Category: Renal

Risk and Predictability for Renal Replacement Therapy in Patients Receiving Mechanical Circulatory Support

Limiting the Gamble: Risk and Predictability for Renal Replacement Therapy in Patients Receiving Mechanical Circulatory Support

This study investigates risk factors for renal replacement therapy (RRT) in patients receiving mechanical circulatory support (MCS). A retrospective analysis of 129 patients revealed an RRT incidence of 36%. Key risk factors include prior immunologic therapy and the presence of pacemakers or internal cardiac defibrillators. Unfractionated heparin showed minimal protection against RRT. Findings suggest systemic inflammation plays a role, emphasizing the need for alternative anticoagulation strategies.

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HGB AKI 2024

Association Between Plasma-Free Haemoglobin and Postoperative Acute Kidney Injury in Paediatric Cardiac Surgery: A Prospective Observational Study

This study investigates the link between plasma-free haemoglobin (PFH) and acute kidney injury (AKI) in children undergoing cardiopulmonary bypass (CPB) during cardiac surgery. Among 179 participants, 41% developed AKI. Peak PFH concentrations were significantly higher in patients with AKI, but multivariable analysis showed CPB duration and patient age, rather than PFH, as primary risk factors. This emphasizes CPB time management in mitigating AKI risk.

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AKI 2024

Factors Associated with Acute Kidney Injury After On-Pump Coronary Artery Bypass Grafting

Acute kidney injury (AKI) is a common complication following cardiac surgeries like coronary artery bypass grafting (CABG). This study analyzed 120 patients to identify risk factors for AKI, which occurred in 26% of the cases. Findings showed that patients with higher EuroSCORE II values, elevated creatinine and urea levels, lower hemoglobin, and reduced oxygen delivery during cardiopulmonary bypass (CPB) were more likely to develop AKI. AKI was also linked to longer hospital stays.

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ECMO Risk

Risk Factors Associated With Hospital Mortality in Non-Surgical Patients Receiving Extracorporeal Membrane Oxygenation and Continuous Renal Replacement Treatment: A Retrospective Analysis

This study identifies risk factors associated with hospital mortality in non-surgical patients receiving extracorporeal membrane oxygenation (ECMO) and continuous renal replacement therapy (CRRT). Using data from December 2013 to April 2023, the analysis revealed that older age, longer duration of CRRT, and CRRT implantation were independent predictors of mortality. A prediction model was developed using these factors, demonstrating good accuracy and clinical utility in estimating patient outcomes.

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Haemo

Intraoperative Haemoadsorption for Antithrombotic Drug Removal During Cardiac Surgery: Initial Report of the International Safe and Timely Antithrombotic Removal (STAR) Registry

This study investigates the monocyte-to-lymphocyte multiplying platelets ratio (MLPR) as a novel inflammatory marker for predicting acute kidney injury (AKI) after cardiac surgery with cardiopulmonary bypass (CPB). Through analysis of 2387 patients, the study found that both MLPR and monocyte-to-lymphocyte ratio (MLR) were significant risk factors for AKI. MLPR displayed a J-shaped curve in relation to AKI, indicating its potential as a useful clinical tool for early AKI detection in cardiac surgery patients.

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AKI 2024

Monocytes to Lymphocytes Multiplying Platelets Ratio as an Early Indicator of Acute Kidney Injury in Cardiac Surgery with Cardiopulmonary Bypass: A Retrospective Analysis

This study investigates the monocyte-to-lymphocyte multiplying platelets ratio (MLPR) as a novel inflammatory marker for predicting acute kidney injury (AKI) after cardiac surgery with cardiopulmonary bypass (CPB). Through analysis of 2387 patients, the study found that both MLPR and monocyte-to-lymphocyte ratio (MLR) were significant risk factors for AKI. MLPR displayed a J-shaped curve in relation to AKI, indicating its potential as a useful clinical tool for early AKI detection in cardiac surgery patients.

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Pedi Kidney

Association of Hyperoxia During Cardiopulmonary Bypass and Postoperative Delirium in the Pediatric Cardiac ICU

This study examines the relationship between hyperoxia during cardiopulmonary bypass (CPB) and postoperative delirium in pediatric patients in a cardiac ICU. Analyzing data from 148 patients, researchers found that 24% experienced delirium within 72 hours post-CPB. However, no significant association was found between hyperoxia and delirium. Exploratory analysis suggested that nutritional status, specifically weight z scores, might influence delirium risk, indicating a need for further research on risk factors.

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Haemoadsorption

Impact of Extracorporeal Haemoadsorption During Prolonged Cardiopulmonary Bypass on the Incidence of Acute Kidney Injury

This study investigates the effects of haemoadsorption (HA) therapy on inflammatory markers and renal damage indices during cardiopulmonary bypass (CPB) and the early postoperative period. Conducted at a single tertiary care center, the retrospective analysis compared three groups of patients who underwent CPB for over 120 minutes. The results showed that haemoadsorption therapy did not significantly reduce the incidence of acute kidney injury (AKI) but decreased the need for renal replacement therapy.

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Kidney Protection

A Randomized Trial of Intravenous Amino Acids for Kidney Protection

This study investigated the efficacy of intravenous amino acids in reducing acute kidney injury (AKI) in patients undergoing cardiac surgery. A total of 3511 patients were randomized to receive either amino acids or a placebo. Results showed a significant reduction in AKI occurrence in the amino acid group (26.9%) compared to the placebo group (31.7%), with a relative risk of 0.85. The severity of AKI and the need for kidney-replacement therapy were also lower in the amino acid group. No major differences in other secondary outcomes or adverse events were observed.

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