Kidney international
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Kidney international · Sep 2007
Acute kidney injury prediction following elective cardiac surgery: AKICS Score.
Acute kidney injury (AKI) following cardiac surgery (AKICS) is associated with increased postoperative (post-op) morbidity and mortality. A prognostic score system for AKI would help anticipate patient (pt) treatment. To develop a predictive score (AKICS) for AKI following cardiac surgery, we used a broad definition of AKI, which included perioperative variables. ⋯ Variables included in the AKICS score were age greater than 65, pre-op creatinine above 1.2 mg/dl, pre-op capillary glucose above 140 mg/dl, heart failure, combined surgeries, cardiopulmonary bypass time above 2 h, low cardiac output, and low central venous pressure. The AKICS score presented good calibration and discrimination in both the study group and validation data set. The AKICS system that we developed, which incorporates five risk categories, accurately predicts AKI following cardiac surgery.
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Kidney international · Sep 2007
CommentCan we do better than a single estimated GFR threshold when screening for chronic kidney disease?
The Modification of Diet in Renal Disease (MDRD) equation has been used to screen for and diagnose chronic kidney disease (CKD). A fixed estimated glomerular filtration rate cutoff point has been advocated by the National Kidney Foundation to diagnose CKD. However, data derived from healthy individuals challenge this approach and suggest that age- and gender-specific reference values may be more useful in the screening setting.
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Kidney international · Sep 2007
Differential effects of vitamin D receptor activators on vascular calcification in uremic rats.
Vascular calcification is associated with cardiovascular disease, the most common cause of death in chronic kidney disease (CKD). Patients with CKD are treated with vitamin D receptor activators (VDRAs); therefore, we determined if this treatment affects vascular calcification. Uremic rats were given vehicle, calcitriol, paricalcitol, or doxercalciferol three times a week for 1 month. ⋯ Doxercalciferol treatment increased the mRNA and protein expression of the bone-related markers Runx2 and osteocalcin in the aorta, whereas paricalcitol did not. Hence, different VDRAs have different effects on vascular calcification in uremic rats. The effects are independent of the serum calcium-phosphate product suggesting independent mechanisms.