Aim: To assess the influence of diabetes mellitus and obesity on contrast-induced acute kidney injury risk in patients with chronic coronary artery disease requiring percutaneous coronary intervention.
Materials And Methods: 1023 patients with chronic coronary artery disease were enrolled in a prospective, open, cohort study (ClinicalTrials.gov ID NCT04014153). Contrast-induced acute kidney injury was defined as an increase of 25% or more, or an absolute increase of 0.5 mg/dl or more in serum creatinine from baseline value, assessed at 48 hours following the administration of the contrast. The majority of the patients were overweight male ones with BMI 29.25.5 kg/m2. The primary endpoint of the study was the development of contrast-induced acute kidney injury according to KDIGO criteria.
Results: The prevalence of contrast-induced acute kidney injury was 12.9% (132 patients). 21.2% suffered from diabetes mellitus, 43% were obese and 12.9% had both diabetes mellitus and obesity. Diabetes wasnt a statistically significant independent risk factor of the contrast-induced acute kidney injury, as well as the combination of diabetes and obesity. In the group of obese patients the prevalence of contrast-induced acute kidney injury was higher (13.4%vs12.5%), but didnt meet statistical significance (p=0.7, OR 0.924, 95% CI 0.641.325). According to the multiple logistic regression model, female gender, age, BMI, weight, arterial hypertension, baseline creatinine were the risk factors of the contrast-induced acute kidney injury development (AUC 0.742,p0.0001).
Conclusion: Diabetes mellitus was not associated with higher incidence of contrast-induced acute kidney injury. The prevalence of contrast-induced kidney injury was higher in the group of patients with BMI30 kg/m2, but didnt meet statistical significance and needs further evaluation in larger studies.
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http://dx.doi.org/10.26442/00403660.2020.10.000753 | DOI Listing |
JAMA Intern Med
January 2025
Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark.
Importance: No large randomized clinical trial has directly compared empagliflozin with dapagliflozin, leaving their comparative effectiveness regarding kidney outcomes unknown.
Objective: To compare kidney outcomes between initiation of empagliflozin vs dapagliflozin in adults with type 2 diabetes who were receiving antihyperglycemic treatment.
Design, Setting, And Participants: This target trial emulation used nationwide, population-based routinely collected Danish health care data to compare initiation of empagliflozin vs dapagliflozin in adults with type 2 diabetes who received antihyperglycemic treatment between June 1, 2014, and October 31, 2020.
Mol Genet Genomics
January 2025
Department of Emergency, Xiangyang No. 1 People's Hospital, Hubei University of Medicine, Xiangyang, 441000, China.
Acute kidney injury (AKI) is one of the most serious and common complications in the course of sepsis, known for its poor prognosis and high mortality rate. Recently, ferroptosis, as a newly discovered regulatory cell death, might be closely associated with the progression of AKI. METTL14 is a writer of RNA m6A, an abundant epigenetic modification in transcriptome with broad function.
View Article and Find Full Text PDFPediatr Nephrol
January 2025
Faculty of Medicine, Department of Pharmacology, Kırıkkale University, Kırıkkale, Turkey.
Homogentisic acid (HGA) accumulation in alkaptonuria (AKU) causes injuries in various organs including the kidney. We present a case of a 9-year-old girl initially diagnosed with AKU-related nephropathy due to proteinuria found in her urine analyses. Despite 1 month of ramipril treatment, the patient's proteinuria progressed, and as a result, kidney biopsy and nitisinone treatment were planned.
View Article and Find Full Text PDFPediatr Crit Care Med
January 2025
Department of Pediatrics, UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA.
Objectives: To report the feasibility of a fluid management practice bundle and describe the pre- vs. post-implementation prevalence and odds of cumulative fluid balance greater than 10% in critically ill pediatric patients with respiratory failure.
Design: Retrospective cohort from May 2022 to December 2022.
J Trauma Acute Care Surg
January 2025
From the Division of Urology, Department of Surgery (S.K., J.B.M.), University of Utah School of Medicine, Salt Lake City, Utah; Department of Surgery (G.T.T.), Scripps Memorial Hospital La Jolla, La Jolla, California; Division of Urology, Department of Surgery (R.M.), University of Toronto, Toronto, Ontario, Canada; Department of Radiology (J.A.G.), University of Washington, Harborview Medical Center, Seattle, Washington; Department of Surgery (C.C.), UC Health Medical Center of the Rockies, Loveland, Colorado; Department of Surgery (K.L.K.), University of California San Francisco Fresno, Fresno, California; Department of Surgery (M.C.), Case Western Reserve University, Cleveland, Ohio; Shock Trauma Center (R.A.K.), University of Maryland School of Medicine, Baltimore, Maryland; Division of Acute Care and Regional General Surgery (N.L.W., B.L.Z.), University of Wisconsin-Madison School of Medicine and Public Health, Madison, Wisconsin; and Scott Department of Urology (M.C.), Baylor College of Medicine, Houston, Texas.
The American Association for the Surgery of Trauma initially published the organ injury scaling for the kidney in 1989, which was subsequently updated in 2018. This current American Association for the Surgery of Trauma kidney organ injury scaling update incorporates the latest evidence in diagnosis and management of renal trauma and is based upon a multidisciplinary consensus. These changes reflect the near universal use of computed tomography for renal trauma evaluation and the widespread adoption of conservative management across all grades of renal trauma.
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