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Acute Kidney Injury (Acute Renal Failure)

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Abrupt reduction in kidney function defined as an absolute increase in serum CREATININE of more than or equal to 0.3. mg/dl, a percentage increase in serum creatinine of more than or equal to 50%, or a reduction in urine output. Acute kidney injury encompasses the entire spectrum of the syndrome including acute kidney failure; ACUTE KIDNEY TUBULAR NECROSIS; and other less severe conditions.

Also Known As:

Acute Renal Failure; Acute Kidney Failure; Acute Kidney Insufficiency; Acute Renal Injury; Acute Renal Insufficiency; Kidney Failure, Acute; Kidney Insufficiency, Acute; Renal Failure, Acute; Renal Insufficiency, Acute; Acute Kidney Failures; Acute Kidney Injuries; Acute Kidney Insufficiencies; Acute Renal Failures; Acute Renal Injuries; Acute Renal Insufficiencies; Kidney Failures, Acute; Kidney Injuries, Acute; Kidney Injury, Acute; Kidney Insufficiencies, Acute; Renal Failures, Acute; Renal Injuries, Acute; Renal Injury, Acute; Renal Insufficiencies, Acute

Networked: 14438 relevant articles (574 outcomes, 1224 trials/studies)

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Disease Context: Research Results

Related Diseases

1.	Sepsis (Septicemia)
2.	Ischemia
3.	Critical Illness (Critically Ill)
4.	Chronic Kidney Failure (Chronic Renal Failure)
5.	Inflammation

Experts

1.	Bellomo, Rinaldo: 127 articles (12/2015 - 01/2002)
2.	Ronco, Claudio: 96 articles (12/2015 - 01/2002)
3.	Devarajan, Prasad: 84 articles (01/2016 - 12/2004)
4.	Kellum, John A: 78 articles (01/2016 - 01/2002)
5.	Bagshaw, Sean M: 69 articles (12/2015 - 08/2004)
6.	Parikh, Chirag R: 62 articles (12/2015 - 07/2004)
7.	Garg, Amit X: 50 articles (12/2015 - 12/2005)
8.	Wald, Ron: 44 articles (12/2015 - 01/2006)
9.	Bonventre, Joseph V: 44 articles (11/2015 - 01/2002)
10.	Goldstein, Stuart L: 43 articles (12/2015 - 09/2003)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Acute Kidney Injury:

1.	Cisplatin (Platino)FDA LinkGeneric 03/01/2004 - "Previous studies demonstrated that during cisplatin-induced acute renal failure, there is a significant reduction in proximal tubule fatty acid oxidation. " 10/10/2008 - "Our results indicated that p53 activation mediated cisplatin-induced RTC death through upregulation of Puma, and suggested that inhibition of p53 and Puma is beneficial for the prevention and treatment of cisplatin-induced acute renal failure." 12/01/2010 - "In this study, we determined whether CD4+CD25+ Treg cells had protective effects against cisplatin-induced acute renal injury in nu/nu mice that lack mature T cells. " 04/01/2014 - "Klotho has dual protective effects on cisplatin-induced acute kidney injury." 01/05/2016 - "NF-κB transcriptional inhibition ameliorates cisplatin-induced acute kidney injury (AKI)."
2.	Glycerol (Glycerine)FDA LinkGeneric 09/01/1993 - "These results suggest that liver cirrhotic rats were in a hyperdynamic state and that this condition would be beneficial in the prevention of glycerol-induced development of acute renal failure." 10/01/2009 - "In conclusion, the present results indicate that (PhSe)(2) was effective in protecting against acute renal failure induced by glycerol." 01/01/2014 - "In our assay, glycerol-induced acute renal failure in rats was employed to study the protective effects of ginsenoside. " 01/01/2010 - "In our assay, glycerol-induced acute renal failure in rats was employed to study the protective effects of ginsenoside. " 01/01/2014 - "Macrophage depletion ameliorates glycerol-induced acute kidney injury in mice."
3.	CreatinineIBA 12/01/2011 - "Patients who met acute kidney injury criteria after adjustment of creatinine for fluid balance (but not before) had a mortality rate that was significantly greater than those who did not meet acute kidney injury criteria both before and after adjustment for fluid balance (31% vs. 12%, p < .001) and those who had acute kidney injury before but not after adjustment for fluid balance (31% vs. 11%, p = .005). " 09/01/2010 - "There was a significantly greater loss of kidney function among the TDF recipients, compared with control subjects (mean difference in calculated creatinine clearance, 3.92 mL/min; 95% confidence interval [CI], 2.13-5.70 mL/min), as well as a greater risk of acute renal failure (risk difference, 0.7%; 95% CI, 0.2-1.2). " 02/01/2012 - "Adding the urine albumin to creatinine ratio to the clinical model to predict acute kidney injury improved the area under the curve from 0.67 to 0.70 (P < .001), and the continuous net reclassification improvement was 29% (P < .001). " 06/01/2010 - "Acute renal failure was defined as 25% decrease from baseline of estimated creatinine clearance and estimated creatinine clearance of 60 mL/min or less on postoperative day 3. Owing to differences in preoperative characteristics between groups, propensity score analysis was used to adjust those differences. " 01/01/2010 - "In patients with acute kidney injury, glomerular filtration rate estimating equations can be improved by incorporating data on creatinine generation and fluid balance. "
4.	Biological Markers (Surrogate Marker)IBA 10/01/2015 - "Z-BUF during bypass surgery is associated with significant reductions in morbidity and biomarkers of CPB-induced acute kidney injury soon after CPB, which are indicative of clearance of inflammatory/immune mediators from the circulation." 04/01/2007 - "The development of sensitive, predictive biomarkers of acute renal failure may help to diagnose the syndrome earlier and allow for meaningful therapeutic intervention. " 06/01/2011 - "Novel urinary biomarkers for the early, sensitive, and specific diagnosis of acute kidney injury (AKI) show promise for the improved management of patients with this treatment-resistant complication. " 12/01/2010 - "Several novel urinary biomarkers have shown promise in the early detection and diagnostic evaluation of acute kidney injury (AKI). " 02/01/2009 - "New biomarkers of acute kidney injury: promise for the future but beware the lure of novelty."
5.	Gentamicins (Gentamicin)FDA LinkGeneric 01/01/1984 - "We have previously shown that the rat with experimental diabetes (DM) of 4-6 months' duration exhibits complete functional and morphologic protection against gentamicin-induced acute renal failure. " 01/01/2009 - "We aimed to investigate the efficacy of ALR in rats with gentamicin (GM)-induced acute renal failure (ARF). " 08/01/2015 - "The objective of the present study was to examine the changes in the expression profile of certain genes in rat model of gentamicin-induced acute kidney injury (AKI) and to see whether time period and routes of administration affect their expression levels. " 01/01/2015 - "Recent studies have suggested that administration of the aminoglycoside antibiotic gentamicin in zebrafish mimics human acute kidney injury (AKI) through the induction of nephron damage, but the timing and details of critical phenotypic events associated with the regeneration process, particularly in existing nephrons, have not been characterized. " 10/01/2010 - "This animal study suggests that pretreatment with RGSE protects against gentamicin-induced acute kidney injury as evident on tissue histology. "
6.	Furosemide (Lasix)FDA LinkGeneric 07/01/2015 - "Question 1: Is the use of furosemide beneficial in the treatment of acute kidney injury in the paediatric population including neonates?" 05/01/2002 - "Her postpartum course was complicated by acute renal failure that responded well to treatment with Lasix and Albumin. " 10/01/2015 - "Prevention of Acute Kidney Injury With the RenalGuard System in Patients Undergoing Transcatheter Aortic Valve Replacement: The PROTECT-TAVI Trial (PROphylactic effecT of furosEmide-induCed diuresis with matched isotonic intravenous hydraTion in Transcatheter Aortic Valve Implantation)." 10/01/2015 - "Acute Kidney Injury With the RenalGuard System in Patients Undergoing Transcatheter Aortic Valve Replacement: The PROTECT-TAVI Trial (PROphylactic effecT of furosEmide-induCed diuresis with matched isotonic intravenous hydraTion in Transcatheter Aortic Valve Implantation)." 08/26/2006 - "Stratifying studies that used frusemide to prevent or treat acute renal failure did not change the results on mortality (relative risk ratio 2.10, 95% confidence interval 0.67 to 6.63) and the risk for requiring dialysis (4.12, 0.46 to 37.2). "
7.	Uranyl NitrateIBA 10/01/2012 - "Reduced clearance of ε-acetamidocaproic acid in rats with acute renal failure induced by uranyl nitrate." 10/01/2012 - "Thus, pharmacokinetic changes in rats with acute renal failure induced by uranyl nitrate (U-ARF rats) were investigated in this study. " 02/09/1984 - "The present studies were designed (1) to examine the pattern of changes in eicosanoid biosynthesis in isolated rat glomeruli, and (2) to correlate these changes with the previously observed alterations in renal perfusion and glomerular filtration rate which occur after uranyl nitrate administration, a model of toxin-induced acute renal failure. " 02/01/1983 - "[Study on uranyl nitrate-induced acute renal failure]." 12/01/1974 - "Uranyl nitrate-induced acute renal failure in the rat: micropuncture and renal hemodynamic studies."
8.	Dopamine (Intropin)FDA LinkGeneric 04/01/2002 - "Controlled trials (in adults) to test the efficacy of "renal dose" dopamine have shown that it is ineffective, and hemofiltration has become increasingly popular as a choice of therapy for acute renal failure." 08/01/2001 - "The use of low-dose dopamine for the treatment or prevention of acute renal failure cannot be justified on the basis of available evidence and should be eliminated from routine clinical use." 04/01/2002 - "But most clinical studies have failed to demonstrate convincingly the benefit of low dose dopamine in acute renal failure. " 07/01/2001 - "Most of the studies demonstrated lack of benefit from dopamine treatment in cases of acute renal failure. " 04/01/1999 - "Therefore, we suggest that renal-dose dopamine should not be used for selective renal vasodilatory and natriuretic actions in those patients with acute renal failure until its efficacy is established in randomized control trials. "
9.	Vancomycin FDA LinkGeneric 01/01/2014 - "Efficacy of high permeability haemodialysis in acute renal failure due to vancomycin." 02/01/2003 - "CVVH can significantly augment the clearance of vancomycin in acute renal failure patients. " 09/01/2000 - "At the end of 38 h of CVVH, the vancomycin concentration had decreased in an exponential manner to 27 microg/ml. Over the subsequent 3-4 days, her renal function improved and the vancomycin concentration decreased further to <5 microg/ml. In conclusion, we believe that a high serum vancomycin concentration may be nephrotoxic and demonstrate that CVVH can be used effectively to remove vancomycin in children with acute renal failure." 06/01/1998 - "CVVH (62% to 262%) and CVVHD (90% to 540%) can significantly augment the clearance of vancomycin in acute renal failure patients. " 02/01/1999 - "The reduced renal clearance of vancomycin in rats with acute renal failure induced by vancomycin was because of a decrease in both GFR and secretory clearance. "
10.	Acetylcysteine (Siran)FDA LinkGeneric 01/01/2014 - "Contrast-induced acute kidney injury (CI-AKI) is one of the most widely discussed and debated topic in cardiovascular medicine and N-acetylcysteine (NAC) is the most widely used pharmacological agent assessed in clinical trials for offering renal protection against CI-AKI. " 11/01/2011 - "However, three different N-acetylcysteine interventions neither significantly improved nor worsened renal function in the milder acute kidney injury model. " 11/01/2011 - "N-acetylcysteine pretreatment was effective in reducing the incidence and severity of acute kidney injury as well as in increasing survival. " 04/01/2011 - "Improved renal recovery has been shown previously with N-acetyl-l-cysteine (NAC) in various acute kidney injuries. " 02/01/2007 - "Among patients receiving N-acetylcysteine, there were trends toward reduced incidence of acute renal failure in patients with baseline Sequential Organ Failure Assessment (SOFA) score>8 (p=.12), lower SOFA scores during the first 4 days of treatment (p=.28), and reduced mortality in patients<65 yrs of age (p=.20). "

Therapies and Procedures

1.	Renal Dialysis (Hemodialysis) 01/01/2006 - "All patients were successfully cured of acute renal failure by hemodialysis or hemodiafiltration. " 01/01/2007 - "To estimate whether continuous veno-venous hemodiafiltration (CVVHDF) is superior to intermittent hemodialysis (IHD) in terms of survival of adult patients with acute renal failure (ARF) admitted to the Intensive Care Unit. " 05/01/1995 - "It has recently been reported that patients with acute renal failure requiring hemodialysis have an improved recovery of renal function and a higher survival rate when the dialysis treatments are performed with a biocompatible membrane rather than a bioincompatible membrane. " 10/01/1987 - "Solute transport in continuous hemodialysis: a new treatment for acute renal failure." 10/01/2012 - "We report a case of acute kidney injury associated with the use of "bath salt" pills that improved with hemodialysis."
2.	Renal Replacement Therapy (Therapies, Renal Replacement) 07/01/1995 - "Despite improvement in care and technological aspects of renal replacement therapy, mortality rates of acute renal failure (ARF) have remained essentially unchanged for over two decades, exceeding 50% in most studies. " 08/01/2014 - "In a subgroup of participants of the Randomized Evaluation of Normal Versus Augmented Level Replacement Therapy Study, earlier commencement of continuous renal replacement therapy relative to RIFLE-I acute kidney injury was not significantly associated with improved survival. " 01/01/2003 - "Despite advanced techniques of renal replacement therapy as well as improved medical care and control over the last decade, the overall mortality of patients with "internal" nontraumatic acute renal failure (ARF) requiring replacement therapy is still high. " 01/01/2009 - "Questions have recently been raised regarding the design and execution of the US Department of Veterans Affairs/National Institutes of Health Acute Renal Failure Trial Network (ATN) Study, which demonstrated no improvement in 60-day all-cause mortality with more intensive management of renal replacement therapy. " 04/01/1987 - "In addition to being a safe and effective means of renal replacement therapy for acute renal failure, CAVH is particularly advantageous for managing conditions of fluid overload in hemodynamically unstable patients."
3.	Peritoneal Dialysis 11/01/1991 - "We conclude that acute peritoneal dialysis is a safe and effective treatment in most pediatric patients with acute renal failure. " 06/01/2003 - "The early initiation of peritoneal dialysis is an effective and safe method to treat acute renal failure after cardiac operation in children." 01/01/1990 - "Peritoneal dialysis is a relatively safe and effective form of therapy for acute renal failure (ARF). " 09/01/2010 - "Although peritoneal dialysis was briefly required for acute renal failure due to low output syndrome, his condition improved and he was discharged 22 days after surgery. " 09/01/1968 - "[Case of acute renal failure from PVP infusion cured by peritoneal dialysis method]."
4.	Transplantation (Transplant Recipients) 12/01/2015 - "Bone marrow-derived mesenchymal stem cells (BMSCs) transplantation is beneficial for the treatment of acute kidney injury (AKI), but the poor survival of BMSCs limits the repair effect. " 06/01/2013 - "Bone-marrow mesenchymal stem cells (BMSCs) transplantation is effective for acute kidney injury (AKI) repair but with limited efficiency. " 01/01/2015 - "Transplantation of induced pluripotent stem cell-derived renal stem cells improved acute kidney injury." 08/15/2013 - "Moreover, transplantation of Tg26 HIV-1 MSCs less effectively improved outcomes compared with healthy MSCs in mice with acute kidney injury. " 07/15/2008 - "To evaluate the efficacy of in vivo magnetic resonance imaging (MRI) of mesenchymal stem cells (MSCs) injected intravascularly in treatment of acute renal failure (ARF) , and to investigate the changes of renal function and pathology of ARF after MSC transplantation. "
5.	Resuscitation 02/01/2012 - "Despite improved resuscitation strategies, acute kidney injury (AKI) remains an important cause of morbidity and high resource use among severely injured patients. " 01/01/1982 - "The appalling mortality of acute renal failure in casualties in the Second World War has been reduced considerably by a better understanding of the clinical manifestations and improved therapeutic techniques which include early dialysis, better resuscitation measures, and maintenance of high urine flows in the high risk patients. " 08/01/2012 - "Moreover, there was an acute renal failure which improved with fluid resuscitation. " 01/01/1987 - "This series suggests that with changing medical practice (particularly the improvement in resuscitation) and an ageing population, the pattern of causes of acute renal failure is altering. " 12/01/2014 - "Hence, we argue that chloride-rich crystalloids such as 0.9% saline should be replaced with balanced crystalloids as the mainstay of fluid resuscitation to prevent 'pre-renal' acute kidney injury. "