Clinical journal of the American Society of Nephrology : CJASN
-
Clin J Am Soc Nephrol · May 2011
Mortality and serum sodium: do patients die from or with hyponatremia?
Severe hyponatremia (<120 mEq/L) in hospitalized patients has a high mortality rate. We hypothesized that underlying diseases causing hyponatremia attribute to mortality rather than hyponatremia itself. ⋯ The nature of underlying illness rather than the severity of hyponatremia best explains mortality associated with hyponatremia. Neurologic complications from hyponatremia are uncommon among patients who die with hyponatremia.
-
Clin J Am Soc Nephrol · Apr 2011
Acute kidney injury and increasing nephrotoxic-medication exposure in noncritically-ill children.
Acute kidney injury (AKI) in hospitalized children results in increased patient morbidity and mortality. Nephrotoxic-medication exposure is a common cause of AKI. Currently, no data exist to quantify the risks of developing AKI for various nephrotoxic medications in children. The primary aim of the current study is to assess for a potential association between nephrotoxic medications and the risk of developing AKI in hospitalized noncritically ill children with no pre-existing renal insufficiency. ⋯ Increasing exposure to three or more nephrotoxic medications places pediatric patients at greater risk of acute kidney injury with resultant increased hospital costs and patient morbidity.
-
Clin J Am Soc Nephrol · Mar 2011
Multicenter StudyPotentially modifiable factors affecting the progression of autosomal dominant polycystic kidney disease.
The Consortium for Radiologic Imaging Studies of Polycystic Kidney Disease (CRISP) was created to identify markers of disease progression in patients with autosomal dominant polycystic kidney disease (ADPKD). ⋯ Serum HDL-cholesterol, U(Na)V, and 24-hour urine osmolality likely affect ADPKD progression. To what extent their modification may influence the clinical course of ADPKD remains to be determined.
-
Clin J Am Soc Nephrol · Mar 2011
Multicenter StudyEnd-stage renal disease status and critical illness in the elderly.
Elderly patients (> 65 years old) are a rapidly growing demographic in the ESRD and intensive care unit (ICU) populations, yet the effect of ESRD status on critical illness in elderly patients remains unknown. Reliable estimates of prognosis would help to inform care and management of this frail and vulnerable population. ⋯ Illness severity on admission, rather than ESRD status per se, appears to be the main driver of in-hospital mortality in elderly patients. However, ESRD status is an independent risk factor for early and late readmission, suggesting that this population might benefit from alternative strategies for ICU discharge.
-
Clin J Am Soc Nephrol · Mar 2011
Neutrophil gelatinase-associated lipocalin in the diagnosis of type 1 cardio-renal syndrome in the general ward.
The early identification of acute heart failure (HF) patients with type 1 cardio-renal syndrome should be the first step for developing prevention and treatment strategies for these patients. This study aimed to assess the performance of neutrophil gelatinase-associated lipocalin (NGAL) and cystatin C in the early detection of type 1 cardio-renal syndrome in patients with acute HF. ⋯ Above a cutoff value of 170 ng/L, NGAL predicts 48- to 72-hour development of type 1 cardio-renal syndrome with a negative predictive value of 100% and a positive predictive value of 50%. NGAL independently associates with type 1 cardio-renal syndrome and might be a useful biomarker in the early recognition of these patients.