American journal of kidney diseases : the official journal of the National Kidney Foundation
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Kidney dysfunction in the intensive care unit (ICU) results in increased morbidity, mortality, and health care costs; however, long-term mortality has not been described across strata of severity in kidney dysfunction. ⋯ Severity of kidney dysfunction in patients in the ICU is associated with an incremental increase in long-term mortality. Although patients classified with either mild or moderate kidney dysfunction had an increased risk for death, use of serum creatinine level alone was poor at discriminating long-term outcome, suggesting this measure alone should not be used for defining long-term prognosis.
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Radiocontrast-induced nephropathy (RCIN) causes acute kidney injury and increases mortality. Studies have examined the capacity of various forms of extracorporeal blood purification therapies for the prevention of RCIN, with conflicting results. We conducted a systematic review of published trials to determine whether periprocedural extracorporeal blood purification prevents RCIN. ⋯ This critical analysis of the published literature suggests that periprocedural extracorporeal blood purification does not decrease the incidence of RCIN compared with standard medical therapy.