Clinical journal of the American Society of Nephrology : CJASN
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Clin J Am Soc Nephrol · Sep 2010
Serum cystatin C is an early predictive biomarker of acute kidney injury after pediatric cardiopulmonary bypass.
Acute kidney injury (AKI) is a frequent complication of cardiopulmonary bypass (CPB). Serum creatinine (SCr), the current standard, is an inadequate marker for AKI since a delay occurs before SCr rises. Biomarkers that are sensitive and rapidly measurable could allow early intervention and improve patient outcomes. We investigated the value of serum cystatin C as an early biomarker for AKI after pediatric CPB. ⋯ Serum cystatin C is an early predictive biomarker for AKI and its clinical outcomes after pediatric CPB.
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Clin J Am Soc Nephrol · Sep 2010
Impact of age and overt proteinuria on outcomes of stage 3 to 5 chronic kidney disease in a referred cohort.
Population-based studies have reported outcomes and risk factors for patients with chronic kidney disease (CKD), defined primarily by decreased estimated GFR (eGFR). They are characterized by old age, low proteinuria level, and stage 3 CKD. However, many patients referred to nephrologists are younger and have overt proteinuria and advanced CKD. This study evaluated the association between outcomes and those factors among referred CKD patients. ⋯ Stratification by age, proteinuria level, and CKD stage could predict the competing outcomes of death before RRT and ESRD among CKD patients.
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Clin J Am Soc Nephrol · Aug 2010
Randomized Controlled Trial Multicenter Study Comparative StudyPredictors of health utility among 60-day survivors of acute kidney injury in the Veterans Affairs/National Institutes of Health Acute Renal Failure Trial Network Study.
Health-related quality of life (HRQOL) after acute kidney injury (AKI) is an area of great importance to patients. It was hypothesized that HRQOL after AKI would relate to intensity of dialysis during AKI and dialysis dependence at follow-up. ⋯ Health utility was low in this cohort of patients after AKI, and intensity of dialysis did not affect subsequent health utility. The effects of a lengthy hospitalization generally outweighed the effects of delayed recovery of kidney function on HRQOL after AKI.
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Clin J Am Soc Nephrol · Aug 2010
Multicenter Study Comparative StudyContinuous renal replacement therapy may increase the risk of catheter infection.
Little is known about the risks of catheter-related infections in patients undergoing intermittent hemodialysis (IHD) as compared with continuous renal replacement therapy (CRRT) techniques. We compared the two modalities among critically ill adults requiring acute renal replacement therapy (RRT). ⋯ Our results do not support the use of CRRT when IHD could be an alternative to reduce the risk of catheter-related infection.
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Clin J Am Soc Nephrol · Aug 2010
Multicenter StudyPlasma cystatin C and acute kidney injury after cardiopulmonary bypass.
Little is known about the performance of plasma cystatin C (CysC) in patients undergoing cardiopulmonary bypass (CPB) and its utility in the early diagnosis of acute kidney injury (AKI). In this post hoc analysis, the goal was to determine whether plasma cystatin C, measured 2 hours after the conclusion of CPB, is a reliable marker of AKI. ⋯ Serial measures of plasma CysC are highly correlated with the development of AKI. However, the discriminatory capacity of plasma CysC as an early marker of AKI remains limited.