5.Risk Factors of Acute Kidney Injury Complicating Adult Primary Nephrotic Syndrome.
Acta Academiae Medicinae Sinicae 2020;42(4):436-443
To explore the risk factors of acute kidney injury(AKI)in adult primary nephrotic syndrome(PNS). Totally 185 patients with PNS were divided into AKI group(=51)and non-AKI group(=134).The demographic data and clinical and histological features at admission were compared between the two groups.The independent risk factors for AKI were evaluated by Logistics regression analysis. In 51 PNS patients with AKI,the common pathological types of AKI included minor glomerular abnormalities(29.4%),IgA nephropathy(25.5%),and membranous nephropathy(17.6%).The incidences of renal tubular casts and epithelial vacuoles in the AKI group were significantly higher than those in the non-AKI group(=0.004,=0.030).Males were more likely to suffer from AKI than females(=0.000).Patients in AKI group had significantly lower albumin level(=0.015)and higher levels of random urine protein,serum creatinine,uric acid,urea nitrogen,and triglyceride than non-AKI group(=0.030,=0.000,=0.000,=0.000,and =0.006),and polyserous and oliguria occurred more often in the AKI group(=0.000,=0.002).The AKI group had significantly higher incidences of high blood pressure and infections(=0.035,=0.000).Multivariate logistics regression analysis showed albumin(<25 g/L),serum creatinine(>96 μmol/L),urea nitrogen(≥6.8 mmol/L),uric acid(≥400 μmol/L),diabetes,infection,and renal tubular casts were the independent risk factors for AKI. AKI complicating PNS is associated with a variety of factors.Its independent risk factors include the levles of albumin,serum creatinine,urea nitrogen,and uric acid,diabetes,infections,and renal tubular casts.
Acute Kidney Injury
;
etiology
;
Adult
;
Creatinine
;
Female
;
Humans
;
Kidney
;
Male
;
Nephrotic Syndrome
;
complications
;
Risk Factors
6.Advances of perioperative acute kidney injury in elderly patients undergoing non-cardiac surgery.
Journal of Central South University(Medical Sciences) 2023;48(5):760-770
The risk of developing perioperative acute kidney injury (AKI) in elderly patients increases with age. The combined involvement of aging kidneys, coexisting multiple underlying chronic diseases, and increased exposure to potential renal stressors and nephrotoxic drugs or invasive procedures constitute susceptibility factors for AKI in elderly patients. The perioperative AKI in elderly patients undergoing noncardiac surgery has its own specific population characteristics, so it is necessary to further explore the characteristics of AKI in elderly patients in terms of epidemiology, clinical diagnosis, risk factors, and preventive and curative measures to provide meaningful clinical advice to improve prognosis, accelerate recovery, and reduce medical burden in elderly patients. Since AKI has the fastest-growing incidence in older patients and is associated with a worse prognosis, early detection, early diagnosis, and prevention of AKI are important for elderly patients in the perioperative period. Large, multicenter, randomized controlled clinical studies in elderly non-cardiac surgery patients with AKI can be conducted in the future, with the aim of providing the evidence to reduce of the incidence of AKI and to improve the prognosis of patients.
Humans
;
Aged
;
Acute Kidney Injury/prevention & control*
;
Kidney
;
Risk Factors
;
Prognosis
;
Incidence
;
Postoperative Complications/prevention & control*
7.Hypothermia-induced acute kidney injury in an elderly patient.
Hyun Ju YOON ; Mun Chul KIM ; Jae Woo PARK ; Min A YANG ; Cheon Beom LEE ; In O SUN ; Kwang Young LEE
The Korean Journal of Internal Medicine 2014;29(1):111-115
Hypothermia, defined as an unintentional decline in the core body temperature to below 35degrees C, is a life-threatening condition. Patients with malnutrition and diabetes mellitus as well as those of advanced age are at high risk for accidental hypothermia. Due to the high mortality rates of accidental hypothermia, proper management is critical for the wellbeing of patients. Accidental hypothermia was reported to be associated with acute kidney injury (AKI) in over 40% of cases. Although the pathogenesis remains to be elucidated, vasoconstriction and ischemia in the kidney were considered to be the main mechanisms involved. Cases of AKI associated with hypothermia have been reported worldwide, but there have been few reports of hypothermia-induced AKI in Korea. Here, we present a case of hypothermia-induced AKI that was treated successfully with rewarming and supportive care.
Acute Kidney Injury/*etiology/therapy
;
Aged
;
Humans
;
Hypothermia/*complications/therapy
;
Male
;
*Rewarming
8.Separate Visceral Revascularization in Thoracoabdominal Aortic Aneurysm Repair: Report of 3 Cases.
Hyang Hee CHOI ; Hyung Kee KIM ; Gun Jik KIM ; Jong Tae LEE ; Seung HUH
Journal of the Korean Society for Vascular Surgery 2010;26(1):48-52
Thoracoabdominal aortic aneurysm (TAAA) involving the roots of the celiac, superior mesenteric and both renal arteries is a rare, but potentially lethal disease. The overall postoperative mortality rate is high even when the intact TAAA is electively repaired. Furthermore, the postoperative complications are often serious and they include acute renal failure, paraplegia, respiratory distress and intestinal ischemia. The inclusion technique using a visceral-aortic patch (VAP) is considered the gold standard method for visceral artery revascularization for the treatment of TAAA. However, the inclusion technique is not feasible for patients with Marfan syndrome or for those patients with inappropriate anatomy for VAP. In such cases, separate visceral revascularization is a useful alternative and this may decrease the visceral ischemic time. Herein we report on 3 cases of TAAA, and the patients all underwent successful separate visceral revascularization, including one patient with Marfan syndrome.
Acute Kidney Injury
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Aortic Aneurysm, Thoracic
;
Arteries
;
Humans
;
Ischemia
;
Marfan Syndrome
;
Paraplegia
;
Postoperative Complications
;
Renal Artery