2010 Mar - Acute kidney injury in non-severe pneumonia is associated with an increased immune response and lower survival
Raghavan Murugan, Vijay Karajala-Subramanyam, Minjae Lee, Sachin Yende, Lan Kong, Melinda Carter, Derek C Angus and John A Kellum on behalf of the Genetic and Inflammatory Markers of Sepsis (GenIMS) Investigators; Kidney Int 2010: 77: 527-535
While sepsis is a leading cause of acute kidney injury in critically ill patients, the relationship between immune response and acute kidney injury in less severely ill patients with infection is not known. Here we studied the epidemiology, 1-year mortality, and immune response associated with acute kidney injury in 1836 hospitalized patients with community-acquired severe and non-severe pneumonia.
2009 Regional Citrate Anticoagulation for Intermittent Predilution Online Hemofiltration
There is no consensus on the optimal renal replacement treatment in intensive care units. Among intermittent dialysis methods, hemofiltration (HF) is preferred by some because of better hemodynamic stability and cytokine removal. We report our experience with regional citrate anticoagulation for intermittent predilution online HF.
2009 Nov - Outcomes of Chronic Dialysis Patients Admitted to the Intensive Care Unit.
Admission rates and outcomes of patients who have ESRD and are admitted to an intensive care unit (ICU) are not well defined. We conducted a historical cohort study using a prospective regional ICU database that captured all 11 adult ICUs in Winnipeg, Canada. Between 2000 and 2006, there were 34,965 total admissions to the ICU, 1173 (3.4%) of which were patients with ESRD.
2009 Oct Acetylcysteine and non-ionic isosmolar contrast-induced nephropathy--a randomized controlled study.
INTRODUCTION: Intravenous administration of saline and non-ionic isosmolar contrast media significantly reduces the incidence of contrast-induced nephropathy, one of the most common causes of acute renal failure. Results with oral N-acetylcysteine are conflicting. The aim of our study was to evaluate the prophylactic role of N-acetylcysteine in patients with stable chronic renal failure undergoing coronary and/or peripheral angiography and/or angioplasty.
009 Sep - Biofilm in bicarbonate-based replacement fluid circuits in CVVH
Nigel S Kanagasundaram, Iain Moore and Nicholas A Hoenich; Kidney Int Sept 2009, 76: 682
Bacterial contamination and biofilm formation are well recognized in the setting of intermittent hemodialysis and have led to the development of well-defined requirements for water and dialysate purity. The standards are even more stringent in the setting of intermittent hemodiafiltration because of the need for systemic infusion of the replacement fluid. Until lately, little attention had been paid to the microbial integrity of the continuous renal replacement therapies (CRRTs) used in critically ill patients. However, recently published work has revealed evidence of widespread microbial contamination of both bicarbonate-based dialysate and replacement fluid circuits in CRRTs....
2009 Long-term risk of mortality and other adverse outcomes after acute kidney injury: a systematic review and meta-analysis
Recommended by Dr SHUM Hoi Ping, ICU, PYNEH, Hong Kong, on 30 May 2009. Coca SG, Yusuf B, Shlipak MG, Garg AX, Parikh CR. Am J Kidney Dis. 2009 Jun;53(6):961-73. Epub 2009 Apr 5.
BACKGROUND: Acute kidney injury (AKI) is common in hospitalized patients. The impact of AKI on long-term outcomes is controversial.
STUDY DESIGN: Systematic review and meta-analysis.
SETTING & PARTICIPANTS: Persons with AKI.
SELECTION CRITERIA FOR STUDIES: MEDLINE and EMBASE databases were searched from 1985 through October 2007. Original studies describing outcomes of AKI for patients who survived hospital discharge were included. Studies were excluded from review when participants were followed up for less than 6 months.
PREDICTOR: AKI, defined as acute changes in serum creatinine level or acute need for renal replacement therapy. OUTCOMES: Chronic kidney disease (CKD), cardiovascular disease, and mortality.
2009 Sodium Bicarbonate Therapy for Prevention of Contrast-Induced Nephropathy: A Systematic Review and Meta-analysis
Background
Optimal hydration measures to prevent contrast-induced nephropathy are controversial.
Study Design
We conducted a systematic review and meta-analysis using the MEDLINE database (1966 to January 2008), EMBASE (January 2008), and abstracts from conference proceedings.
Setting & Population
Adult patients undergoing contrast procedures.