Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association
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Nephrol. Dial. Transplant. · Oct 2011
Serum urea concentration is probably not related to outcome in ICU patients with AKI and renal replacement therapy.
Acute kidney injury (AKI) is a common complication in patients admitted to the intensive care unit (ICU). Among other variables, serum urea concentrations are recommended for timing of initiation of renal replacement therapy (RRT). The aim of this study was to evaluate whether serum urea concentration or different serum urea concentration cutoffs as recommended in the literature were associated with in-hospital mortality at time of initiation of RRT for AKI. ⋯ This retrospective study suggests that serum urea concentration and serum urea concentration cut-offs at time of initiation of RRT have no predictive value for in-hospital mortality in ICU patients with AKI.
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Nephrol. Dial. Transplant. · Oct 2011
Comparative StudyComparison of bioimpedance methods for estimating total body water and intracellular water changes during hemodialysis.
The accurate assessment of body fluid volume is important in many clinical situations. Hannan et al. proposed a single-frequency bioimpedance equation (HE) to calculate extracellular water (ECW) and total body water (TBW). There are two equations based on the bioimpedance spectroscopy (BIS) method for the evaluation of body fluid volume: Xitron equations (XE) and body composition spectroscopy equations (BCSE). The aim of the study was to compare the accuracy of these three equations in body fluid volume point estimation in maintenance hemodialysis (MHD) patients. ⋯ Our study indicated that BCSE provided a better point estimation of ICW and TBW.
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Nephrol. Dial. Transplant. · Oct 2011
Clinical TrialImpact of blood volume monitoring on fluid removal during intermittent hemodialysis of critically ill children with acute kidney injury.
In chronic pediatric patients treated with intermittent hemodialysis (IHD), blood volume monitoring (BVM) is commonly used to assess and manage volume status during the dialysis session. Minimal data exists on its use during IHD in critically ill children with acute kidney injury (AKI). In these cases, fluid removal may be limited by hemodynamic instability. ⋯ In conclusion, in our experience of IHD sessions in critically ill children with AKI, the use of BVM allowed a higher UF in those with BVM without influencing the frequency of hypotensive episodes. Applying specific guidelines on BVM use may decrease hypotensive episodes during IHD treatment in critically ill patients.
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Nephrol. Dial. Transplant. · Oct 2011
Comparative StudyUrinary kidney injury molecule-1 in patients with IgA nephropathy is closely associated with disease severity.
The pathological characteristics of IgA nephropathy (IgAN) are highly variable. Urinary kidney injury molecule-1 (KIM-1) is a sensitive biomarker for proximal tubule injury. The aim of the study is to investigate the value of KIM-1 as a biomarker for assessing the renal injury in IgAN. ⋯ Urinary KIM-1 may be a useful biomarker to evaluate kidney injury in IgAN.
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Nephrol. Dial. Transplant. · Oct 2011
Using the MDRD value as an outcome predictor in emergency medical admissions.
Both physiological- and laboratory-derived variables, alone or in combination, have been used to predict mortality among acute medical admissions. Using the Modification of Diet in Renal Disease (MDRD) not as an estimate of glomerular filtration rate but as an outcome predictor for hospital mortality, we examined the relationship between the MDRD value and in-hospital death during an emergency medical admission. ⋯ Many factors predict survival following an emergency medical admission. The MDRD value offers a novel readily available and reliable estimate of mortality risk.