Journal ArticleDOI
Diagnostic accuracy of Doppler renal resistive index for reversibility of acute kidney injury in critically ill patients.
Michael Darmon,Frédérique Schortgen,Frédéric Vargas,Aissam Liazydi,Aissam Liazydi,Benoit Schlemmer,Christian Brun-Buisson,Christian Brun-Buisson,Laurent Brochard,Laurent Brochard +9 more
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TLDR
Preliminary results suggest that Doppler renal RI may be a promising tool for predicting the reversibility of AKI in critically ill patients.Abstract:
Diagnosing persistent acute kidney injury (AKI) as opposed to transient AKI in critically ill patients may help physicians in making treatment decisions. This diagnosis relies chiefly on urinary indices, which may be of limited value or difficult to obtain. We assessed the performance of the Doppler renal resistive index (RI) in diagnosing persistent AKI. Prospective observational study. Twenty-four-bed medical intensive care unit in a university hospital. Consecutive patients requiring mechanical ventilation, without severe chronic renal dysfunction or receiving diuretic therapy. Persistent AKI was defined as AKI lasting longer than 3 days. AKI resolving within 3 days in a patient with a cause of renal hypoperfusion was considered to be transient AKI. Results are reported as median values with interquartile range (IQR). Of the 51 patients enrolled in the study, 16 had no AKI, 13 had transient AKI, and 22 had persistent AKI. The RI was 0.71 (0.66–0.77) in the no-AKI group, 0.71 (0.62–0.77) in the transient AKI group, and 0.82 (0.80–0.89) in the persistent AKI group (P 0.795 had a 92% sensitivity and 85% specificity for persistent AKI. Logistic regression analysis revealed that an RI > 0.795 [odds ratio (OR) 28.2; 95% CI 4.0–198] and a higher logistic organ dysfunction score (OR 1.85/point; 95% CI 1.20–2.85) predicted persistent AKI. These preliminary results suggest that Doppler renal RI may be a promising tool for predicting the reversibility of AKI in critically ill patients.read more
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Acute Kidney Injury Network: report of an initiative to improve outcomes in acute kidney injury
Ravindra L. Mehta,John A. Kellum,Sudhir V. Shah,Bruce A. Molitoris,Claudio Ronco,David G. Warnock,Adeera Levin +6 more
TL;DR: An initiative to develop uniform standards for defining and classifying AKI and to establish a forum for multidisciplinary interaction to improve care for patients with or at risk for AKI is described.
Journal ArticleDOI
Acute kidney disease and renal recovery: consensus report of the Acute Disease Quality Initiative (ADQI) 16 Workgroup
Lakhmir S. Chawla,Rinaldo Bellomo,Azra Bihorac,Stuart L. Goldstein,Edward D. Siew,Sean M. Bagshaw,D B Bittleman,Dinna N. Cruz,Zoltan H. Endre,Robert L. Fitzgerald,Lui G. Forni,Sandra L. Kane-Gill,Eric Hoste,Jay L. Koyner,Kathleen D. Liu,Etienne Macedo,Ravindra L. Mehta,Patrick T. Murray,Mitra K. Nadim,Marlies Ostermann,Paul M. Palevsky,Neesh Pannu,Mitchell H. Rosner,Ron Wald,Alexander Zarbock,Claudio Ronco,John A. Kellum +26 more
TL;DR: The Acute Disease Quality Initiative (ADQI) proposes definitions, staging criteria for AKD, and strategies for the management of affected patients, and makes recommendations for areas of future research, which aim to improve understanding of the underlying processes and improve outcomes for patients with AKD.
Journal ArticleDOI
Pathophysiology of COVID-19-associated acute kidney injury.
Matthieu Legrand,Samira Bell,Lui G. Forni,Michael Joannidis,Jay L. Koyner,Kathleen D. Liu,Vincenzo Cantaluppi +6 more
TL;DR: A number of potential pathophysiological pathways through which acute kidney injury (AKI) can develop in the context of SARS-CoV-2 infection are investigated in this article.
Book ChapterDOI
Acute Kidney Injury
TL;DR: It is demonstrated that elevations of the Scr less than used in the RIFLE classification are associated with a twofold risk of short-term death and a rational evidence-based approach to fluid resuscitation is therefore essential to reduce the risk of renal dysfunction in critically ill patients.
Journal ArticleDOI
Ultrasound Doppler renal resistive index: a useful tool for the management of the hypertensive patient
TL;DR: Evidence has been accumulating showing that an increased renal resistive index not only reflects changes in intrarenal perfusion but is also related to systemic hemodynamics and the presence of subclinical atherosclerosis, and may thus provide useful prognostic information in patients with primary hypertension.
References
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APACHE II: a severity of disease classification system.
TL;DR: The form and validation results of APACHE II, a severity of disease classification system that uses a point score based upon initial values of 12 routine physiologic measurements, age, and previous health status, are presented.
Journal ArticleDOI
Definitions for Sepsis and Organ Failure and Guidelines for the Use of Innovative Therapies in Sepsis
Roger C. Bone,Robert A. Balk,F. B. Cerra,R. P. Dellinger,A. M. Fein,William A. Knaus,Roland M. H. Schein,W. J. Sibbald +7 more
TL;DR: An American College of Chest Physicians/Society of Critical Care Medicine Consensus Conference was held in Northbrook in August 1991 with the goal of agreeing on a set of definitions that could be applied to patients with sepsis and its sequelae as mentioned in this paper.
Journal ArticleDOI
Acute renal failure - definition, outcome measures, animal models, fluid therapy and information technology needs: the Second International Consensus Conference of the Acute Dialysis Quality Initiative (ADQI) Group.
TL;DR: A 2-day consensus conference on acute renal failure (ARF) in critically ill patients was organized by ADQI as discussed by the authors, where the authors sought to review the available evidence, make recommendations and delineate key questions for future studies.
Journal ArticleDOI
Acute Kidney Injury Network: Report of an Initiative to Improve Outcomes in Acute Kidney Injury
Ravindra L. Mehta,John A. Kellum,Sudhir V. Shah,Bruce A. Molitoris,Claudio Ronco,David G. Warnock,Adeera Levin +6 more
TL;DR: The Acute Kidney Injury Network (AKI Network) as discussed by the authors is a multidisciplinary collaborative network focused on AKI, which was established to improve care for patients with or at risk for AKI.
Acute Kidney Injury Network: report of an initiative to improve outcomes in acute kidney injury
Ravindra L. Mehta,John A. Kellum,Sudhir V. Shah,Bruce A. Molitoris,Claudio Ronco,David G. Warnock,Adeera Levin +6 more
TL;DR: An initiative to develop uniform standards for defining and classifying AKI and to establish a forum for multidisciplinary interaction to improve care for patients with or at risk for AKI is described.