA-AKI in Palestinian patients admitted for AKI. Risk factors for AKI included diabetes, CKD, and medications (antibiotics, NSAID, diuretics, and ACE-I/ARB). Preventive measures, medication management, and disease state management are necessary to minimize AKI during hospital admission or in the community.

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Section: Aki Stagementioning

confidence: 99%

Characteristics, Risk Factors, and Outcomes in Acute Kidney Injury Patients: A Retrospective Cross-Sectional Study, Palestine

Damin Abukhalil,

Alyazouri,

Alsheikh

et al. 2024

The Scientific World Journal

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“…Suncheol Heo 1* ; Eun-Ae Kang 2* ; Jae Yong Yu 3* PhD; Hae Reong Kim 1 PhD; Suehyun Lee 4 PhD; Kwangsoo Kim 5 PhD; Yul Hwangbo 6 MD, PhD; Rae Woong Park 7 MD, PhD; Hyunah Shin 8 ; Kyeongmin Ryu 8 ; Chungsoo Kim 9 PharmD; Hyojung Jung 10 ; Yebin Chegal 11 ; Jae-Hyun Lee 12 MD, PhD; Yu Rang Park 3 PhD through hospital electronic health records (EHR)-based DRNs. This approach can help identify risk factors and enable early detection of adverse drug reactions when prescribing drugs that cause renal toxicity before AKI occurs.…”

Section: Development and Verification Of A Time Series Ai Model For A...mentioning

confidence: 99%

“…Acute kidney injury (AKI) is associated with a mortality rate of 40%-70% in hospitalized patients who develop AKI and causes significant kidney damage even after recovery, leading to dialysis, longer hospital stays, and increased costs of care [1][2][3][4]. Early detection of AKI increases the likelihood of AKI prevention, associated morbidity, and costs [5].…”

Section: Introductionmentioning

confidence: 99%

Time Series AI Model for Acute Kidney Injury Detection Based on a Multicenter Distributed Research Network: Development and Verification Study

Heo,

Kang,

et al. 2024

JMIR Med Inform

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Background: Acute kidney injury (AKI) is a marker of clinical deterioration and renal toxicity. While there are many studies offering prediction models for the early detection of AKI, those predicting AKI occurrence using distributed research network (DRN)-based time series data are rare.Objective: In this study, we aimed to detect the early occurrence of AKI by applying the interpretable LSTM-based model on a hospital EHR-based time series in patients who took nephrotoxic drugs using a DRN. Methods:We conducted a multi-institutional retrospective cohort study of data from six hospitals using a DRN. For each institution, a patient-based dataset was constructed using five drugs for AKI, and the interpretable multi-variable long short-term memory (IMV-LSTM) model was used for training. This study employed propensity score matching to mitigate differences in demographics and clinical characteristics. Additionally, the temporal attention values of the AKI prediction model's contribution variables were demonstrated for each institution and drug, with differences in highly important feature distributions between the case and control data confirmed using one-way analysis of variance.Results: This study analyzed 8,643 and 31,012 patients with and without AKI, respectively, across six hospitals. When analyzing the distribution of AKI onset, vancomycin showed an earlier onset (median: 12 days), and acyclovir was the slowest compared to the other drugs (median: 23 days). Our temporal deep learning model for AKI prediction performed well for most drugs. Acyclovir had the highest average area under the receiver operating characteristic curve score per drug (0.94), followed by acetaminophen (0.93), vancomycin (0.92), naproxen (0.90), and celecoxib (0.80). Based on the temporal attention values of the variables in the AKI prediction model, verified lymphocytes and calcium had the highest attention, whereas lymphocytes, albumin, and hemoglobin tended to decrease over time, and urine pH and prothrombin time tended to increase. Conclusions:Early surveillance of AKI outbreaks can be achieved by applying the IMV-LSTM based on time series data

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“…Kidney disease represents a significant global health burden affecting millions of individuals worldwide [ 142 , 143 , 144 , 145 ]. Despite advancements in treatment, the management of acute kidney injury (AKI) is mostly conservative [ 146 , 147 , 148 ], and the treatment of glomerulonephritis with immunosuppressive agents is accompanied by systemic side effects [ 149 , 150 , 151 ].…”

Section: Clinical Application Of Exosomes-based Drug Deliverymentioning

confidence: 99%

Exosome-Based Drug Delivery: Translation from Bench to Clinic

Koh,

Kim,

Kang

et al. 2023

Pharmaceutics

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Exosome-based drug delivery is emerging as a promising field with the potential to revolutionize therapeutic interventions. Exosomes, which are small extracellular vesicles released by various cell types, have attracted significant attention due to their unique properties and natural ability to transport bioactive molecules. These nano-sized vesicles, ranging in size from 30 to 150 nm, can effectively transport a variety of cargoes, including proteins, nucleic acids, and lipids. Compared to traditional drug delivery systems, exosomes exhibit unique biocompatibility, low immunogenicity, and reduced toxicity. In addition, exosomes can be designed and tailored to improve targeting efficiency, cargo loading capacity, and stability, paving the way for personalized medicine and precision therapy. However, despite the promising potential of exosome-based drug delivery, its clinical application remains challenging due to limitations in exosome isolation and purification, low loading efficiency of therapeutic cargoes, insufficient targeted delivery, and rapid elimination in circulation. This comprehensive review focuses on the transition of exosome-based drug delivery from the bench to clinic, highlighting key aspects, such as exosome structure and biogenesis, cargo loading methods, surface engineering techniques, and clinical applications. It also discusses challenges and prospects in this emerging field.

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Comparison of Outcomes of Mild and Severe Community- and Hospital-Acquired Acute Kidney Injury

Cited by 6 publications

References 29 publications

Characteristics, Risk Factors, and Outcomes in Acute Kidney Injury Patients: A Retrospective Cross-Sectional Study, Palestine

Characteristics, Risk Factors, and Outcomes in Acute Kidney Injury Patients: A Retrospective Cross-Sectional Study, Palestine

Time Series AI Model for Acute Kidney Injury Detection Based on a Multicenter Distributed Research Network: Development and Verification Study

Exosome-Based Drug Delivery: Translation from Bench to Clinic

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