Renal failure
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Randomized Controlled Trial
The pharmacodynamics of vecuronium in chronic renal failure patients: the impact of different priming doses.
The concept of priming was introduced to facilitate a faster onset of nondepolarizing neuromuscular blocker for endotracheal intubation. Vecuronium is still very much in use for most chronic renal failure patients posted for renal transplantation. The aim of this study was to examine the pharmacodynamics of vecuronium without and with preceding different small doses. ⋯ Priming the chronic renal failure patients with 10% of ED(95) vecuronium dose acquit the best pharmacodynamics with the fewest signs of muscle weakness. Larger vecuronium priming doses are unfavorable and convey no more clinical utility.
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Multicenter Study Comparative Study
Epidemiology of postoperative acute kidney injury in Hungarian intensive care units: an exploratory analysis.
The aim of this study was to evaluate the incidence and outcome of postoperative acute kidney injury (AKI) after major noncardiac surgery in Hungarian intensive care units (ICUs). ⋯ The results of this study confirm that there is a high incidence of AKI following major noncardiac surgery, which is associated with higher ICU and in-hospital mortality.
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Comparative Study
Combination of renal biomarkers predicts acute kidney injury in critically ill adults.
Most studies so far have focused on the performance of individual biomarkers to detect early acute kidney injury (AKI) in the adult intensive care unit (ICU) patients; however, they have not determined the predictive ability of their combinations. The aim of this study was to compare the predictive abilities of plasma neutrophil gelatinase-associated lipocalin (pNGAL), urine neutrophil gelatinase-associated lipocalin (uNGAL), plasma cystatin C (pCysC), serum creatinine (sCr), and their combinations in detecting AKI in an adult general ICU population. ⋯ The biomarker combinations had better predictive characteristics compared with those of each biomarker alone.
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Comparative Study
Major barriers against renin-angiotensin-aldosterone system blocker use in chronic kidney disease stages 3-5 in clinical practice: a safety concern?
Renin-angiotensin-aldosterone system (RAAS) blockers are underutilized in patients with chronic kidney disease (CKD). We aimed to determine barriers against the use of RAAS blockers in these patients. Patients with stage 3-5 CKD referred to Hacettepe University Hospital Nephrology Unit during a 1 year period were evaluated for RAAS blocker use. ⋯ In 37.4% of patients, reasons for not starting RAAS blockers were unclear. This study showed that hyperkalemia is the major barrier against the use of RAAS blockers in patients with CKD. There was, however, a subset of patients who did not receive RAAS blockers even without clear contraindications.
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In this article, we report a patient with crush syndrome (CS) who developed acute renal failure (ARF) and acute pancreatitis. Continuous venovenous hemofiltration (CVVH) and intermittent hemoperfusion (HP) were successfully performed in this patient and satisfactory effects were achieved. The treatment of this patient suggested that early intervention with continuous renal replacement therapy (CRRT) may be useful and a multiple-mode treatment may be a better choice.