1.Epidemiology of acute kidney injury in hospitalized patients in China.
Xiabing LANG ; Yi YANG ; Jianghua CHEN
Journal of Zhejiang University. Medical sciences 2016;45(2):208-213
Acute kidney injury (AKI) is a disease spectrum ranging from minimal elevation of serum creatinine to complete renal failure. It is significantly associated with increased mortality, length of hospital stay and medical care cost. With the increasing awareness of the importance of AKI, several high quality and multicenter epidemiological studies have been published recently in China. However, the results differ a lot due to the differences in regional economic development, the selection of target population and testing indicators, the disease definition and study strategies. The reported incidence of AKI in China is much lower than that in the developed countries. This article will analyze the current status and the problems facing AKI epidemiological studies of hospitalized patients with our own data and those from literature. The article intends to clarify the burden of AKI,to increase the awareness of AKI among clinicians and policy makers for achieving the goal of "zero by 2025" in China.
Acute Kidney Injury
;
epidemiology
;
China
;
epidemiology
;
Hospitalization
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Humans
;
Length of Stay
3.Acute kidney injury in patients hospitalized with COVID-19 in Wuhan, China: a single-center retrospective observational study.
Guanhua XIAO ; Hongbin HU ; Feng WU ; Tong SHA ; Zhenhua ZENG ; Qiaobing HUANG ; Haijun LI ; Jiafa HAN ; Wenhong SONG ; Zhongqing CHEN ; Shumin CAI
Journal of Southern Medical University 2021;41(2):157-163
OBJECTIVE:
To assess the predictors and outcomes of acute kidney injury (AKI) among patients with coronavirus disease 2019 (COVID-19).
OBJECTIVE:
This retrospective observational study was conducted among patients with a confirmed diagnosis of COVID-19 admitted to Hankou Hospital between January, 5 and March 8, 2020. We evaluated the association of AKI with the demographic and biochemical parameters and clinical outcomes of the patients using univariate regression analysis.
OBJECTIVE:
Atotal of 287 COVID-19 patients, including 55 with AKI and 232 without AKI, were included in the analysis. Compared with the patients without AKI, the patients with AKI were older, predominantly male, and were more likely to have hypoxia and pre-existing hypertension and cerebrovascular diseases. The patients with AKI also had higher levels of white blood cells, D-dimer, aspartate aminotransferase, total bilirubin, creatine kinase, lactate dehydrogenase, procalcitonin, C-reactive protein, a higher prevalence of hyperkalemia, lower lymphocyte counts, and higher chest computed tomographic scores. The incidence of stage 1 AKI was 14.3% and that of stage 2 or 3 AKI was 4.9%. The patients with AKI had much higher mortality rate than those without AKI.
OBJECTIVE
AKI is an important complication of COVID-19. An older age, a male gender, multiple pre- existing comorbidities, lymphopenia, increased infection indicators, elevated D-dimer, and impaired heart and liver functions are all potential risk factors ofAKI. COVID- 19 patients with AKI that progresses into stages 2 or 3 AKI have a high mortality rate. Prevention of AKI and monitoring kidney function is critical in the care of COVID-19 patients.
Acute Kidney Injury/epidemiology*
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Aged
;
COVID-19
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China/epidemiology*
;
Humans
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Male
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Retrospective Studies
;
SARS-CoV-2
4.Acute renal failure in pediatrics.
Korean Journal of Pediatrics 2007;50(10):948-953
Acute renal failure is the generic term for an abrupt and sustained decrease in renal function resulting in retention of nitrogenous and non nitrogenous waste product. This may results in life threatening consequences including volume overload, hyperkalemia, and metabolic acidosis. Acute renal failure is both common and carries high mortality rate, but as it is often preventable, identification of patients at risk and and appropriate management are crucial. This review summarized the most recent information on definition, epidemiology, clinical causes and management of acute renal failure in pediatric patients.
Acidosis
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Acute Kidney Injury*
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Epidemiology
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Humans
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Hyperkalemia
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Mortality
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Nitrogen
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Pediatrics*
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Waste Products
5.Evidence-Based Clinical Practice Guideline for Fluid Therapy to Prevent Contrast-induced Nephropathy
Kyung Hae LEE ; Kyung Min SHIN ; Hyeon Jeong LEE ; So Young KIM ; JungWon CHAE ; Mi Ra KIM ; Min Young HAN ; Mi Sook AHN ; Jin Kyung PARK ; Mi Ae CHUNG ; Sang Hui CHU ; Jung Hwa HWANG
Journal of Korean Clinical Nursing Research 2017;23(1):83-90
PURPOSE: This study was to develop evidence-based clinical practice guideline in order to prevent contrast-induced nephropathy (CIN) for patients undergoing percutaneous coronary intervention (PCI). METHODS: The guideline was developed based on the “Scottish Intercollegiate Guidelines Network (SIGN)”. The first draft of guideline was developed through 5 stages and evaluated by 10 experts.(1) Clinical questions were ensured in PICO format.(2) Two researchers conducted a systematic search through electronic database, identifying 170 studies. We selected 27 full text articles including 16 randomized clinical trials, 7 systematic reviews, and 4 guidelines. Quality of each studies were evaluated by the Cochran's Risk of Bias, AMSTAR, K-AGREEII. Among the studies, 11 studies were excluded.(3) The strength of recommendations were classified and quality of recommendations were ranked.(4) Guideline draft was finalized.(5) Content-validation was conducted by an expert group. All contents were ranked above 0.8 in CVI. RESULTS: Evidence-based clinical practice guideline to prevent CIN was dveloped.(1) The guideline for preventing CIN recommends using 0.9% saline.(2) Standardized rate of fluid therapy is 1 to 1.5ml/kg/hr.(3) Execute hydration for 6~12hrs before PCI and after PCI. CONCLUSION: This study suggests evidence-based clinical practice guideline for preventing CIN which can be more efficiently used in clinical practice.
Acute Kidney Injury
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Bias (Epidemiology)
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Contrast Media
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Evidence-Based Practice
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Fluid Therapy
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Humans
;
Percutaneous Coronary Intervention
6.Analysis of clinical data and pathological types in 1 211 adult patients with renal biopsy.
Xiang-qing XU ; Yun-cheng XIA ; Ying-hong LIU ; Youming PENG ; Wenling JIANG ; Jiang LI
Journal of Central South University(Medical Sciences) 2005;30(6):733-735
Acute Kidney Injury
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epidemiology
;
pathology
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Adolescent
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Adult
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Aged
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Biopsy, Needle
;
methods
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China
;
epidemiology
;
Female
;
Glomerulonephritis, Membranoproliferative
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epidemiology
;
pathology
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Humans
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Kidney
;
pathology
;
Kidney Diseases
;
epidemiology
;
pathology
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Male
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Middle Aged
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Nephrotic Syndrome
;
epidemiology
;
pathology
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Ultrasonography, Interventional
7.Outcomes of Hemodialysis in Children: A 35-Year Experience at Severance Hospital.
Hyun Seung SHIN ; Ji Young OH ; Se Jin PARK ; Ji Hong KIM ; Jae Seung LEE ; Jae Il SHIN
Yonsei Medical Journal 2015;56(4):1007-1014
PURPOSE: The aim of this study was to analyze the results of children treated with hemodialysis (HD) at Severance Hospital over 35 years in terms of incidence, etiologies, characteristics, complications, and clinical outcomes. MATERIALS AND METHODS: We analyzed 46 children admitted to Severance Hospital who had undergone HD between January 1979 and December 2013. RESULTS: The main etiologies of the 23 end-stage renal disease (ESRD) patients who had received HD were chronic glomerulonephritis (7 patients, 30.4%) and congenital anomalies of the kidney and urinary tract (7 patients, 30.4%), whereas the etiology of the 23 acute kidney injury (AKI) patients was hemolytic uremic syndrome (6 patients, 26.1%). Compared with ESRD patients, hemocatheter placement in the femoral vein was preferred over the subclavian or internal jugular vein in the AKI patients (p=0.012). The most common complication was catheter related complication (10 patients, 21.7%). The site of hemocatheter insertion was not related to the frequency of oozing. Placing the hemocatheter in the femoral vein resulted in significantly more events of catheter obstruction than insertion in the internal jugular vein or the subclavian vein (p=0.001). Disequilibrium syndrome occurred more frequently in older patients (p=0.004), as well as patients with a greater body weight (p=0.008) and a higher systolic and diastolic blood pressure before HD (systolic: p=0.021; diastolic: p=0.040). CONCLUSION: Based on the 35 years of experience in our center, HD can be sufficiently and safely carried out even in children without significant complications.
Acute Kidney Injury/epidemiology
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Body Weight
;
Child
;
Child, Preschool
;
Chronic Disease
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Female
;
Humans
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Infant
;
Jugular Veins
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Kidney Failure, Chronic/epidemiology/*therapy
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Male
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Renal Dialysis/*methods
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Treatment Outcome
8.A Clinical Study of Serologically Diagnosed Yersinia Pseudotuberculosis Infection in Chidren.
Yong Kyu LEE ; Jeong Wan SEO ; Jin Keun CHANG ; Hoan Jong LEE
Journal of the Korean Pediatric Society 1994;37(1):26-32
A retrospective analysis of clinical findings in 23 patients with Y. pseudotuberculosis infection who visited Department of Pediatrics of Han Il Hospital from May. 1990 to June, 1992 was performed. 1) The most prevalent age group was 7 to 12 years (16 case: 69.6)and male-to-female ratio was 1.1:1. 2) Monthly distribution showed a high frequency in April, May and June (22 cases:95.7%) 3) The common symptoms were fever(23 cases:100%), abdominal pain (18 cases: 78.3%) vomiting(16 cases: 69.6%), diarrhea (13 cases: 56.7%), rash (13 cases: 56.5%)and acute renal failure (6 cases: 26.1%) in order of frequency, respectively. 4) The laboratory findings were anemia (17.4%), WBC>1(10E4/mm((73.9%), ESR>20mm/hr (91.3%), CRP>3+(91.3%), Positive Widal test (13.0%), BUN>20mg/dl (26.1%) and creatinine> 1.2mg/dl (26.1%). 5) The most common serotype was 4a (30.4%), followed by 4b, 5b, 2b, 2c, 5a, 1b, 1a, 6 in order of frequency. The results suggest that Yersinia pseudotuberculosis infection is one of the important causes of the important causes of fever, eruptive skin diseases and acute renal failure in Korean children and further studies including epidemiology, pathogenesis, etc, are needed.
Abdominal Pain
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Acute Kidney Injury
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Anemia
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Child
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Diarrhea
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Epidemiology
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Exanthema
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Fever
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Humans
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Pediatrics
;
Retrospective Studies
;
Skin Diseases
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Yersinia pseudotuberculosis*
;
Yersinia*
9.Comparison of diagnostic criteria for acute kidney injury in critically ill children.
Yu Xian KUAI ; Min LI ; Zhen JIANG ; Jiao CHEN ; Zhen Jiang BAI ; Xiao Zhong LI ; Guo Ping LU ; Yan Hong LI
Chinese Journal of Pediatrics 2023;61(11):1011-1017
Objective: The kidney disease: improving global outcome (KDIGO) and pediatric reference change value optimized for acute kidney injury (pROCK) criteria were used to evaluate the incidence, stages and mortality of acute kidney injury (AKI). The differences between the 2 criteria were compared for exploring the value of pROCK criteria in diagnosing pediatric AKI and predicting adverse outcomes. Methods: In the multicenter prospective clinical cohort study, we collected general data and clinical data such as serum creatinine values from 1 120 children admitted to 4 PICUs of Children's Hospital of Soochow University, Children's Hospital of Fudan University, Anhui Provincial Children's Hospital, and Xuzhou Children's Hospital from September 2019 to February 2021. AKI was defined and staged according to the KDIGO and pROCK criteria. The incidence of AKI, the consistency of AKI definite diagnosis and stages, and the mortality in PICU were compared between the 2 groups. The chi-square test or Fisher's exact test was applied for comparison between 2 groups. The Cohen's Kappa and Weighted Kappa analyses were used for evaluating diagnostic consistency. The Cox regression analysis was used to evaluate the correlation between AKI and mortality. Results: A total of 1 120 critically ill children were included, with an age of 33 (10, 84) months. There are 668 boys and 452 girls. The incidence of AKI defined by the KDIGO guideline was higher than that defined by pROCK criteria (27.2%(305/1 120), 14.7%(165/1 120), χ2=52.78, P<0.001). The concordance rates of the 2 criteria for the diagnosis of AKI and AKI staging were 87.0% (κ=0.62) and 79.7% (κ=0.58), respectively. Totally 63 infants with AKI stage 1 defined by the KDIGO guideline were redefined as non-AKI by following the pROCK criteria. The PICU mortality rate of these infants was similar to patients without AKI defined by KDIGO guideline(P=0.761). After adjusting for confounders, AKI defined by KDIGO or pROCK criteria was an independent risk factor of death in PICU (AHR=2.04, 2.73,95%CI 1.27-3.29, 1.74-4.28, both P<0.01), and the risk of death was higher when using the pROCK compared with the KDIGO criteria. As for the KDIGO criteria, mild AKI was not associated with the mortality in PICU (P=0.702), while severe AKI was associated with increased mortality (P<0.001). As for the pROCK criteria, both mild and severe AKI were risk factors of PICU death in children (HR=3.51, 6.70, 95%CI 1.94-6.34, 4.30-10.44, both P<0.001). In addition, The AKI severity was positively associated with the mortality. Conclusions: The AKI incidence and staging varied depending on the used diagnostic criteria. The KDIGO definition is more sensitive, while the pROCK-defined AKI is more strongly associated with high mortality rate.
Child
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Child, Preschool
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Female
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Humans
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Infant
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Male
;
Acute Kidney Injury/epidemiology*
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Cohort Studies
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Critical Illness
;
Prospective Studies
;
Risk Factors
10.Analysis of the risk factors of acute renal insufficiency following coronary artery bypass grafting.
Xu-jun CHEN ; Ming-di XIAO ; Wen-hui FENG ; Bi-bo YANG ; Yong ZHANG ; Zhi-qian LÜ ; Da-lian LI
Chinese Journal of Surgery 2006;44(22):1532-1534
OBJECTIVETo study the risk factors of acute renal insufficiency (ARI) following coronary artery bypass grafting (CABG).
METHODSThe clinic data of 2242 patients undertaking CABG between July 1997 and July 2006 were retrospectively analyzed, and ARI following CABG was included.
RESULTSARI occurred in 219 patients, with an incidence of 9.8%. Univariate analysis revealed that advanced age, diabetes mellitus, preoperative chronic renal dysfunction, left main disease, low left ventricular erection faction, emergency operation, on-pump CABG, ascending aortic atherosclerosis, postoperative respiratory function insufficiency and low cardiac output syndrome were significantly related to ARI following CABG, and logistic multivariate regression analysis showed that presence of advanced age (P = 0.031), preoperatively chronic renal dysfunction (CrCl
CONCLUSIONSAdvanced age, preoperatively chronic renal dysfunction, on-pump CABG, postoperative respiratory function insufficiency and low cardiac output syndrome are the risk factors of ARI following CABG.
Acute Kidney Injury ; epidemiology ; etiology ; China ; epidemiology ; Coronary Artery Bypass ; adverse effects ; Female ; Humans ; Incidence ; Male ; Middle Aged ; Postoperative Complications ; epidemiology ; etiology ; Retrospective Studies ; Risk Factors