Prevention of acute kidney injury in Intensive Care Units

Mas-Font, S; Martínez, José Ros; Pérez–Calvo, César; Villa-Díaz, P.; Aldunate-Calvo, S.; Moreno-Clarí, Ester

doi:10.1016/j.medine.2017.03.005

Cited by 3 publications

(4 citation statements)

References 66 publications

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“…Furthermore, there were six articles included in the above-mentioned meta-analysis that reported average age, and the mean age of five studies was higher than this study. Generally, elderly patients with multiple chronic diseases or poor general health suffered a higher risk of AKI associated with open surgery than young and middle-aged patients [27]. TBAD patients in our study received TEVAR only, and most of them were young and middle-aged people (mean age of all cases in this study was 52.8 years), while only 7 (2.7%) patients were older than 70 years.…”

Section: Discussionmentioning

confidence: 73%

Risk factors of acute kidney injury in patients with Stanford type B aortic dissection involving the renal artery who underwent thoracic endovascular aortic repair

Guo

et al. 2021

Renal Failure

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Background: Acute kidney injury (AKI) is one of the most common and serious complications in patients with type B aortic dissection (TBAD). This study aimed at investigating the incidence and risk factors of in-hospital AKI in TBAD patients involving the renal artery who underwent thoracic endovascular aortic repair (TEVAR) only. Methods: A total of 256 patients who were diagnosed as TBAD combined with renal artery involvement were included in this retrospective study. All patients were divided into the AKI group and the non-AKI group according to the KDIGO criteria. The risk factors for AKI were identified using a multivariate logistic regression model. Results: A total of 256 patients were included in this study, and the incidence of AKI was 18% (46/256). Patients in the AKI group were more likely to have a higher proportion of the youth, a higher level of body mass index, and a shorter time from onset to admission. Multivariate logistic regression analysis revealed that the youth (age 40 years) (OR: 2.853, 95%CI: 1.061-7.668, p ¼ .038) were prone to AKI, and lower estimated glomerular filtration rate (eGFR) (OR: 1.526, per 15-ml/min/1.73 m 2 decrease, 95%CI: 1.114-2.092; p ¼ .009), higher diastolic blood pressure (DBP) (OR: 1.418, per 10-mmHg increase; 95%CI: 1.070-1.879; p ¼ .015), and fasting blood glucose (FBG) 7 mmol/L on admission (OR: 2.592; 95%CI: 1.299-5.174; p ¼ .007) were independent risk factors for AKI. Conclusions: Higher incidence of AKI had been perceived in this study, most of them were young and middle-aged patients. Renopreventive measures should be considered in those highrisk patients with younger age, lower eGFR, higher DBP, and higher FBG on admission.

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Section: Discussionmentioning

confidence: 73%

Risk factors of acute kidney injury in patients with Stanford type B aortic dissection involving the renal artery who underwent thoracic endovascular aortic repair

Guo

et al. 2021

Renal Failure

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“…Nephrotoxic agents are the third most common cause of AKI in intensive care units, and the list of potentially nephrotoxic agents is extensive. 23 Although the exact mechanism of AKI in the setting of COVID-19 is unclear, it is important to note that nephrotoxic agents can have additive or synergistic effects with respect to toxicity, 23 and therefore may worsen the AKI caused by COVID-19. Implementation of the KDIGO supportive care guidelines, 24 especially those regarding avoidance of nephrotoxic agents, is likely to reduce the occurrence and severity of AKI in COVID-19.…”

Section: Questionsmentioning

confidence: 99%

Pragmatic Recommendations for the Prevention and Treatment of Acute Kidney Injury in Patients with COVID-19 in Low- and Middle-Income Countries

Rudd

Çizmeci

Galli

et al. 2021

The American Journal of Tropical Medicine and Hygiene

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. Current recommendations for the management of patients with COVID-19 and acute kidney injury (AKI) are largely based on evidence from resource-rich settings, mostly located in high-income countries. It is often unpractical to apply these recommendations to resource-restricted settings. We report on a set of pragmatic recommendations for the prevention, diagnosis, and management of patients with COVID-19 and AKI in low- and middle-income countries (LMICs). For the prevention of AKI among patients with COVID-19 in LMICs, we recommend using isotonic crystalloid solutions for expansion of intravascular volume, avoiding nephrotoxic medications, and using a conservative fluid management strategy in patients with respiratory failure. For the diagnosis of AKI, we suggest that any patient with COVID-19 presenting with an elevated serum creatinine level without available historical values be considered as having AKI. If serum creatinine testing is not available, we suggest that patients with proteinuria should be considered to have possible AKI. We suggest expansion of the use of point-of-care serum creatinine and salivary urea nitrogen testing in community health settings, as funding and availability allow. For the management of patients with AKI and COVID-19 in LMICS, we recommend judicious use of intravenous fluid resuscitation. For patients requiring dialysis who do not have acute respiratory distress syndrome (ARDS), we suggest using peritoneal dialysis (PD) as first choice, where available and feasible. For patients requiring dialysis who do have ARDS, we suggest using hemodialysis, where available and feasible, to optimize fluid removal. We suggest using locally produced PD solutions when commercially produced solutions are unavailable or unaffordable.

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“…However, the ability of dopamine to achieve these goals is poorly documented and largely anecdotal 8 . Mas-Font et al 9 examined the protective effect of low dose dopamine in patients undergoing coronary artery bypass surgery. These researchers found that dopamine neither improved renal function nor prevented ARF when compared with a control group 7,9 .…”

mentioning

confidence: 99%

“…Mas-Font et al 9 examined the protective effect of low dose dopamine in patients undergoing coronary artery bypass surgery. These researchers found that dopamine neither improved renal function nor prevented ARF when compared with a control group 7,9 . In early and established ARF, the results have been mixed.…”

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confidence: 99%

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2021

IJPSR

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Background: This was a conventional comparative treatmentcontrolled study designed to analyze the effect of dopamine infusion in the treatment of prerenal azotemia (PRA). Material and Methods: thirty randomized consecutive adult patients (group A= 15, B=15) aged 18 and 58 years with PRA were recruited. Group a received conventional treatment only (fluid replacement and frusemide), while group B received conventional treatment and dopamine. 24 hours urine volume, hemodynamic changes (pulse and blood pressure), serum electrolyte, urea, and creatinine were measured for the first 5 days of hospitalization. Duration of oliguria and hospitalization, mortality, number of patients who developed acute tubular necrosis (ATN), and or required dialysis was computed. Results: Duration of oliguria and hospitalization were shorter in group B than in group A patients (P = 0.025). The daily and hourly urine output was more in group B than in group A patients (P = 0.025). However, from the second day, patients in group B excreted more sodium than patients in group A (P = 0.001). 5 patients in group A (33.30 %) and 3 (20 %) in group B developed ATN; while 6 (40%) in group A and 4 (26.7 %) in group B developed uremic syndrome and needed dialysis (P > 0.05). 2 (13.3 %) died in group A and 1 (6.7%) in group B from uremia. Conclusion: Although dopamine infusion added to conventional treatment increased the urinary output, shortened the duration of oliguria and hospitalization in patients with PRA, Renal function, development of ATN, uremic syndrome, need for dialysis and mortality were not influenced. Hence, routine prescription of dopamine infusion in the treatment of PRA is not recommended by this study.

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Prevention of acute kidney injury in Intensive Care Units

Cited by 3 publications

References 66 publications

Risk factors of acute kidney injury in patients with Stanford type B aortic dissection involving the renal artery who underwent thoracic endovascular aortic repair

Risk factors of acute kidney injury in patients with Stanford type B aortic dissection involving the renal artery who underwent thoracic endovascular aortic repair

Pragmatic Recommendations for the Prevention and Treatment of Acute Kidney Injury in Patients with COVID-19 in Low- and Middle-Income Countries

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