Renal failure
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Observational Study
Renal echography for predicting acute kidney injury in critically ill patients: a prospective observational study.
Objective: To investigate the diagnostic performances of renal resistive index (RRI) and semiquantitative power Doppler ultrasound (PDU) scores in predicting acute kidney injury (AKI) stage 3 in critically ill patients. Methods: This prospective observational study included 148 patients (80 with reduced cardiac index [CI], 68 with maintained CI). RRI and semiquantitative PDU scores were measured within 6 h after intensive care unit admission. ⋯ The predictive value of PDU score for AKI stage 3 was statistically different between CI-reduced and CI-maintained patients (p = 0.021). Conclusions: PDU scores could effectively predict AKI stage 3 in CI-reduced patients but not in CI-maintained patients. RRI is a poor predictor of AKI stage 3 in patients with reduced or maintained CI.
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Purpose: The results from randomized controlled trials (RCTs) concerning the timing of initiation of renal replacement therapy (RRT) for patients with acute kidney injury (AKI) are still inconsistent. Materials and methods: We searched for RCTs, as well as relevant references, focusing on the timing of RRT for AKI patients in the Medline, Embase, Cochrane Library, Google Scholar and Chinese databases from their inception to December 2018. Results: We included 18 RCTs from 1997 to 2018 involving 2856 patients. ⋯ There was also no difference in the incidence of dialysis independence (RR 0.75, 95% CI: 0.47 to 1.2, p = .2) (I2 = 0). However, an early RRT strategy was associated with a significantly higher incidence of the need for RRT for AKI patients (RR 1.24, 95% CI: 1.13 to 1.36, p < .01) (I2 = 34%). Conclusions: As no life-threatening complications occurred, there was no evidence to show any benefit of an early RRT strategy for critically ill or community-acquired AKI patients; in contrast, a delayed strategy might avert the need for RRT.
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Observational Study
Serum elabela and apelin levels during different stages of chronic kidney disease.
The association of serum elabela (ELA) and apelin with the progression of chronic kidney disease (CKD) is unknown. We determined if serum ELA and apelin levels were associated with CKD stage. ⋯ In CKD patients, serum ELA levels decreased with decreasing eGFR. This finding may provide a new target for the prediction, diagnosis, and staging of CKD.
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Whether exercise can improve cardiovascular health in kidney transplant recipients (KTRs) is unclear. Therefore, we performed a systematic review of the effects of exercise on cardiovascular risk factors in this population setting. ⋯ Exercise intervention in KTRs improves arterial stiffness but does not consistently contribute to the modification of other CVD risk factors like hypertension, dyslipidemia, hyperglycemia, decreased kidney function and obesity. Exercise also improves exercise tolerance and QOL in KTRs.