Renal failure
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The prognosis of critically ill patients with cirrhosis is poor. Our aim was to identify an objective variable that can improve the prognostic value of the Model of End-Stage Liver Disease (MELD) score in patients who have cirrhosis and are admitted to the intensive care unit (ICU). This retrospective cohort study included 177 patients who had liver cirrhosis and were admitted to the ICU. ⋯ Bicarbonate level assessment, as an objective and reproducible laboratory test, has significant predictive value in critically ill patients with cirrhosis. In contrast, the predictive value of total bilirubin is not as prominent in this setting. The MELD-Bicarbonate equation, which included three variables (international normalized ratio, creatinine level, and HCO3 level), showed better prognostic value than the original MELD score in critically ill patients with cirrhosis.
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The association between statins use and the risk of acute kidney injury (AKI) remains elusive. We aimed to evaluate the association of statins use with AKI risk by performing a meta-analysis. Twenty-one studies were included in our meta-analysis by searching electronic databases according to predefined criteria. ⋯ Exclusion of any single study had little impact on the pooled ORs. In conclusion, statins use is not associated with the risk of AKI in overall populations, Caucasians, Asians, and patients undergoing cardiac and elective surgery. Statins use decreases the risk of CIN and may increase the risk of AKI in CAP patients.
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To evaluate the association between acute kidney injury (AKI) and long-term survival in lung transplant patients. ⋯ The occurrence of AKI after LTx is common. Severe AKI would increase long-term mortality risk. Several variables, including pre-LT hypertension and mechanical ventilation, are associated with AKI after LTx.
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Observational Study
Intra-abdominal pressure as a predictor of acute kidney injury in postoperative abdominal surgery.
The purpose of this study was to determine if intra-abdominal pressure (IAP) could predict acute renal injury (AKI) in the postoperative period of abdominal surgeries, and which would be its cutoff value. ⋯ IAH was frequent in patients undergoing abdominal surgeries during ICU stay, and it predicted the occurrence of AKI. Serial assessments of IAP did not provided better discriminatory power than initial evaluation.
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Determination of fluid overload is important in chronic kidney disease. Early diagnosis and treatment of volume overload may decrease morbidity and mortality. We aimed to determine body composition by using bioelectrical impedance analysis, and studying other clinical characteristics, inferior vena cava diameter, and N-terminal pro-B natriuretic peptide associated with hydration status in chronic kidney disease Stages 3&4 and 5 in patients not undergoing dialysis. ⋯ Overhydration is more prevalent in Stage 5 chronic kidney disease patients than in Stages 3&4 patients. Bioelectrical impedance analysis, inferior vena cava diameter, and NT-proBNP analysis in chronic kidney disease are useful methods to determine the volume overload.