Metabolomics, as a promising and powerful approach, refers to comprehensive assessment and identification of small molecule endogenous metabolites in a biological system which is capable of further understanding the mechanisms of diseases for early diagnosis, effective treatment and prognosis. Acute kidney injury (AKI) induced by contrast is a serious complication in patients undergoing administration of iodinated contrast media. It is becoming a major health concern in clinic, however, the molecular mechanisms of contrast-induced acute kidney injury (CI-AKI) have not been well characterized. In this study, we used serum metabolomics based on liquid chromatography-mass spectrometry (LC-MS) combined with pattern recognition to explore and characterize potential metabolites and metabolic pathway in an experimental model for CI-AKI. Seventeen differentiating metabolites in the serum were identified involving the pivotal metabolic pathways related to tryptophan metabolism, glycerophospholipid metabolism, steroid hormone biosynthesis, pyrimidine metabolism, sphingolipid metabolism, aminoacyl-tRNA biosynthesis. Our study provides novel insight into pathophysiologic mechanisms of AKI by changing biomarkers and pathways.
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http://dx.doi.org/10.1039/c8ra01749b | DOI Listing |
Nephrol Nurs J
January 2025
Clinical Applications and Product Innovation Staff Engineer, Fresenius Medical Care, Lawrence, MA.
Citrate anticoagulation offers a targeted and effective method for preventing clotting in extracorporeal blood circuits during dialysis. This article reviews the mechanisms, benefits, risks, and best practices associated with citrate anticoagulation, emphasizing its growing role within critical care and dialysis.
View Article and Find Full Text PDFNephrol Nurs J
January 2025
Senior Consultant to the Global Medical Office, Fresenius Medical Care, Waltham, MA.
Patients with acute kidney injury often require dialysis (AKI-D) in the outpatient setting following hospitalization. Management of the patient with AKI-D should focus on preventing further insult to the damaged kidney and recovery of kidney function. Clinical attention should include continuity of care, education, infection control, medication management, and fluid management.
View Article and Find Full Text PDFJ Vasc Access
January 2025
Division of Vascular and Endovascular Surgery, Brigham and Women's Hospital, Boston, MA, USA.
Background: Although conventional pre-operative venography can accurately delineate venous anatomy as an alternative to ultrasound for hemodialysis access planning, it may carry a risk of contrast-induced acute kidney injury (AKI) and progression of renal failure in chronic kidney disease (CKD) patients not yet on dialysis. Therefore, the objective of this study was to evaluate the safety and efficacy of pre-operative venograms in pre-end-stage kidney disease (ESKD) patients.
Methods: We performed a retrospective cohort study (2018-2022) of consecutive pre-ESKD patients who underwent staged bilateral venograms for preoperative vein mapping prior to hemodialysis access creation at a tertiary care medical center.
Int J Cardiol Cardiovasc Risk Prev
March 2025
Department of Internal Medicine, University of New Mexico Health Sciences Center, Albuquerque, NM, USA.
Background: Transcatheter aortic valve replacement (TAVR) has significantly advanced the treatment of severe aortic stenosis (AS), particularly in elderly patients who often have coexisting coronary artery disease (CAD). Chronic total occlusion (CTO), a severe form of CAD, may negatively impact outcomes in TAVR patients, though data are limited. This meta-analysis aims to evaluate the impact of CTO on TAVR outcomes.
View Article and Find Full Text PDFF1000Res
January 2025
Department of Nephrology, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, 575001, India.
Background: We evaluated if the course of recovery from sepsis-induced acute kidney injury (AKI) can be predicted using variables collected at admission.
Methods: A total of 63 patients admitted for sepsis-induced AKI in our Mangalore ICU were evaluated and baseline demographic and clinical/laboratory parameters, including serum creatinine (SCr), base excess (BE), Plethysmographic Variability Index (PVI), Caval Index, R wave variability index (RVI), mean arterial pressure (MAP) and renal resistivity index (RI) using renal doppler and need for inotropes were assessed on admission. Patients were managed as per standard protocol.
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