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Genetic and pharmacological inhibition of fatty acid-binding protein 4 alleviated inflammation and early fibrosis after toxin induced kidney injury.

Int Immunopharmacol 2021 May 12;96:107760. Epub 2021 May 12.

Kidney Research Institute, Division of Nephrology, West China Hospital of Sichuan University, Chengdu 610041, China.

Considerable data have suggested that acute kidney injury (AKI) is often incompletely repaired and could lead to chronic kidney disease (CKD). As we known, toxin-induced nephropathy triggers the rapid production of proinflammatory mediators and the prolonged inflammation allows the injured kidneys to develop interstitial fibrosis. In our previous study, fatty acid-binding protein 4 (Fabp4) has been reported to be involved in the process of AKI. Read More

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Comparison of machine learning and logistic regression models in predicting acute kidney injury: A systematic review and meta-analysis.

Int J Med Inform 2021 May 8;151:104484. Epub 2021 May 8.

ICU, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Shandong, China. Electronic address:

Introduction: We aimed to assess whether machine learning models are superior at predicting acute kidney injury (AKI) compared to logistic regression (LR), a conventional prediction model.

Methods: Eligible studies were identified using PubMed and Embase. A total of 24 studies consisting of 84 prediction models met inclusion criteria. Read More

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Factors predicting the recovery from acute kidney injury in children with primary nephrotic syndrome.

Clin Exp Nephrol 2021 May 15. Epub 2021 May 15.

Department of Pediatrics, Peking University First Hospital, No.1 Xi An Men Da Jie, Beijing, China.

Background: The prognosis of acute kidney injury (AKI) varies in children with nephrotic syndrome (NS), data on factors predicting the recovery and recurrence of AKI in children with NS are limited. This study aimed to explore the possible factors predicting the recovery from and recurrence of AKI in children with primary NS.

Methods: Children with primary NS complicated with AKI from 1993 to 2017 in a single centre were reviewed retrospectively. Read More

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Xuebijing injection in septic rats mitigates kidney injury, reduces cortical microcirculatory disorders, and suppresses activation of local inflammation.

J Ethnopharmacol 2021 May 11:114199. Epub 2021 May 11.

Department of Critical Care Medicine, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, China. Electronic address:

Ethnopharmacological Relevance: Xuebijing injections originate from the traditional Chinese medicine (TCM) prescription XuefuZhuyu Decoction. It is composed of five Chinese herbal extracts; Carthami flos, Paeoniae radix rubra, Chuanxiong rhizoma, Salviae miltiorrhizae, and Angelicae Sinensis radix. The China Food and Drug Administration approved Xuebijing injections as a TCM preparation for the adjuvant treatment of sepsis. Read More

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Acute kidney injury after lung transplantation: a narrative review.

Ann Transl Med 2021 Apr;9(8):717

Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

Acute kidney injury (AKI) is a commonly recognized complication after lung transplantation (LT) and is related to increased mortality and morbidity. With the improvement of survival after LT and the increasing number of lung transplant recipients, the detrimental impact of current management on renal function has become increasingly apparent. Multifarious risk factors in the perioperative setting contribute to the development of AKI, including the preoperative status and complications of the recipient, complex perioperative problems especially hemodynamic fluctuation, and exposure to nephrotoxic agents, mainly calcineurin inhibitors (CNIs) and antimicrobial drugs. Read More

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AKI Epidemiology and Outcomes: A Retrospective Cohort Study from the Prenephrology Era.

Int J Nephrol 2021 26;2021:5549316. Epub 2021 Apr 26.

Zentrum für Innere Medizin 1, Kardiologie, Angiologie, Nephrologie, Klinikum Brandenburg, Medizinische Hochschule Brandenburg, Brandenburg, Germany.

Background: Acute kidney injury substantially worsens the prognosis of hospitalized patients. The Brandenburg Medical School was founded in 2014, and a nephrology section was opened in summer 2017. The aim of the study was to analyze AKI epidemiology and outcomes in one of two university hospitals belonging to the medical school. Read More

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A nomogram incorporating functional and tubular damage biomarkers to predict the risk of acute kidney injury for septic patients.

BMC Nephrol 2021 May 13;22(1):176. Epub 2021 May 13.

Department of Intensive Care Unit of Cardiovascular Surgery, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, 106 Zhongshan Er Road, 510080, Guangzhou, PR China.

Background: Combining tubular damage and functional biomarkers may improve prediction precision of acute kidney injury (AKI). Serum cystatin C (sCysC) represents functional damage of kidney, while urinary N-acetyl-β-D-glucosaminidase (uNAG) is considered as a tubular damage biomarker. So far, there is no nomogram containing this combination to predict AKI in septic cohort. Read More

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Improvement of renal function after transcatheter aortic valve replacement in patients with chronic kidney disease.

PLoS One 2021 13;16(5):e0251066. Epub 2021 May 13.

Department of Cardiology, Heart Institute (InCor), Clinical Hospital, Faculty of Medicine, University of Sao Paulo, Sao Paulo, Brazil.

Background: Chronic kidney disease is commonly found in patients with aortic stenosis (AS) undergoing transcatheter aortic valve replacement (TAVR) and has marked impact in their prognosis. It has been shown however that TAVR may improve renal function by alleviating the hemodynamic barrier imposed by AS. Nevertheless, the predictors of and clinical consequences of renal function improvement are not well established. Read More

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Metabolomics Analysis of the Development of Sepsis and Potential Biomarkers of Sepsis-Induced Acute Kidney Injury.

Oxid Med Cell Longev 2021 23;2021:6628847. Epub 2021 Apr 23.

Department of Critical Care Medicine, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China.

Sepsis-induced acute kidney injury (SI-AKI) is a serious condition in critically ill patients. Currently, the diagnosis is based on either elevated serum creatinine levels or oliguria, which partially contribute to delayed recognition of AKI. Metabolomics is a potential approach for identifying small molecule biomarkers of kidney diseases. Read More

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Response to comment on "Nuclear receptor PXR targets AKR1B7 to protect mitochondrial metabolism and renal function in AKI".

Sci Transl Med 2021 May;13(593)

Department of Nephrology, Children's Hospital of Nanjing Medical University, Nanjing 210008, China.

The nuclear pregnane X receptor protects against bilateral renal ischemia/reperfusion-induced acute kidney injury in mice. Read More

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Urinary NGAL as a Diagnostic and Prognostic Marker for Acute Kidney Injury in Cirrhosis: A Prospective Study.

Clin Transl Gastroenterol 2021 May 11;12(5):e00359. Epub 2021 May 11.

Liver Center and Gastrointestinal Division, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA.

Introduction: Urinary neutrophil gelatinase-associated lipocalin (NGAL) has shown promise in differentiating acute tubular necrosis (ATN) from other types of acute kidney injuries (AKIs) in cirrhosis, particularly hepatorenal syndrome (HRS). However, NGAL is not currently available in clinical practice in North America.

Methods: Urinary NGAL was measured in a prospective cohort of 213 US hospitalized patients with decompensated cirrhosis (161 with AKI and 52 reference patients without AKI). Read More

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The role and mechanism of PKM2 in the development of LPS-induced acute kidney injury.

Histol Histopathol 2021 May 12:18343. Epub 2021 May 12.

Shanghai General Hospital of Nanjing Medical University, Shanghai, China.

A previous study suggested that pyruvate kinase M2 (PKM2) plays a vital role of metabolic reprogramming in the regulation of the innate inflammatory response, while PKM2 is a sensitive biomarker for nephrotoxicity. In this study, we investigated the role and mechanism of PKM2 in development of LPS-induced acute kidney injury. The AKI model of mice was established using LPS. Read More

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Postoperative acute kidney injury in adult non-cardiac surgery: joint consensus report of the Acute Disease Quality Initiative and PeriOperative Quality Initiative.

Nat Rev Nephrol 2021 May 11. Epub 2021 May 11.

Center for Critical Care Nephrology, Department of Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA, USA.

Postoperative acute kidney injury (PO-AKI) is a common complication of major surgery that is strongly associated with short-term surgical complications and long-term adverse outcomes, including increased risk of chronic kidney disease, cardiovascular events and death. Risk factors for PO-AKI include older age and comorbid diseases such as chronic kidney disease and diabetes mellitus. PO-AKI is best defined as AKI occurring within 7 days of an operative intervention using the Kidney Disease Improving Global Outcomes (KDIGO) definition of AKI; however, additional prognostic information may be gained from detailed clinical assessment and other diagnostic investigations in the form of a focused kidney health assessment (KHA). Read More

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Long-term kidney function of patients discharged from hospital after an intensive care admission: observational cohort study.

Sci Rep 2021 May 11;11(1):9928. Epub 2021 May 11.

Department of Critical Care, King's College London, Guy's and St Thomas' NHS Foundation Trust, London, SE1 7EH, UK.

The long-term trajectory of kidney function recovery or decline for survivors of critical illness is incompletely understood. Characterising changes in kidney function after critical illness and associated episodes of acute kidney injury (AKI), could inform strategies to monitor and treat new or progressive chronic kidney disease. We assessed changes in estimated glomerular filtration rate (eGFR) and impact of AKI for 1301 critical care survivors with 5291 eGFR measurements (median 3 [IQR 2, 5] per patient) between hospital discharge (2004-2008) and end of 7 years of follow-up. Read More

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Therapy with lopinavir/ritonavir and hydroxychloroquine is associated with acute kidney injury in COVID-19 patients.

PLoS One 2021 11;16(5):e0249760. Epub 2021 May 11.

Department of Medicine IV, Faculty of Medicine, Medical Center, University of Freiburg, Freiburg, Germany.

Background: Acute kidney injury (AKI) is an independent risk factor for mortality, which affects about 5% of hospitalized coronavirus disease-2019 (COVID-19) patients and up to 25-29% of severely ill COVID-19 patients. Lopinavir/ritonavir and hydroxychloroquine show in vitro activity against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and have been used for the treatment of COVID-19. Both, lopinavir and hydroxychloroquine are metabolized by cytochrome P450 (CYP) 3A4. Read More

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AACC Guidance Document on Laboratory Investigation of Acute Kidney Injury.

J Appl Lab Med 2021 May 11. Epub 2021 May 11.

Program of Applied Translational Research, Yale School of Medicine, New Haven, CT, USA.

Background: Acute kidney injury (AKI) is a sudden episode of kidney damage or failure affecting up to 15% of hospitalized patients and is associated with serious short- and long-term complications, mortality, and health care costs. Current practices to diagnose and stage AKI are variable and do not factor in our improved understanding of the biological and analytical variability of creatinine. In addition, the emergence of biomarkers, for example, cystatin C, insulin-like growth factor binding protein 7, and tissue inhibitor of metalloproteinases 2, and electronic notification tools for earlier detection of AKI, highlights the need for updated recommendations to address these developments. Read More

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Electronic alerts for acute kidney injury across primary and secondary care.

BMJ Open Qual 2021 May;10(2)

Department of Nephrology, Royal Berkshire NHS Foundation Trust, Reading, UK.

Problem: In 2009 the National Confidential Enquiry into Patient Outcome and Death suggested only 50% of patients with acute kidney injury (AKI) receive good standards of care. In response National Health Service (NHS) England mandated the use of electronic AKI alerts within secondary care. However, we recognised AKI is not just a secondary care problem, where primary care has a crucial role to play in prevention, early detection and management as well as post-AKI care. Read More

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Hydroxyethyl starch 130/0.4 for volume replacement therapy in surgical patients: a systematic review and meta-analysis of randomized controlled trials.

Perioper Med (Lond) 2021 May 11;10(1):16. Epub 2021 May 11.

Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China.

Background: The safety of perioperative intravenous hydroxyethyl starch (HES) products, specifically HES 130/0.4, continues to be the source of much debate. The aim of this meta-analysis was to update the existing evidence and gain further insight into the clinical effects of HES 130/0. Read More

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A novel risk-predicted nomogram for sepsis associated-acute kidney injury among critically ill patients.

BMC Nephrol 2021 May 10;22(1):173. Epub 2021 May 10.

Department of President's Office, YouJiang Medical University for Nationalities, Baise, China.

Background: Acute kidney injury (AKI) is a prevalent and severe complication of sepsis contributing to high morbidity and mortality among critically ill patients. In this retrospective study, we develop a novel risk-predicted nomogram of sepsis associated-AKI (SA-AKI).

Methods: A total of 2,871 patients from the Medical Information Mart for Intensive Care III (MIMIC-III) critical care database were randomly assigned to primary (2,012 patients) and validation (859 patients) cohorts. Read More

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Factors associated with acute kidney injury during delivery or the postpartum period: A case control study.

Eur J Obstet Gynecol Reprod Biol 2021 Apr 27;261:200-204. Epub 2021 Apr 27.

Department of Obstetrics, Maternal Medicine Service, St George's Hospital, Blackshaw Road, London, SW17 0QT, United Kingdom. Electronic address:

Introduction: To investigate the incidence of risk factors associated with acute kidney injury(AKI) occurring during the intrapartum or the immediate postpartum period.

Material And Methods: A retrospective case control study in a tertiary UK hospital of pregnant women identified with AKI in labour or in the postpartum period between July 2019 and June 2020 was carried out. Women identified with pregnancy related AKI (pr-AKI) in labour or postpartum were compared with a matched cohort of women with no evidence of pr-AKI, using multiple regression analysis. Read More

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Checkpoint inhibitor therapy-associated acute kidney injury: time to move on to evidence-based recommendations.

Clin Kidney J 2021 May 10;14(5):1301-1306. Epub 2021 Mar 10.

Department of Microbiology, Immunology and Transplantation, Laboratory of Molecular Immunology, Rega Institute, KU Leuven, Leuven, Belgium.

Immune checkpoint inhibitors (ICIs) have revolutionized cancer treatment since their introduction ∼15 years ago. However, these monoclonal antibodies are associated with immune-related adverse events that can also affect the kidney, resulting in acute kidney injury (AKI), which is most commonly due to acute tubulointerstitial nephritis (ATIN). Limited data are available on the true occurrence of ICI-associated AKI. Read More

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Short Term Prognosis of Renal Artery Stenosis Secondary to Acute Type B Aortic Dissection With TEVAR.

Front Cardiovasc Med 2021 23;8:658952. Epub 2021 Apr 23.

Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.

To determine the effect of renal artery stenosis (RAS) resulting from acute type B aortic dissection (ATBAD) with thoracic endovascular aortic repair (TEVAR) on early prognosis in patients with ATBAD. A total of 129 ATBAD patients in the National Acute Aortic Syndrome Database (AASCN) who underwent TEVAR between 2019 and 2020 were enrolled in our study. Patients were divided into two groups: the RAS group and the non-RAS group. Read More

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Angiotensin II Receptor Blockers but Not Angiotensin-Converting Enzyme Inhibitors Are Associated With a Reduced Risk of Acute Kidney Injury After Major Surgery.

Front Pharmacol 2021 23;12:662301. Epub 2021 Apr 23.

Department of Internal Medicine, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan.

We investigated the respective effects of preoperative angiotensin-converting-enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) on the incidence of postoperative acute kidney injury (AKI) and mortality. In this nested case-control study, we enrolled 20,276 patients who received major surgery. We collected their baseline demographic data, comorbidities and prescribed medication, the outcomes of postoperative AKI and mortality. Read More

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Renal replacement therapy during extracorporeal membrane oxygenation.

Indian J Thorac Cardiovasc Surg 2021 Apr 29;37(Suppl 2):261-266. Epub 2020 Jan 29.

Apollo Hospitals Chennai, Chennai, Tamil Nadu India.

The use of extracorporeal membrane oxygenator (ECMO) has significantly increased in the past 20 years. There is a high incidence of acute kidney injury (AKI) in the group of patients on ECMO, with need for continuous renal replacement therapy (CRRT) in most of them. This article will review the basics of CRRT, its indications, the technical aspects of incorporating CRRT with ECMO circuit, data on clinical aspects, and outcomes. Read More

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Review of acute kidney injury and continuous renal replacement therapy in pediatric extracorporeal membrane oxygenation.

Indian J Thorac Cardiovasc Surg 2021 Apr 23;37(Suppl 2):254-260. Epub 2020 Nov 23.

Children's of Dallas, Department of Pediatrics, Section of Critical Care, University of Texas Southwestern Medical Center, Dallas, TX USA.

Purpose: To review the relevant literature of acute kidney injury (AKI) and continuous renal replacement therapy (CRRT) as it relates to pediatric extracorporeal membrane oxygenation (ECMO).

Methods: Available online relevant literature.

Results: ECMO is a therapeutic modality utilized to support patients with refractory respiratory and/or cardiac failure. Read More

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[Lead poisoning associated with an Indian-manufactured unauthorized dietary supplement].

Rinsho Ketsueki 2021 ;62(4):267-269

Department of Hematology, Kochi Medical School, Kochi University.

We report the case of a patient with lead poisoning caused by a dietary supplement. A 40-year-old man was referred to us due to intermittent upper abdominal pain and normocytic anemia. His hemoglobin level was 9. Read More

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Hypoxia-inducible factor prolyl hydroxylase inhibitor roxadustat (FG-4592) protects against renal ischemia/reperfusion injury by inhibiting inflammation.

Ren Fail 2021 Dec;43(1):803-810

Department of Nephrology, Taizhou People's Hospital, Fifth Affiliated Hospital to Nantong University, Taizhou, Jiangsu, China.

Hypoxia-induced inflammation is the critical pathological feature of acute kidney injury (AKI). Activation of hypoxia-inducible factor (HIF) signaling is considered as a central mechanism of body adapting to hypoxia. Hypoxia-inducible factor prolyl hydroxylase inhibitor FG-4592 (Roxadustat) is a first-in-class HIF stabilizer for the treatment of patients with renal anemia. Read More

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December 2021

Risk predictive role of hypernatremia for occurrence of sepsis-induced acute kidney injury.

Ann Palliat Med 2021 Apr;10(4):4705-4715

Department of Critical Care Medicine, Beijing Friendship Hospital, Capital Medical University, Beijing, China.

Background: Septic acute kidney injury (AKI), identified when sepsis and AKI present concurrently, is a syndrome of acute function impairment and organ damage, which accounts for ~50% AKI in the intensive care unit (ICU).

Methods: This study retrospectively reviewed 591 patients who were diagnosed with sepsis and admitted to the ICU of Beijing Friendship Hospital from January 2009 to December 2014. According to the concentration of serum sodium, the 591 patients were further divided into 3 groups: normal group, hyponatremia group, and hypernatremia group. Read More

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MiR-182 Promotes Ischemia/Reperfusion-Induced Acute Kidney Injury in Rat by Targeting FoxO3.

Urol Int 2021 May 7:1-10. Epub 2021 May 7.

Department of Urology, Renmin Hospital of Wuhan University, Wuhan, China.

Background: Renal ischemia/reperfusion (I/R) injury (RIRI) is the main cause of acute kidney injury (AKI) in patients. We investigated the role of miR-182 after renal ischemia/reperfusion (I/R) in rat to characterize the microRNA (miRNA) network activated during development and recovery from RIRI.

Methods And Results: 12 h after lethal (45 min) renal ischemia, AKI was verified by renal histology (tubular necrosis and regeneration), blood urea nitrogen level, and renal mRNA expression in Wistar rats. Read More

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Dexmedetomidine Exerts Renal Protective Effect by Regulating the PGC-1α/STAT1/IRF-1 Axis.

Nephron 2021 May 7:1-12. Epub 2021 May 7.

Department of Orthopedics, Affiliated Hospital of Chengde Medical College, Chengde, China.

Background: Ischemia-reperfusion (I/R) injury is the main cause of acute kidney injury (AKI), and its incidence and mortality increase year by year in the population. Dexmedetomidine (DEX) can improve AKI by regulating inflammation and oxidative stress, but its mechanism is still unclear.

Methods: A hypoxia/reoxygenation (H/R) model of HK-2 cells and a kidney I/R model of C57BL/6J mice were established. Read More

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