American journal of kidney diseases : the official journal of the National Kidney Foundation
-
The overall incidence of acute kidney injury (AKI) or mortality after cardiac surgery is low, but mortality in patients with AKI remains high. Effects of factors such as change in comorbid disease burden, intraoperative factors, or postoperative complications on trends in the incidence of AKI and associated mortality after cardiac surgery were not examined. ⋯ The incidence of AKI after cardiac surgery has increased over time. Although the adjusted risk of mortality decreased in patients with AKI without other postoperative complications, it is unchanged in those with multiorgan system failure.
-
Multicenter Study Comparative Study
Posttraumatic stress disorder in hemodialysis patients.
We aim to assess the prevalence and severity of posttraumatic stress disorder (PTSD) in patients who receive long-term hemodialysis (HD) and investigate its correlation with depression, anxiety, health-related quality of life, and service utilization. ⋯ PTSD is common in HD patients, but little work has been done to explore the variables associated with PTSD. Data suggest that PTSD is underdiagnosed and undertreated in HD patients. Interventions should target these patients with the goal to improve well-being and quality of life.
-
The accuracy of fractional excretion of sodium (FENa) for the diagnosis of transient acute kidney injury (AKI) caused by decreased kidney perfusion is reported to be low in patients administered diuretics. ⋯ In patients without diuretic use, FENa is better able to distinguish transient from persistent AKI. In patients administered diuretics, this distinction cannot be made accurately by means of FENa. FEur cannot be used as an alternative tool because it lacks specificity.
-
Randomized Controlled Trial Comparative Study
Hemodialysis membrane with a high-molecular-weight cutoff and cytokine levels in sepsis complicated by acute renal failure: a phase 1 randomized trial.
Sepsis is the leading cause of acute renal failure. Intermittent hemodialysis (IHD) is a common treatment for patients with acute renal failure. However, standard hemodialysis membranes achieve only little diffusive removal of circulating cytokines. Modified membranes may enable both successful IHD treatment and simultaneous diffusive cytokine removal. ⋯ In septic patients with acute renal failure, HCO-IHD achieved simultaneous uremic control and diffusive cytokine clearances and a greater relative decrease in plasma cytokine concentrations than standard HF-IHD.
-
Randomized Controlled Trial Comparative Study
A randomized trial of pulsatile perfusion using an intra-aortic balloon pump versus nonpulsatile perfusion on short-term changes in kidney function during cardiopulmonary bypass during myocardial reperfusion.
Nonpulsatile perfusion during cardiopulmonary bypass can induce renal damage. We evaluated whether pulsatile perfusion using an intra-aortic balloon pump preserves renal function in patients undergoing myocardial revascularization. ⋯ Use of automatic pulsatile intra-aortic balloon pumps during cardiopulmonary bypass is associated with better renal function during myocardial reperfusion. More studies are needed to verify the effects of pulsatile intra-aortic balloon pumps.