Clinical journal of the American Society of Nephrology : CJASN
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Clin J Am Soc Nephrol · Jun 2012
Multicenter StudyAssociation of statin use with risk and outcome of acute kidney injury in community-acquired pneumonia.
Sepsis is a leading cause of AKI. Animal studies suggest that the pleiotropic effect of statins attenuates the risk for AKI and decreases mortality. This study examined whether statin use was associated with a lower risk for pneumonia-induced AKI and 1-year and cause-specific mortality in patients with AKI. ⋯ In a large cohort of patients hospitalized with pneumonia, statins did not reduce the risk for AKI. Among patients with AKI, statin use was not associated with lower risk for death at 1 year. The higher risk for AKI observed among statin users may be due to indication bias.
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Clin J Am Soc Nephrol · Mar 2012
Multicenter StudyKidney volume and functional outcomes in autosomal dominant polycystic kidney disease.
Autosomal dominant polycystic kidney disease (ADPKD) is characterized by increased total kidney volume (TKV) and renal failure. This study aimed to determine if height-adjusted TKV (htTKV) predicts the onset of renal insufficiency. ⋯ Baseline htTKV ≥600 cc/m predicted the risk of developing renal insufficiency in ADPKD patients at high risk for renal disease progression within 8 years of follow-up, qualifying htTKV as a prognostic biomarker in ADPKD.
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Clin J Am Soc Nephrol · Mar 2012
Multicenter StudyPharmacokinetics and pharmacodynamics of piperacillin-tazobactam in 42 patients treated with concomitant CRRT.
Current recommendations for piperacillin-tazobactam dosing in patients receiving continuous renal replacement therapy originate from studies with relatively few patients and lower continuous renal replacement therapy doses than commonly used today. This study measured the pharmacokinetic and pharmacodynamic characteristics of piperacillin-tazobactam in patients treated with continuous renal replacement therapy using contemporary equipment and prescriptions. ⋯ There is significant patient to patient variability in pharmacokinetic/pharmacodynamic parameters in patients receiving continuous renal replacement therapy. Many patients did not achieve pharmacodynamic targets, suggesting that therapeutic drug monitoring might optimize therapy.
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Clin J Am Soc Nephrol · Nov 2011
Multicenter StudyEffectiveness and safety of warfarin initiation in older hemodialysis patients with incident atrial fibrillation.
Although generally recommended in atrial fibrillation (AF) patients, the effectiveness and safety of oral anticoagulation in dialysis patients with AF is unknown. ⋯ Although we confirmed association between warfarin use and hemorrhagic stroke in dialysis patients with AF, we found no association between warfarin use and ischemic stroke. Adequately powered randomized trials are required to conclusively determine the risks and benefits of the studied warfarin indication in hemodialysis patients.
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Clin J Am Soc Nephrol · Nov 2011
Randomized Controlled Trial Multicenter Study Comparative StudyWarfarin in atrial fibrillation patients with moderate chronic kidney disease.
The efficacy of adjusted-dose warfarin for prevention of stroke in atrial fibrillation patients with stage 3 chronic kidney disease (CKD) is unknown. ⋯ Among atrial fibrillation patients participating in the Stroke Prevention in Atrial Fibrillation III trials, stage 3 CKD was associated with higher rates of ischemic stroke/systemic embolism. Adjusted-dose warfarin markedly reduced ischemic stroke/systemic embolism in high-risk atrial fibrillation patients with stage 3 CKD.