Impact on fluid balance of an optimized restrictive strategy targeting non-resuscitative fluids in intensive care patients with septic shock: a single-blind, multicenter, randomized, controlled, pilot study.

Background: In septic shock, the classic fluid resuscitation strategy can lead to a potentially harmful positive fluid balance. This multicenter, randomized, single-blind, parallel, controlled pilot study assessed the effectiveness of a restrictive fluid strategy aiming to limit daily volume.

Methods: Patients 18-85 years' old admitted to the ICU department of three French hospitals were eligible for inclusion if they had septic shock and were in the first 24 h of vasopressor infusion.

Machine learning for the prediction of mortality in patients with sepsis-associated acute kidney injury: a systematic review and meta-analysis.

Background: Predicting mortality in sepsis-related acute kidney injury facilitates early data-driven treatment decisions. Machine learning is predicting mortality in S-AKI in a growing number of studies. Therefore, we conducted this systematic review and meta-analysis to investigate the predictive value of machine learning for mortality in patients with septic acute kidney injury.

Liver assistive devices in acute liver failure: Current use and future directions.

Acute liver failure (ALF) is a rare syndrome where rapid deterioration of liver function occurs after an acute insult in a patient without prior chronic liver disease and leads to jaundice, hepatic encephalopathy (HE), and oftentimes multiorgan failure (MOF). At this time, the only definitive treatment for ALF is LT but some patients, particularly APAP-induced ALF patients, may have ongoing regenerative capacity of the liver and may not require LT with ongoing supportive management. As a result, extracorporeal liver support (ECLS) has been a topic of interest both as a bridge to LT and as a bridge to spontaneous recovery and aims to remove damaging toxins that further aggravate liver failure, stimulate regeneration of the liver, and improve pathophysiologic consequences of liver failure.

Evaluation and management of neurological complications in acute liver failure.

Neurological complications in acute liver failure are the most common cause of mortality in this group of patients. Almost all neurologic complications arise from underlying increase in intracranial pressure in ALF. In addition to symptomatic management, the treatment relies on measures to bring down ICP.

Infections in acute liver failure - Assessment, prevention, and management.

Infections in acute liver failure (ALF) increase the associated morbidity and mortality, and often hamper the possibility of transplantation. Two-thirds of the infections in ALF are bacterial while one-third is fungal. High suspicion for infection is essential whenever there is clinical deterioration.

Use of vancomycin and acute kidney injury in critically ill patients with sepsis or septic shock: A retrospective observational cohort study.

Introduction: The independent association of vancomycin with Acute Kidney Injury (AKI) in the critically ill patient with sepsis or septic Shock is controversial. The aim of this study was to evaluate the incidence of AKI in a cohort of patients with sepsis or septic Shock with an adequate and strict monitoring of vancomycin, guided by the area under the concentration-time curve in relation to the minimum inhibitory concentration (AUC/MIC ratio).

Material And Methods: Retrospective cohort study on 106 patients admitted to the ICU with a diagnosis of sepsis or septic shock with vancomycin treatment, consecutively from January 2017 to December 2019.

Cardiorenal outcomes associated with sodium-glucose co-transporter-2 inhibitors in chronic kidney disease stage 5 (CKD V): A propensity score-matched analysis.

Background: There remains a paucity of data regarding the cardio-renal benefits of sodium-glucose co-transporter-2 inhibitors (SGLT2i) in patients with chronic kidney disease stage 5 (CKD V) based on major clinical trials.

Objective: This retrospective study aimed to identify potential cardiovascular and renal outcomes associated with SGLT2i use in CKD V patients.

Methods: We queried the TriNetX Global collaborative network from Jan 2014 - Aug 2023 for patients ≥18 years diagnosed with CKD V but not on dialysis.

Alemtuzumab Associated With Higher Mortality Than Basiliximab in Older Kidney Transplant Recipients.

Introduction: Kidney transplantation (KT) in older age is increasingly common as more elderly patients live with end-stage renal disease. Immunosuppression (IS) after KT confers additional risk in aging patients with weakened immune systems. We hypothesized that 1-year mortality among KT recipients aged 70 y and older would be higher in those receiving induction IS with alemtuzumab lymphocyte depletion versus basiliximab interleukin-2 inhibition.

Crush injuries to the lower limbs at a major UK trauma centre: a retrospective observational study.

Purpose: Crush injuries result from the physical compression of muscles and may lead to crush syndrome. Early fluid resuscitation and surgical intervention is key. Few studies have reported the outcomes of crush injuries in the non-disaster setting.

Retrospective review of the development and implementation of a bedside tunneled dialysis catheter program.

Background: The decision to place a subcutaneously tunneled catheter is an infection prevention strategy for long term venous access allowing the proceduralist to access a vein and relocate the catheter exit site to a region on the body where care and maintenance can be safely performed. Subcutaneously tunneled centrally inserted dialysis catheter (ST-CIDC) placement is commonly performed in patients with renal disease and is traditionally performed with fluoroscopy in the interventional radiology suite or the operating theater. However, today's interventional radiologists and surgeons perform advanced invasive procedures that can be time-consuming resulting in delays in the scheduling of elective tunneled catheter placements.

Acute kidney injury and tacrolimus toxicity in a kidney transplant recipient treated with nirmaltrevir/ritonavir: a case report.

Background: Kidney transplant recipients with severe acute respiratory syndrome-coronavirus-2 infection have an increased risk of severe disease and mortality. Nirmaltrevir/ritonavir (Paxlovid) is an effective oral disease-modifying therapy that has been shown to reduce risk of progression to severe disease in high-risk, nonhospitalized adults. However, owing to the potential for serious drug-drug interactions owing to ritonavir-induced inhibition of the CYP3A enzyme, this drug is not suitable option for transplant recipients with mild-moderate severe acute respiratory syndrome-coronavirus-2 infection.

Association between serum urate levels and all-cause mortality, cardiovascular and renal outcomes among gout patients in Singapore.

Objectives: We investigated the longitudinal association between Serum Urate (SU) level and Acute Myocardial Infarction (AMI), Stroke, End Stage Renal Failure (ESRF) and all-cause mortality.

Design: We conducted a retrospective hospital-based cohort study of individuals with gout managed in specialist outpatient clinics. Cox proportional hazards regression was used to estimate HR and 95% CI, with adjustments for potential confounders.

Deletion of lymphotoxin-β receptor (LTβR) protects against acute kidney injury by PPARα pathway.

Background: Recent data has shown a considerable advancement in understanding the role of lymphotoxin-β receptor (LTβR) in inflammation. However, the functions and underlying mechanisms of LTβR in acute kidney injury (AKI) remain largely unknown.

Methods: AKI was induced in mice by renal ischemia-reperfusion (I/R).

Endothelial-specific deletion of connexin 43 improves renal function and structure after acute kidney injury.

Background: We have previously reported that the gap junction protein connexin 43 (Cx43) was upregulated in chronic renal disease in humans and rodents and plays a crucial role in the progression of experimental nephropathy. In this study, we investigated its role after renal ischemia/reperfusion (rIR), which is a major mechanism of injury in acute renal injury (AKI) and renal transplant graft dysfunction.

Methods: Wild-type mice (WT) and mice in which Cx43 expression was genetically reduced by half (Cx43 ±) were unilaterally nephrectomized.

Independent prognostic importance of the albumin-corrected anion gap in critically ill patients with congestive heart failure: a retrospective study from MIMIC-IV database.

Background: The associations between the albumin-corrected anion gap (ACAG) and all-cause mortality in patients with congestive heart failure in the intensive care unit remain uncertain. This study aimed to investigate this unknown.

Methods: The MIMIC-IV (version 3.

The nadir platelet count in the first 48 h after ICU admission is a potential predictor of acute kidney injury in hemorrhagic shock patients.

Background: The relationship between the nadir platelet count within the first 48 h after intensive care unit (ICU) admission and the occurrence of acute kidney injury (AKI) in hemorrhagic shock patients remains unclear. This study investigated this association in adult patients admitted to the surgical ICU for hemorrhagic shock.

Methods: We included 124 hemorrhagic shock patients, excluding those with pre-existing AKI or chronic kidney disease (CKD), admitted to two affiliated hospitals between January 2019 and May 2022.

Acute Kidney Injury Among Florida Construction Workers: A Pilot Study.

Background: While construction workers have the second highest rate of heat-related mortality, less is known about the prevelance of heat-related illness (HRI) symptoms, dehydration and kidney dysfunction. The aim of this study was to conduct a biomedical field-based study with construction workers to characterize HRI symptoms, dehydration, and kidney dysfunction, and analyze relationships between post-work urine specific gravity (USG) percentiles and predictors such as work hours, water consumption, and sugary beverage consumption.

Methods: In collaboration with the Farmworker Association of Florida, 58 construction workers in Central Florida were monitored pre- and post-work shift on one workday.

Intraoperative Goal-directed Hemodynamic Therapy Targeting Both Arterial Pressure and Flow Parameters Using Uncalibrated Pulse Contour Techniques: A Meta-Analysis of Randomized Controlled Trials.

Background: Goal-directed haemodynamic therapy (GDHT) aims to optimize haemodynamic variables. However, its effectiveness in reducing postoperative complications in major abdominal surgery, particularly when targeting both arterial pressure and flow variables, remains unclear. This meta-analysis addresses this by evaluating GDHT using uncalibrated pulse contour (uPC) methods.

Flammulina Velutipes polysaccharides ameliorate cisplatin-induced acute kidney injury in mice via regulation of gut microbiota and Ferroptosis pathway.

Acute kidney injury (AKI) is a common and serious clinical complication with high incidence. Polysaccharides extracted from Flammulina velutipes (FVPs) have been proven to possess anti-inflammatory and antioxidant properties. The present study aimed to investigate the ameliorative effect and mechanism of FVPs on cisplatin (CDPP)-induced AKI.

Guidelines for sex-specific considerations to improve rigor in renal research, and how we got there.

Biological sex significantly influences disease presentation, progression, and therapeutic outcomes in chronic kidney disease and acute kidney injury. Sex hormones, including estrogen and testosterone, modulate key renal functions, including renal blood flow, glomerular filtration, and electrolyte transport, thereby affecting disease trajectory in a sex-specific manner. It is critical for researchers to understand why and how to integrate sex as a biological variable in data collection, analysis, and reporting.

Amino Acid Infusion for Kidney Protection in Cardiac Surgery Patients with Chronic Kidney Disease: A Secondary Analysis of the PROTECTION Trial.

Background: In the PROTECTION trial, intravenous amino acids (AA) decreased the occurrence of acute kidney injury (AKI) in cardiac surgery patients with cardiopulmonary bypass (CPB). Recruitment of renal functional reserve may be responsible for such protection. However, patients with chronic kidney disease (CKD) have diminished renal functional reserve, and AA may be less protective in such patients.

Safety of prolonged bilateral antegrade cerebral perfusion in aortic arch surgery with moderate hypothermia.

Objectives: This study investigates the impact of bilateral antegrade cerebral perfusion time on outcomes in aortic arch surgery.

Methods: In total, 961 patients underwent either hemi arch (n = 385) or total arch replacement (n = 576) with bilateral antegrade cerebral perfusion and moderate hypothermia management between 2006 and 2020 across 2 aortic centers. Antegrade cerebral perfusion time was categorized into 4 groups (≤30 min: n = 169, 30-60min: n = 298, 60-90min: n = 261, >90min: n = 233).

Melanin-Deferoxamine Nanoparticles Targeting Ferroptosis Mitigate Acute Kidney Injury via RONS Scavenging and Iron Ion Chelation.

Rhabdomyolysis (RM)-induced acute kidney injury (AKI) involves the release of large amounts of iron ions from excess myoglobin in the kidneys, which mediates the overproduction of reactive species with the onset of iron overload via the Fenton reaction, thus inducing ferroptosis and leading to renal dysfunction. Unfortunately, there are no effective treatments for AKI other than supportive care. Herein, we developed a multifunctional nanoplatform (MPD) by covalently bonding melanin nanoparticles (MP NPs) to deferoxamine.

Bioprospecting hydroxylated chalcones in model of ischemia-reoxygenation and probing NOX4 interactions via molecular docking.

Ischemia/reperfusion injury (I/R) is a leading cause of acute kidney injury (AKI) in conditions like kidney transplants, cardiac surgeries, and nephrectomy, contributing to high global mortality and morbidity. This study aimed to analyze the protective effects of 2'-hydroxychalcones in treating I/R-induced AKI by targeting key pathological pathways. Considering strong antioxidant action along with other pharmacological roles of chalcone derivatives, six 2'-hydroxychalcones were synthesized via Claisen-Schmidt condensation and analyzed for their protective effects in an I/R induced AKI model using HK-2 cells.