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Acute kidney disease and long-term outcomes in critically ill acute kidney injury patients with sepsis: a cohort analysis.

Clin Kidney J 2021 May 27;14(5):1379-1387. Epub 2020 Sep 27.

Division of Nephrology and Renal Transplantation, Department of Medicine, Centro Hospitalar Lisboa Norte, EPE, Lisboa, Portugal.

Background: Acute kidney injury (AKI) is frequent during hospitalization and may contribute to adverse short- and long-term consequences. Acute kidney disease (AKD) reflects the continuing pathological processes and adverse events developing after AKI. We aimed to evaluate the association of AKD, long-term adverse renal function and mortality in a cohort of patients with sepsis. Read More

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Factors associated with acyclovir nephrotoxicity in children: data from 472 pediatric patients from the last 10 years.

Eur J Pediatr 2021 May 6. Epub 2021 May 6.

Department of Pediatric Infectious Diseases, Dr. Sami Ulus Children's Health and Diseases Research and Training Hospital, Ankara, Turkey.

Acyclovir may cause acute kidney injury (AKI) due to the accumulation of relatively insoluble acyclovir crystals in renal tubules. The aim of this study was to evaluate risk factors associated with acyclovir-related AKI in children. Between January 2010 and December 2019, pediatric recipients of intravenous (IV) acyclovir were evaluated retrospectively. Read More

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The combination of vitamin D3 and erythropoietin alleviates acute kidney injury induced by ischemia-reperfusion via inhibiting inflammation and apoptosis.

Iran J Basic Med Sci 2021 Feb;24(2):167-174

Department of Nephrology, Guizhou Provincial People's Hospital & NHC Key Laboratory of Pulmonary Immunological Disease (Guizhou Provincial People's Hospital), Guiyang, Guizhou, 550002, P.R. China.

Objectives: Acute renal ischemia may cause acute renal dysfunction due to lack of blood supply; the manifestations are renal tubular cell apoptosis, infiltration of macrophages, and microvascular destruction. Many studies have shown that erythropoietin (EPO) and vitamin D3 (VD3) can be used to prevent or treat renal ischemia-reperfusion (I/R) injury, and VD3 may interact with EPO. In the present study, the effects of the combination of VD3 and EPO in I/R acute kidney injury were studied. Read More

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February 2021

Venous bicarbonate and creatine kinase as diagnostic and prognostic tools in the setting of acute traumatic rhabdomyolysis.

S Afr Med J 2021 Mar 31;111(4):333-337. Epub 2021 Mar 31.

Department of Surgery, Tygerberg Hospital and Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa; Department of Surgery, Khayelitsha District Hospital and Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.

Background: Myorenal or crush syndrome often develops following soft-tissue traumatic injury. It is a spectrum of disease that may result in severe renal dysfunction and kidney injury requiring renal replacement therapy.

Objectives: To review a large cohort of patients with so-called myorenal or crush syndrome and assess the biochemical markers of venous bicarbonate and creatine kinase as predictors for the development of acute kidney injury (AKI). Read More

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Ultrasound enhances the therapeutic potential of mesenchymal stem cells wrapped in greater omentum for aristolochic acid nephropathy.

Stem Cell Res Ther 2021 May 3;12(1):261. Epub 2021 May 3.

Department of Nephrology, Chinese PLA General Hospital, Chinese PLA Institute of Nephrology, State Key Laboratory of Kidney Diseases, National Clinical Research Center of Kidney Diseases, Beijing, 100853, China.

Background: Mesenchymal stem cells (MSCs) have been reported to promote regeneration in both subjects with acute kidney injury (AKI) and chronic kidney disease (CKD), but their efficacy remains limited, probably because most of the cells accumulate in the lungs, liver, and spleen after an intravenous infusion. Therefore, ultrasound-guided administration of MSCs represents a possible approach to solve this problem. The greater omentum is used to promote cell survival due to its rich vasculature. Read More

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How new biomarkers aid the anesthetist to detect and prevent perioperative acute kidney injury.

Curr Opin Anaesthesiol 2021 Jun;34(3):364-372

Department of Anesthesiology, Intensive Care and Pain Medicine, University Hospital Münster, Germany.

Purpose Of Review: Acute kidney injury (AKI) is underestimated but common in the perioperative setting. Although the association of this syndrome with an increased morbidity and mortality has been well established, little progress has been made in the diagnosis or prevention of AKI in recent years. This is partly due to the late detection of AKI by conventional criteria based of functional biomarkers, serum creatinine, and urine output. Read More

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Mild increases in plasma creatinine after intermediate to high-risk abdominal surgery are associated with long-term renal injury.

BMC Anesthesiol 2021 Apr 30;21(1):135. Epub 2021 Apr 30.

Department of Anesthesiology, Brugmann Hospital, Université Libre de Bruxelles, 4, Place A. Van Gehuchten, 1020 Bruxelles, Bruxelles, Belgium.

Background: The potential relationship between a mild acute kidney injury (AKI) observed in the immediate postoperative period after major surgery and its effect on long term renal function remains poorly defined. According to the "Kidney Disease: Improving Global Outcomes" (KDIGO) classification, a mild injury corresponds to a KIDIGO stage 1, characterized by an increase in creatinine of at least 0.3 mg/dl within a 48-h window or 1. Read More

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Nephrotoxicity as a Complication of Chemotherapy and Immunotherapy in the Treatment of Colorectal Cancer, Melanoma and Non-Small Cell Lung Cancer.

Int J Mol Sci 2021 Apr 28;22(9). Epub 2021 Apr 28.

Department of Nephrology, Hypertension and Family Medicine, Medical University of Łódź, Żeromskiego 113, 90-549 Łódź, Poland.

Acute kidney injury is a common complication of many medical procedures, including those used in cancer treatment. Both chemotherapy and immunotherapy may result in deterioration of kidney function, which may lead to an increase in mortality among patients with cancer. Antineoplastic agents can affect any element of the nephron, leading to the appearance of clinical symptoms such as proteinuria, hypertension, electrolyte disorders, glomerulonephritis, acute and chronic interstitial nephritis and acute kidney injury. Read More

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Glycerol Improves Intracerebral Hemorrhagic Brain Injury and Associated Kidney Dysfunction in Rats.

Antioxidants (Basel) 2021 Apr 19;10(4). Epub 2021 Apr 19.

Department of Medical Research, Taichung Veterans General Hospital, Taichung City 407, Taiwan.

In stroke patients, the development of acute kidney injury (AKI) is closely linked with worse outcomes and increased mortality. In this study, the interplay between post-stroke and AKI and treatment options was investigated in a rodent model of hemorrhagic stroke. Intrastriatal collagenase injection for 24 h caused neurological deficits, hematoma formation, brain edema, apoptosis, blood-brain barrier disruption, oxidative stress, and neuroinflammation in Sprague Dawley rats. Read More

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Perioperative ABO Blood Group Isoagglutinin Titer and the Risk of Acute Kidney Injury after ABO-Incompatible Living Donor Liver Transplantation.

J Clin Med 2021 Apr 14;10(8). Epub 2021 Apr 14.

Department of Anesthesiology and Pain medicine, Seoul National University Hospital, Seoul National University College of Medicine, #101 Daehak-ro, Jongno-GU, Seoul 03080, Korea.

For ABO-incompatible liver transplantation (ABO-i LT), therapeutic plasma exchange (TPE) is performed preoperatively to reduce the isoagglutinin titer of anti-ABO blood type antibodies. We evaluated whether perioperative high isoagglutinin titer is associated with postoperative risk of acute kidney injury (AKI). In 130 cases of ABO-i LT, we collected immunoglobulin (Ig) G and Ig M isoagglutinin titers of baseline, pre-LT, and postoperative peak values. Read More

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Severity and Duration of Acute Kidney Injury and Chronic Kidney Disease after Cardiac Surgery.

J Clin Med 2021 Apr 7;10(8). Epub 2021 Apr 7.

Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine, #101 Daehak-ro, Jongno-GU, Seoul 03080, Korea.

We aimed to evaluate whether the duration and stage of acute kidney injury (AKI) are associated with the occurrence of chronic kidney disease (CKD) in patients undergoing cardiac or thoracic aortic surgery. A total of 2009 cases were reviewed. The patients with postoperative AKI stage 1 and higher stage were divided into transient (serum creatinine elevation ≤48 h) or persistent (>48 h) AKI, respectively. Read More

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Survey of Current Practices of Outpatient Hemodialysis for AKI Patients.

Kidney Int Rep 2021 Apr 28;6(4):1156-1160. Epub 2021 Jan 28.

Department of Internal Medicine, Division of Nephrology, Bone and Mineral Metabolism, University of Kentucky Medical Center, Lexington, Kentucky, USA.

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Modeling acid-base balance for in-series extracorporeal carbon dioxide removal and continuous venovenous hemofiltration devices.

Artif Organs 2021 Apr 28. Epub 2021 Apr 28.

Baxter Deutschland GmbH, Unterschleissheim, Germany.

Patients with acute respiratory distress syndrome and acute kidney injury (AKI) treated by kidney replacement therapy may also require treatment with extracorporeal carbon dioxide removal (ECCO R) devices to permit protective or ultraprotective mechanical ventilation. We developed a mathematical model of acid-base balance during extracorporeal therapy using ECCO R and continuous venovenous hemofiltration (CVVH) devices applied in series for treatment of mechanically ventilated AKI patients. Published data from clinical studies of mechanically ventilated AKI patients treated by CVVH at known infusion rates of substitution fluid without ECCO R were used to adjust model parameters to fit plasma levels of arterial partial pressure of carbon dioxide (PaCO ), arterial plasma bicarbonate concentration ([HCO ]), and plasma pH (as well as certain other unmeasured physiological variables). Read More

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Mortality, Kidney Failure, and Hospitalization Among Medicare Beneficiaries With CKD and Pulmonary Hypertension.

Am J Kidney Dis 2021 Apr 24. Epub 2021 Apr 24.

Selzman Institute for Kidney Health, Section of Nephrology, Department of Medicine, Baylor College of Medicine, Houston, Texas, USA.

Rationale And Objectives: Pulmonary hypertension (PH) is highly prevalent among patients with non-dialysis dependent CKD. We studied the associations of PH with mortality, kidney failure, as well as cardiovascular (CV) and non-CV hospitalization among Medicare beneficiaries diagnosed with CKD.

Setting: and Participants: Patients with PH (based on two claims within 2 years) and patients without PH matched on CKD stage from the Medicare 5% CKD sample (1996-2016). Read More

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Porcine Models of Acute Kidney Injury.

Am J Physiol Renal Physiol 2021 Apr 26. Epub 2021 Apr 26.

Department of Medicine, Rhode Island Hospital, Brown University, Providence, RI, United States.

Pigs represent a potentially attractive model for medical research. Similar body size and physiological patterns of kidney injury that more closely mimic those described in humans make larger animals attractive for experimentation. Using larger animals, including pigs, to investigate the pathogenesis of acute kidney injury (AKI) also serves as an experimental bridge, narrowing the gap between clinical disease and preclinical discoveries. Read More

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A deep-learning model to continuously predict severe acute kidney injury based on urine output changes in critically ill patients.

J Nephrol 2021 Apr 26. Epub 2021 Apr 26.

S.C. Nefrologia e Dialisi, Azienda Ospedaliera Di Perugia, Piazzale Giorgio Menghini 1, 06129, Perugia, Italy.

Background: Acute Kidney Injury (AKI), a frequent complication of pateints in the Intensive Care Unit (ICU), is associated with a high mortality rate. Early prediction of AKI is essential in order to trigger the use of preventive care actions.

Methods: The aim of this study was to ascertain the accuracy of two mathematical analysis models in obtaining a predictive score for AKI development. Read More

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Fiber Derived Microbial Metabolites Prevent Acute Kidney Injury Through G-Protein Coupled Receptors and HDAC Inhibition.

Front Cell Dev Biol 2021 8;9:648639. Epub 2021 Apr 8.

Kidney Node Laboratory, The Charles Perkins Centre, University of Sydney, Camperdown, NSW, Australia.

Short-chain fatty acids (SCFA) derived from gut microbial fermentation of fiber have been shown to exert anti-inflammatory and immune-modulatory properties in acute kidney injury (AKI). However the direct mechanistic link between SCFAs, diet and the gut microbiome is yet to be established. Using the murine model of folic-acid nephropathy (FAN), we examined the effect of dietary fiber on development of AKI (day 2) and subsequent chronic kidney disease (CKD) (day 28). Read More

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Renal Tissue Damage Induced by Acute Kidney Injury in Sepsis Rat Model Is Inhibited by Cynaropicrin via IL-1β and TNF-α Down-Regulation.

Dokl Biochem Biophys 2021 Mar 24;497(1):151-157. Epub 2021 Apr 24.

Emergency Department, The Second People's Hospital of Yunnan Province, 650021, Kunming, Yunnan, China.

Acute kidney injury (AKI), one of the frequently diagnosed and serious sepsis induced complication has high morbidity and mortality. The present study investigated the effect of cynaropicrin on AKI induced pathological damage in rat model in vivo. Treatment with cynaropicrin suppressed AKI induced urea nitrogen and creatinine in the rat serum in dose-dependent manner. Read More

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Predicting the Risk of Acute Kidney Injury in Patients After Percutaneous Coronary Intervention (PCI) or Cardiopulmonary Bypass (CPB) Surgery: Development and Assessment of a Nomogram Prediction Model.

Med Sci Monit 2021 Apr 25;27:e929791. Epub 2021 Apr 25.

Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Taiyuan, Shanxi, China (mainland).

BACKGROUND We sought to create a model that incorporated ultrasound examinations to predict the risk of acute kidney injury (AKI) after percutaneous coronary intervention (PCI) or cardiopulmonary bypass (CPB) surgery. MATERIAL AND METHODS A total of 292 patients with AKI after PCI or CPB surgery were enrolled for the study. Afterwards, treatment-related information, including data pertaining to ultrasound examination, was collected. Read More

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Phenotypic screen identifies calcineurin-sparing FK506 analogs as BMP potentiators for treatment of acute kidney injury.

Cell Chem Biol 2021 Apr 17. Epub 2021 Apr 17.

Novartis Institutes for Biomedical Research, Cambridge, MA, USA.

Acute kidney injury (AKI) is a life-threatening disease with no known curative or preventive therapies. Data from multiple animal models and human studies have linked dysregulation of bone morphogenetic protein (BMP) signaling to AKI. Small molecules that potentiate endogenous BMP signaling should have a beneficial effect in AKI. Read More

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Calprotectin and Neutrophil Gelatinase-Associated Lipocalin As Biomarkers of Acute Kidney Injury in Acute Coronary Syndrome.

Am J Med Sci 2020 Nov 2. Epub 2020 Nov 2.

Department of Nephrology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Ji'nan, China.

Background: Acute kidney injury (AKI) is increasingly being seen in patients with acute coronary syndromes (ACS) and it is associated with higher short-term and long-term morbidity and mortality. Therefore, it is of paramount importance to identify those ACS patients at risk for the development of AKI. The objective of this study was to evaluate two different plasma biomarkers calprotectin and neutrophil gelatinase-associated lipocalin (NGAL) in early detecting the development of AKI in ACS patients. Read More

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November 2020

A scalable approach for developing clinical risk prediction applications in different hospitals.

J Biomed Inform 2021 Apr 20;118:103783. Epub 2021 Apr 20.

Dedalus HealthCare, Roderveldlaan 2, 2600 Antwerp, Belgium. Electronic address:

Objective: Machine learning (ML) algorithms are now widely used in predicting acute events for clinical applications. While most of such prediction applications are developed to predict the risk of a particular acute event at one hospital, few efforts have been made in extending the developed solutions to other events or to different hospitals. We provide a scalable solution to extend the process of clinical risk prediction model development of multiple diseases and their deployment in different Electronic Health Records (EHR) systems. Read More

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Major signaling pathways and key mediators of macrophages in acute kidney injury (Review).

Mol Med Rep 2021 Jun 21;23(6). Epub 2021 Apr 21.

Institute of Disaster Medicine, Tianjin University, Tianjin 300072, P.R. China.

Acute kidney injury (AKI) has become a global public health problem with high morbidity and mortality rates, as well as high healthcare costs. Immune cells, particularly macrophages, which regulate tissue development, destroy pathogens, control homeostasis and repair wounds, play crucial and complex roles in AKI. In various types of AKI, numerous rapidly recruited monocytes and tissue‑resident macrophages act in a coordinated manner. Read More

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Severe Hypothyroidism Presenting With Rhabdomyolysis in a Young Patient.

Cureus 2021 Mar 19;13(3):e13993. Epub 2021 Mar 19.

Internal Medicine, Hamad Medical Corporation, Doha, QAT.

Rhabdomyolysis is an uncommon but potentially life-threatening medical condition. The acute muscle breakdown leads to the release of toxic muscle contents which can damage the kidneys and can cause the development of acute kidney injury (AKI) and fatal electrolyte imbalances associated with high morbidity and mortality. There are a variety of causes including exposure to extremely hot weather, toxins, trauma, certain drugs, and rarely endocrine disorders in particular thyroid dysfunction. Read More

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Alterations in the lipid profile associate with a dysregulated inflammatory, prothrombotic, anti-fibrinolytic state and development of severe acute kidney injury in coronavirus disease 2019 (COVID-19): A study from Cincinnati, USA.

Diabetes Metab Syndr 2021 Apr 14;15(3):863-868. Epub 2021 Apr 14.

Section of Clinical Biochemistry, University of Verona, Verona, Italy.

Background And Aims: Reduction of atherogenic lipoproteins is often the ultimate goal of nutritional interventions, however this is complicated given that hypolipidemia is frequently observed in coronavirus disease 2019 (COVID-19) patients. We aimed to explore the association of hypolipidemia with patient outcomes in terms of immunothrombosis and multiorgan injury, focusing on specialized apolipoproteins apo A1 and apo B.

Methods: Lipid profiles of 50 COVID-19 patients and 30 sick controls presenting to the Emergency Department (ED) were measured in this prospective observational study. Read More

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A simplified acute kidney injury predictor following transcatheter aortic valve implantation: the ACEF score.

Kardiol Pol 2021 Apr 6. Epub 2021 Apr 6.

Background: Transcatheter aortic valve implantation ( is an effective, less invasive treatment alternative for symptomatic severe aortic stenosis ( Acute kidney injury ( following TAVI is a common complication and is associated with worse outcomes. ACEF age, creatinine, ejection fraction) score is a simple scoring method, including only three parameters; a ge, creatinine, and ejection fraction ( The score was well established in predicting AKI after coronary interventions.

Aims: We aimed to evaluate whether this simple scoring method, ACEF, may predict a development of AKI in patients who underwent TAVI. Read More

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Bioinformatic analysis identifies potential biomarkers and therapeutic targets of septic-shock-associated acute kidney injury.

Hereditas 2021 Apr 16;158(1):13. Epub 2021 Apr 16.

Department of Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, No.1277, Jiefang Avenue, Wuhan, 430022, China.

Background: Sepsis and septic shock are life-threatening diseases with high mortality rate in intensive care unit (ICU). Acute kidney injury (AKI) is a common complication of sepsis, and its occurrence is a poor prognostic sign to septic patients. We analyzed co-differentially expressed genes (co-DEGs) to explore relationships between septic shock and AKI and reveal potential biomarkers and therapeutic targets of septic-shock-associated AKI (SSAKI). Read More

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Roles of microRNAs in renal disorders related to primary podocyte dysfunction.

Life Sci 2021 Apr 18;277:119463. Epub 2021 Apr 18.

Stem Cell Research Center, Tabriz University of Medical Sciences, Tabriz, Iran. Electronic address:

Through the regulation of gene expression, microRNAs (miRNAs) are capable of modulating vital biological processes, such as proliferation, differentiation, and apoptosis. Several mechanisms control the function of miRNAs, including translational inhibition and targeted miRNA degradation. Through utilizing high-throughput screening methods, such as small RNA sequencing and microarray, alterations in miRNA expression of kidneys have recently been observed both in rodent models and humans throughout the development of chronic kidney disease (CKD) and acute kidney injury (AKI). Read More

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Real-Time Clinical Decision Support Based on Recurrent Neural Networks for In-Hospital Acute Kidney Injury: External Validation and Model Interpretation.

J Med Internet Res 2021 Apr 16;23(4):e24120. Epub 2021 Apr 16.

Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.

Background: Acute kidney injury (AKI) is commonly encountered in clinical practice and is associated with poor patient outcomes and increased health care costs. Despite it posing significant challenges for clinicians, effective measures for AKI prediction and prevention are lacking. Previously published AKI prediction models mostly have a simple design without external validation. Read More

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A Simple Nomogram to Predict Contrast-Induced Acute Kidney Injury in Patients with Congestive Heart Failure Undergoing Coronary Angiography.

Cardiol Res Pract 2021 23;2021:9614953. Epub 2021 Mar 23.

The Second School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong, China.

Background: Patients with congestive heart failure (CHF) are vulnerable to contrast-induced kidney injury (CI-AKI), but few prediction models are currently available. Therefore, we aimed to establish a simple nomogram for CI-AKI risk assessment for patients with CHF undergoing coronary angiography.

Methods: A total of 1876 consecutive patients with CHF (defined as New York Heart Association functional class II-IV or Killip class II-IV) were enrolled and randomly (2:1) assigned to a development cohort and a validation cohort. Read More

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