Prognosis in acute renal failure of septic origin: A multivariate analysis

Lombardi, Raúl; Zampedri, Laura; Rodriguez, I; Alegre, Sarah Monte; Ursu, Marcela; M, Di Fabio

doi:10.3109/08860229809045169

Cited by 19 publications

(13 citation statements)

References 34 publications

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“…In addition, the proportional, estimated survival in ARF patients, compared to non-ARF patients, was reduced throughout the first 30 days. The 43 % ICU mortality rate of ARF patients in our study population is comparable to recent values quoted in the literature [3,4,5,6,7,8,10,11,12]. In the present study, mortality was 3 times higher in those with, than in those without, ARF.…”

Section: Discussionsupporting

confidence: 79%

“…We believe that the combination of these two aspects is important, as oliguria may precede a rise in creatinine concentration. As in other studies [5,6,8,10,13], oliguria was an important prognostic factor; it independently doubled the risk of death for the entire population.…”

Section: Discussionmentioning

confidence: 61%

“…The incidence of ARF in intensive care unit (ICU) patients varies from 3 to 16 %, depending on the population studied and the criteria used to define ARF [1,2,3]. The mortality rate in ARF patients remains high [1,4,5,6,7,8,9,10,11] despite improvements in renal replacement techniques. Possible explanations for this finding include the fact that ICU patients today are older and more debilitated than previously [12], and that the same pathophysiologic factors involved in the development of ARF are also incriminated in the failure of other organs, so that ARF is often part of the multiple organ failure (MOF) syndrome [1,13].…”

Section: Introductionmentioning

confidence: 99%

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Acute renal failure in the ICU: risk factors and outcome evaluated by the SOFA score

Mendonça

Vincent

et al. 2000

Intensive Care Medicine

658

397

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In ICU patients, the most important risk factors for ARF or mortality from ARF are often present on admission. During the ICU stay, other organ failures (especially cardiovascular) are important risk factors. Oliguric ARF was an independent risk factor for ICU mortality, and infection increased the contribution to mortality by other factors. The severity of circulatory shock was the most important factor influencing outcome in ARF patients.

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Section: Discussionsupporting

confidence: 79%

Section: Discussionmentioning

confidence: 61%

Section: Introductionmentioning

confidence: 99%

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Acute renal failure in the ICU: risk factors and outcome evaluated by the SOFA score

Mendonça

Vincent

et al. 2000

Intensive Care Medicine

658

397

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“…Esta observación es de vital importancia si se tiene en cuenta que la falla renal aguda es una de la principales causas de mortalidad en los pacientes con procesos infecciosos graves (75,76) y que su lesión durante la sepsis, generada por una serie de factores como la hipovolemia y la hipotensión, es un fenómeno común (77) y potencialmente reversible (49).…”

Section: Leucocitosunclassified

Urinalysis as a diagnostic tool in severe malaria

Barrera

Tobón-Castaño

2017

biomedica

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Recibido: 15/07/16; aceptado: 26/02/17 Contribución de los autores:Sebastián Barrera: búsqueda bibliográfica y escritura del manuscrito Alberto Tobón: búsqueda bibliográfica, revisión crítica, corrección y escritura del manuscrito Los dos autores participaron en la escritura del manuscrito. La malaria produce complicaciones y muerte especialmente en poblaciones con acceso limitado a la atención en salud. La malaria grave puede reconocerse tempranamente mediante la detección en la orina de hallazgos como la hematuria, la coluria y la proteinuria. Se hizo una revisión narrativa basada en estudios sobre malaria grave y el empleo del análisis de orina mediante la consulta de 91 publicaciones. Mediante el análisis de la orina, se pueden detectar alteraciones metabólicas y lesiones en distintos órganos. En estudios recientes en Colombia se ha confirmado su utilidad como apoyo en el diagnóstico de la disfunción renal, la disfunción hepática y la anemia asociada con hemólisis, las cuales son complicaciones frecuentes en la malaria. El examen constituye una herramienta de fácil aplicación en la consulta ambulatoria y en pacientes hospitalizados para reconocer tempranamente casos complicados, y permite la detección oportuna de diferentes lesiones en el paciente con malaria, contribuyendo así a la reducción de la morbilidad grave y la mortalidad.Palabras clave: malaria, proteinuria, hematuria.doi: https://doi.org/10.7705/biomedica.v34i2.3416 Urinalysis as a diagnostic tool in severe malariaMalaria accounts for a significant morbidity and mortality rate around the world, especially in communities with limited access to healthcare. Some clinical signs in urine, like haematuria, coluria and proteinuria, help for the early diagnosis of severe malaria cases. A narrative review was conducted by analyzing 91 publications on studies about severe malaria cases and the use of urinalysis. A urinalysis can detect metabolic disturbances and organ injury. Its diagnostic utility for frequent complications caused by malaria, such as hepatic injury, kidney dysfunction and hemolysis, has been confirmed by recent Colombian studies. This test is an easy-to-use tool in outpatient clinics and with hospitalized patients to promptly recognize complicated cases, allowing the timely identification of different lesions in patients with malaria, thus contributing to the reduction of severe morbidity and mortality. La malaria es una enfermedad que afecta principalmente a las comunidades que habitan en regiones tropicales en donde constituye un importante problema de salud pública; las poblaciones afectadas tienen, en general, un acceso limitado a la atención en salud y a los recursos diagnósticos.En 2015 se informó una incidencia de 214 millones de casos clínicos y 438.000 muertes, la mayoría en el África subsahariana (1). La malaria afecta de manera importante a los niños, grupo que representó el 16 % del total de casos en 2015 (2) y se consideró la causa de 7 % de las muertes

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“…In a multivariate analysis, it has been found that three variables affect the result. These are; age over 60, pulmonary failure and hemodynamic failure (51). Especially, co-presence of pulmonary and renal failures is one of the most important factors threatening life.…”

Section: Early Antibiotic Therapy and Control Of The Source Of The Inmentioning

confidence: 99%

Sepsis and the Kidney: New Developments in Pathogenesis and Treatment

Koçkara¹,

Kayataş²

2013

Turk Neph Dial Transpl

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Sepsis is a common and important cause of mortality in critically ill patients. Acute kidney injury (AKI) is one of the most important factors determining morbidity and mortality in this clinical picture. Recent studies have indicated that the pathogenetic mechanism in septic acute kidney injury (AKI) is totally different from that in non-septic AKI. Our understanding of sepsis-associated AKI pathophysiology is shifting from renal vasoconstriction, ischemia, and acute tubular necrosis to that of heterogeneous vasodilation, hyperemia, and acute tubular apoptosis.Apoptosis is especially gradually gaining importance in the development of renal injury. In recently published studies, the frequency of renal tubular apoptosis on biopsies of septic patients has been pointed out. Apoptosis can be triggered by ischemia, exogenous toxins or endogenous mediators. In animal models, hyperglycemia, which is common in critically ill patients, has been shown to cause apoptosis in renal tubule cells.In the light of recent findings, new treatment options have emerged. Treatment of hyperglycemia has a different significance, since besides anti-inflammatory effect it has a protective role on the kidney. Hemofiltration methods cleaning toxic mediators from the circulation should be applied in the early stages. Ghrelin that inhibits pro-inflammatory cytokines, caspase inhibitors that block the apoptotic pathway, and nitric oxide synthase inhibitors are currently under study. Regarding pathogenesis, rates of morbidity and mortality are aimed to be reduced through the new agents of therapy that are being studied.KEY wORds: Sepsis, Pathophysiology, Apoptosis, Renal failure ÖzSepsis yoğun bakım ünitelerindeki hastalarda mortalitenin sık ve önemli bir nedenidir. Akut böbrek hasarı (ABH) da bu tabloda morbidite ve mortaliteyi belirleyen en önemli faktörlerden biridir. Son yıllarda yapılan çalışmalar, septik akut böbrek hasarında patogenetik mekanizmanın septik olmayan akut böbrek hasarından tamamen farklı olduğunu göstermiştir. Sepsis ile ilişkili akut böbrek hasarının patofizyolojisi ile ilgili görüşler de, renal vazokonstriksiyon, iskemi ve akut tübüler nekrozdan, heterojen vazodilatasyon, hiperemi ve akut tübüler apoptoza doğru kaymaktadır.Özellikle apoptoz, renal hasar gelişiminde giderek öne çıkmaktadır. Yakın zamanda yayınlanan çalışmalarda, sepsis hastalarından yapılan renal biyopsilerde tübüler apoptozun sıklığına dikkat çekilmiştir. Apoptoz, iskemi, eksojen toksinler veya endojen mediatörler tarafından tetiklenebilmektedir. Hayvan deneylerinde, yoğun bakım gerektiren hastalarda sık görülen hipergliseminin de böbrek tübül hücrelerinde apoptoza neden olduğu gösterilmiştir.Bu yeni bilgiler ışığında yeni tedavi seçenekleri gündeme gelmiştir. Hiperglisemi tedavisi, antiinflamatuvar etkisi yanında böbrek koruyucu rolü de olduğundan ayrı bir öneme sahiptir. Toksik mediyatorleri dolaşımdan temizleyen hemofiltrasyon yöntemleri erken dönemde uygulanmalıdır. Proinflamatuvar sitokinleri inhibe eden ghrelin, apoptotik yolağı bloke eden ...

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Prognosis in acute renal failure of septic origin: A multivariate analysis

Cited by 19 publications

References 34 publications

Acute renal failure in the ICU: risk factors and outcome evaluated by the SOFA score

Acute renal failure in the ICU: risk factors and outcome evaluated by the SOFA score

Urinalysis as a diagnostic tool in severe malaria

Sepsis and the Kidney: New Developments in Pathogenesis and Treatment

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