Publications by authors named "Hessey E"
Background: Acute kidney injury (AKI) is common in critically ill children and associated with adverse short-term outcomes; however, long-term outcomes are not well described.
Methods: This longitudinal prospective cohort study examined the prevalence of chronic kidney disease (CKD) and hypertension (HTN) 11 vs. 6 years after pediatric intensive care unit (PICU) admission and association with AKI.
Unlabelled: Acute kidney injury is common in critically ill children, but the long-term outcomes are not well defined.
Objectives: Evaluated whether nonrecovery of kidney function, following acute kidney injury, was associated with postdischarge mortality, healthcare utilization, and chronic kidney disease.
Design: Retrospective, two-center, observational study.
Background: Children who develop acute kidney injury (AKI) in the pediatric intensive care unit (PICU) may be at higher risk of long-term chronic kidney disease and hypertension. The objectives of this study were to determine the prevalence of post-discharge hypertension and albuminuria using reference-standard measurements in children admitted to the PICU, and evaluate their association with AKI.
Methods: Single-center longitudinal cohort study of children admitted to the PICU from 2005 to 2010 with 7-8 years of follow-up (n = 207).
Background: Nephrotoxic medication (NTM) avoidance may prevent further kidney damage in children with acute kidney injury (AKI). We compared outpatient NTM prescriptions in children with or without AKI during pediatric intensive care (PICU) hospitalization. We hypothesize that children with AKI are prescribed NTMs at the same rate as those without it.
View Article and Find Full Text PDFAcute kidney injury (AKI) in the pediatric intensive care unit (PICU) is an important risk factor for increased morbidity and mortality during hospitalization. Over the past decade, accumulated data on children and young people indicates that acute episodes of kidney dysfunction can have lasting consequences on multiple organ systems and health outcomes. To date, there are no guidelines for follow-up of surviving children that may be at risk of long-term sequelae following AKI in the PICU.
View Article and Find Full Text PDFBackground: Frailty is a known risk factor for an array of adverse outcomes including more frequent and prolonged health services use and high health care costs. Aging of the population has implications for care provision across the care continuum, particularly for people living with frailty. Despite known risks associated with frailty, there has been limited research on care pathways that address the needs of persons living with frailty.
View Article and Find Full Text PDFBackground: Acute kidney Injury (AKI) in children undergoing cardiac surgery (CS) is strongly associated with hospital morbidity. Post-discharge CS AKI outcomes are less clear. We evaluated associations between AKI and post-discharge (a) healthcare utilization, (b) chronic kidney disease (CKD) or hypertension and (c) mortality.
View Article and Find Full Text PDFBackground: Few studies have characterized follow-up after pediatric acute kidney injury (AKI). Our aim was to describe outpatient AKI follow-up after pediatric intensive care unit (PICU) admission.
Methods: Two-center retrospective cohort study (0-18 years; PICU survivors (2003-2005); noncardiac surgery; and no baseline kidney disease).
Background: Children undergoing cardiac surgery are at risk of high blood pressure (BP), a risk factor for cardiovascular and kidney disease. Twenty-four-hour ambulatory BP monitoring (ABPM) is a reference standard hypertension (HTN) test. Little data exist on ABPM abnormalities in children several years post cardiac surgery.
View Article and Find Full Text PDFIntroduction: In December 2019, the first cases of COVID-19 associated with SARS-CoV-2 viral infection were described in Wuhan, Hubei Province, China. Since then, it has spread rapidly affecting 188 countries and was declared a pandemic by the WHO on 11 March 2020. Preliminary reports suggest up to 30% of patients require intensive care unit (ICU) admission and case fatality rate estimate is 2.
View Article and Find Full Text PDFBackground: The prevalence of frailty, an important risk factor for short- and long-term outcomes in hospitalized adults, differs by sex. Studies in critically ill adults have also found differences in mortality and organ support rates in males and females. The objective of this study was to determine if these observed differences in mortality and organ support rates can be explained by sex and frailty alone, or if the interaction between sex and frailty is an important risk factor.
View Article and Find Full Text PDFArticle Synopsis
- Advances in care have led to more neonates surviving cardiac repairs, prompting a study to assess the prevalence of chronic kidney disease (CKD) and hypertension six years post-surgery, as well as the potential impact of cardiac surgery-associated acute kidney injury (CS-AKI).
- The study involved 58 children who underwent congenital heart surgery between 2005 and 2012, revealing that 17% had CKD, 30% had hypertension, and 58% experienced CS-AKI; however, CS-AKI was not linked to CKD or hypertension.
- The findings highlight the importance of monitoring for CKD and hypertension in these children, as the conditions are prevalent, and the study suggests current definitions of CS-AKI
Article Synopsis
- There is a lack of data and guidelines regarding renal follow-up for neonates after cardiovascular surgery, leading to a study that evaluates post-operative renal function and factors affecting follow-up care.
- A retrospective study was conducted on children aged 5-7 who had neonatal cardiac surgery, analyzing factors linked to post-discharge creatinine measurements and estimating glomerular filtration rate using laboratory values.
- Findings revealed that 30% of kids did not have any creatinine measured after surgery, and for those who did, there was no consistent follow-up pattern, indicating the need for a systematic follow-up approach to monitor kidney health in these children.
Background: To develop a pediatric-specific hypertension algorithm using administrative data and use it to evaluate the association between acute kidney injury (AKI) in the intensive care unit (ICU) and hypertension diagnosis 5 years post-discharge.
Methods: Two-center retrospective cohort study of children (≤ 18 years old) admitted to the pediatric ICU in Montreal, Canada, between 2003 and 2005 and followed until 2010. Patients with a valid healthcare number and without end-stage renal disease were included.
Article Synopsis
- The study examines the long-term effects of acute kidney injury (AKI) in children admitted to pediatric intensive care units (PICUs), focusing on kidney abnormalities and blood pressure issues after 6 years.
- Researchers found that 25% of the 277 children had AKI, with those who experienced stage 2/3 AKI having significantly higher odds of developing chronic kidney disease signs and elevated blood pressure.
- The findings indicate that kidney and blood pressure problems are prevalent years after PICU admission and are linked to prior AKI, highlighting the need for further research to improve follow-up care and reduce health risks.
Acute Kidney Injury in Critically Ill Children and Subsequent Chronic Kidney Disease.
Can J Kidney Health Dis
October 2019
Background: The progression from acute kidney injury (AKI) to chronic kidney disease (CKD) is not well understood in children.
Objectives: We aimed to develop a pediatric CKD definition using administrative data and use it to evaluate the association between AKI in critically ill children and CKD 5 years after hospital discharge.
Design: Retrospective cohort study using chart collection and administrative data.
Background: Large studies evaluating pediatric acute kidney injury (AKI) epidemiology and outcomes are lacking, partially due to underuse of large administrative health care data.
Objective: To assess the diagnostic accuracy of administrative health care data-defined AKI in children admitted to the pediatric intensive care unit (PICU).
Design: Retrospective cohort study utilizing chart and administrative data.
Background: Childhood cancer survivors treated with cisplatin, ifosfamide, or carboplatin are at risk for late kidney and blood pressure (BP) abnormalities. Few studies have comprehensively evaluated kidney outcomes and 24-h ambulatory BP monitoring (ABPM) in this population. We aimed to describe chemotherapy-associated acute kidney injury (AKI) and late kidney outcomes using standardized definitions.
View Article and Find Full Text PDFArticle Synopsis
- The study aimed to assess the link between acute kidney injury (AKI) in pediatric intensive care units (PICUs) and long-term mortality, and to see if including urine output data changes this association.
- Conducted as a retrospective cohort study with 2041 children post noncardiac surgery, the results showed that AKI patients had significantly higher mortality rates 5 to 7 years post-discharge despite only a few deaths occurring in the year following hospitalization.
- The research concludes that while AKI is linked to increased long-term mortality, it does not confirm causation, suggesting that high-risk AKI patients warrant special follow-up care until more is understood about these connections.
Background And Objectives: Little is known about the long-term burden of AKI in the pediatric intensive care unit. We aim to evaluate if pediatric AKI is associated with higher health service use post-hospital discharge.
Design, Setting, Participants, & Measurements: This is a retrospective cohort study of children (≤18 years old) admitted to two tertiary centers in Montreal, Canada.
Article Synopsis
- Baseline serum creatinine (bSCr) is crucial for diagnosing acute kidney injury (AKI) in children, but measurements are often missing, especially when height is unavailable for estimating bSCr using equations.
- A study of 538 children in the ICU found that both height-based and height-independent methods underestimated bSCr, but had good agreement in defining AKI compared to measured values.
- The findings suggest that both estimation methods are similar and that they can aid in AKI research and clinical care, particularly when height data is not accessible.
Objectives: To evaluate factors associated with renal recovery from acute kidney injury in critically ill children and the extent to which serum creatinine is measured before discharge.
Design: Retrospective cohort study.
Setting: Two PICUs at tertiary centers in Montreal, QC, Canada.
Background: In the IMAGEstudy, rituximab plus methotrexate (MTX) inhibited joint damage and improved clinical outcomes at 1 year in MTX-naïve patients with early active rheumatoid arthritis.
Objective: The aim of this study was to assess joint damage progression and clinical outcomes over 2 years.
Methods: Patients (n=755) were randomised to receive rituximab 2×500 mg+MTX, 2×1000 mg+MTX or placebo+MTX.
Objectives: Rituximab is an effective treatment in patients with established rheumatoid arthritis (RA). The objective of the IMAGE study was to determine the efficacy of rituximab in the prevention of joint damage and its safety in combination with methotrexate (MTX) in patients initiating treatment with MTX.
Methods: In this double-blind randomised controlled phase III study, 755 MTX-naïve patients with active RA were randomly assigned to MTX alone, rituximab 2×500 mg + MTX or rituximab 2×1000 mg + MTX.