LIVIVO - The Search Portal for Life Sciences

zur deutschen Oberfläche wechseln
Advanced search

Search results

Result 1 - 10 of total 21

Search options

  1. Article ; Online: Definition of hourly urine output influences reported incidence and staging of acute kidney injury.

    Allen, Jennifer C / Gardner, David S / Skinner, Henry / Harvey, Daniel / Sharman, Andrew / Devonald, Mark A J

    BMC nephrology

    2020  Volume 21, Issue 1, Page(s) 19

    Abstract: Background: Acute kidney injury (AKI) is commonly defined using the KDIGO system, which includes criteria based on reduced urine output (UO). There is no consensus on whether UO should be measured using consecutive hourly readings or mean output. This ... ...

    Abstract Background: Acute kidney injury (AKI) is commonly defined using the KDIGO system, which includes criteria based on reduced urine output (UO). There is no consensus on whether UO should be measured using consecutive hourly readings or mean output. This makes KDIGO UO definition and staging of AKI vulnerable to inconsistency which has implications both for research and clinical practice. The objective of this study was to investigate whether the way in which UO is defined affects incidence and staging of AKI.
    Methods: We conducted a retrospective analysis of two single centre observational studies investigating (i) patients undergoing cardiac surgery and (ii) patients admitted to general intensive care units (ICU). AKI was identified using KDIGO serum creatinine (SCr) criteria and two methods of UO (UO
    Results: Data from 151 CICU and 150 ICU admissions were analysed. Incidence of AKI using SCr alone was 23.8% in CICU and 32% in ICU. Incidence increased in both groups when UO was considered, with inclusion of UO
    Conclusions: We demonstrate a serious lack of clarity in the internationally accepted AKI definition leading to significant variability in reporting of AKI incidence.
    MeSH term(s) Acute Kidney Injury/diagnosis ; Acute Kidney Injury/epidemiology ; Acute Kidney Injury/physiopathology ; Adult ; Aged ; Biomarkers/blood ; Biomarkers/urine ; Cardiac Surgical Procedures ; Creatinine/blood ; Female ; Hospitalization ; Humans ; Incidence ; Intensive Care Units ; Male ; Middle Aged ; Retrospective Studies ; Sensitivity and Specificity ; Severity of Illness Index ; Urine ; Urine Specimen Collection/methods
    Chemical Substances Biomarkers ; Creatinine (AYI8EX34EU)
    Language English
    Publishing date 2020-01-15
    Publishing country England
    Document type Journal Article ; Observational Study ; Research Support, Non-U.S. Gov't
    ZDB-ID 2041348-8
    ISSN 1471-2369 ; 1471-2369
    ISSN (online) 1471-2369
    ISSN 1471-2369
    DOI 10.1186/s12882-019-1678-2
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

    Order via subito

    This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.

  2. Article ; Online: Hyperosmolar dehydration: A predictor of kidney injury and outcome in hospitalised older adults.

    El-Sharkawy, Ahmed M / Devonald, Mark A J / Humes, David J / Sahota, Opinder / Lobo, Dileep N

    Clinical nutrition (Edinburgh, Scotland)

    2019  Volume 39, Issue 8, Page(s) 2593–2599

    Abstract: Background & aims: Hospitalised older adults are vulnerable to dehydration. However, the prevalence of hyperosmolar dehydration (HD) and its impact on outcome is unknown. Serum osmolality is not measured routinely but osmolarity, a validated alternative, ...

    Abstract Background & aims: Hospitalised older adults are vulnerable to dehydration. However, the prevalence of hyperosmolar dehydration (HD) and its impact on outcome is unknown. Serum osmolality is not measured routinely but osmolarity, a validated alternative, can be calculated using routinely measured serum biochemistry. This study aimed to use calculated osmolarity to measure the prevalence of HD (serum osmolarity >300 mOsm/l) and assess its impact on acute kidney injury (AKI) and outcome in hospitalised older adults.
    Methods: This retrospective cohort study used data from a UK teaching hospital retrieved from the electronic database relating to all medical emergency admissions of patients aged ≥ 65 years admitted between 1st May 2011 and 31st October 2013. Using these data, Charlson comorbidity index (CCI), National Early Warning Score (NEWS), length of hospital stay (LOS) and mortality were determined. Osmolarity was calculated using the equation of Krahn and Khajuria.
    Results: A total of 6632 patients were identified; 27% had HD, 39% of whom had AKI. HD was associated with a median (Q1, Q3) LOS of 5 (1, 12) days compared with 3 (1, 9) days in the euhydrated group, P < 0.001. Adjusted Cox-regression analysis demonstrated that patients with HD were four-times more likely to develop AKI 12-24 h after admission [Hazards Ratio (95% Confidence Interval) 4.5 (3.5-5.6), P < 0.001], and had 60% greater 30-day mortality [1.6 (1.4-1.9), P < 0.001], compared with those who were euhydrated.
    Conclusion: HD is common in hospitalised older adults and is associated with increased LOS, risk of AKI and mortality. Further work is required to assess the validity of osmolality or osmolarity as an early predictor of AKI and the impact of HD on outcome prospectively.
    MeSH term(s) Acute Kidney Injury/etiology ; Acute Kidney Injury/mortality ; Aged ; Aged, 80 and over ; Comorbidity ; Dehydration/complications ; Dehydration/diagnosis ; Dehydration/mortality ; Early Warning Score ; Female ; Hospital Mortality ; Hospitalization/statistics & numerical data ; Humans ; Inpatients/statistics & numerical data ; Length of Stay/statistics & numerical data ; Male ; Osmolar Concentration ; Predictive Value of Tests ; Prevalence ; Retrospective Studies ; Risk Factors ; Serum/chemistry
    Language English
    Publishing date 2019-11-22
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 604812-2
    ISSN 1532-1983 ; 0261-5614
    ISSN (online) 1532-1983
    ISSN 0261-5614
    DOI 10.1016/j.clnu.2019.11.030
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

    In stock of ZB MED Cologne/Königswinter

    Zs.A 1774: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (1.OG)
    ab Jg. 2022: Lesesaal (EG)

    Order via subito

    This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.

  3. Article ; Online: Urinary Trace Elements Are Biomarkers for Early Detection of Acute Kidney Injury.

    Gardner, David S / Allen, Jennifer C / Goodson, Deborah / Harvey, Daniel / Sharman, Andrew / Skinner, Henry / Szafranek, Adam / Young, John S / Bailey, Elizabeth H / Devonald, Mark A J

    Kidney international reports

    2022  Volume 7, Issue 7, Page(s) 1524–1538

    Abstract: Introduction: Acute kidney injury (AKI) is common in hospitalized patients and associated with poor outcomes. Current methods for identifying AKI (rise in serum creatinine [sCr] or fall in urine output [UO]) are inadequate and delay detection. Early ... ...

    Abstract Introduction: Acute kidney injury (AKI) is common in hospitalized patients and associated with poor outcomes. Current methods for identifying AKI (rise in serum creatinine [sCr] or fall in urine output [UO]) are inadequate and delay detection. Early detection of AKI with easily measurable biomarkers might improve outcomes by facilitating early implementation of AKI care pathways.
    Methods: From a porcine model of AKI, we identified trace elements (TEs) in urine that were associated with subsequent development of AKI. We tested these putative biomarkers in 2 observational cohort studies of patients at high risk of AKI: 151 patients undergoing cardiac surgery and 150 patients admitted to a general adult intensive care unit (ICU).
    Results: In adults admitted to the ICU, urinary cadmium (Cd) (adjusted for urinary creatinine) had area under the receiver operating characteristic curve (AUROC) 0.70 and negative predictive value (NPV) 89%; copper (Cu) had AUROC 0.76 and NPV 91%. In humans (but not pigs), urinary zinc (Zn) was also associated with AKI and, in the ICU study, had AUROC 0.67 and NPV 80%. In patients undergoing cardiac surgery, Zn had AUROC 0.77 and NPV 91%; urinary Cd and Cu had poor AUROC but NPV of 93% and 95%, respectively. In control studies, we found that the urinary biomarkers are stable at room temperature for at least 14 days and are not affected by other confounding factors, such as chronic kidney disease (CKD).
    Conclusion: Urinary Cd, Cu, and Zn are novel biomarkers for early detection of AKI. Urinary trace metals have advantages over proteins as AKI biomarkers because they are stable at room temperature and have potential for cheap point-of-care testing using electrochemistry.
    Language English
    Publishing date 2022-04-29
    Publishing country United States
    Document type Journal Article
    ISSN 2468-0249
    ISSN (online) 2468-0249
    DOI 10.1016/j.ekir.2022.04.085
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

    Order via subito

    This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.

    Inter-library loan at ZB MED

    Your chosen title can be delivered directly to ZB MED Cologne location if you are registered as a user at ZB MED Cologne.

  4. Article ; Online: Micronutrient and amino acid losses in acute renal replacement therapy.

    Oh, Weng C / Gardner, David S / Devonald, Mark A J

    Current opinion in clinical nutrition and metabolic care

    2015  Volume 18, Issue 6, Page(s) 593–598

    Abstract: Purpose of review: A wide range of renal replacement therapies is now available to support patients with acute kidney injury. These treatments utilize diffusion, convection or a combination of these mechanisms to remove metabolic waste products from the ...

    Abstract Purpose of review: A wide range of renal replacement therapies is now available to support patients with acute kidney injury. These treatments utilize diffusion, convection or a combination of these mechanisms to remove metabolic waste products from the bloodstream. It is inevitable that physiologically important substances including micronutrients will also be removed. Here we review current knowledge of the extent of micronutrient loss, how it varies between treatment modalities and its clinical significance.
    Recent findings: Very few studies have specifically investigated micronutrient loss in renal replacement therapy for acute kidney injury. Recent data suggest that trace elements and amino acids are lost during intermittent dialysis, hybrid therapies such as sustained low-efficiency diafiltration and continuous therapies. Extent of micronutrient loss appears to vary with treatment type, with continuous convection-based treatments probably causing greatest losses.
    Summary: Patients with acute kidney injury are at high risk of disease-related malnutrition. The use of renal replacement therapy, although often essential for life support, results in loss of micronutrients into the filtrate or dialysate. Losses are probably greater with continuous convective treatments, but it is not yet known whether these losses are clinically significant or whether their replacement would improve patient outcomes.
    MeSH term(s) Acute Kidney Injury/therapy ; Amino Acids/deficiency ; Humans ; Malnutrition/etiology ; Micronutrients/deficiency ; Nutritional Status ; Renal Replacement Therapy/adverse effects
    Chemical Substances Amino Acids ; Micronutrients
    Language English
    Publishing date 2015-09-15
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't ; Review
    ZDB-ID 1460178-3
    ISSN 1473-6519 ; 1363-1950
    ISSN (online) 1473-6519
    ISSN 1363-1950
    DOI 10.1097/MCO.0000000000000220
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

    In stock of ZB MED Cologne/Königswinter

    Zs.A 5586: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (2.OG)
    ab Jg. 2022: Lesesaal (EG)

    Order via subito

    This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.

  5. Article: Urinary Trace Elements Are Biomarkers for Early Detection of Acute Kidney Injury

    Gardner, David S. / Allen, Jennifer C. / Goodson, Deborah / Harvey, Daniel / Sharman, Andrew / Skinner, Henry / Szafranek, Adam / Young, John S. / Bailey, Elizabeth H. / Devonald, Mark A.J.

    International Society of Nephrology Kidney international reports. 2022 Apr. 18,

    2022  

    Abstract: Acute kidney injury (AKI) is common in hospitalized patients and associated with poor outcomes. Current methods for identifying AKI (rise in serum creatinine [sCr] or fall in urine output [UO]) are inadequate and delay detection. Early detection of AKI ... ...

    Abstract Acute kidney injury (AKI) is common in hospitalized patients and associated with poor outcomes. Current methods for identifying AKI (rise in serum creatinine [sCr] or fall in urine output [UO]) are inadequate and delay detection. Early detection of AKI with easily measurable biomarkers might improve outcomes by facilitating early implementation of AKI care pathways. From a porcine model of AKI, we identified trace elements (TEs) in urine that were associated with subsequent development of AKI. We tested these putative biomarkers in 2 observational cohort studies of patients at high risk of AKI: 151 patients undergoing cardiac surgery and 150 patients admitted to a general adult intensive care unit (ICU). In adults admitted to the ICU, urinary cadmium (Cd) (adjusted for urinary creatinine) had area under the receiver operating characteristic curve (AUROC) 0.70 and negative predictive value (NPV) 89%; copper (Cu) had AUROC 0.76 and NPV 91%. In humans (but not pigs), urinary zinc (Zn) was also associated with AKI and, in the ICU study, had AUROC 0.67 and NPV 80%. In patients undergoing cardiac surgery, Zn had AUROC 0.77 and NPV 91%; urinary Cd and Cu had poor AUROC but NPV of 93% and 95%, respectively. In control studies, we found that the urinary biomarkers are stable at room temperature for at least 14 days and are not affected by other confounding factors, such as chronic kidney disease (CKD). Urinary Cd, Cu, and Zn are novel biomarkers for early detection of AKI. Urinary trace metals have advantages over proteins as AKI biomarkers because they are stable at room temperature and have potential for cheap point-of-care testing using electrochemistry.
    Keywords acute kidney injury ; adults ; ambient temperature ; biomarkers ; blood serum ; creatinine ; electrochemistry ; kidneys ; models ; risk ; swine ; urine ; zinc
    Language English
    Dates of publication 2022-0418
    Publishing place Elsevier Inc.
    Document type Article
    Note Pre-press version
    ISSN 2468-0249
    DOI 10.1016/j.ekir.2022.04.085
    Database NAL-Catalogue (AGRICOLA)

    More links

    Kategorien

    Order via subito

    This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.

    Inter-library loan at ZB MED

    Your chosen title can be delivered directly to ZB MED Cologne location if you are registered as a user at ZB MED Cologne.

  6. Article ; Online: How acute kidney injury is investigated and managed in UK intensive care units--a survey of current practice.

    Jones, Sarah L / Devonald, Mark A J

    Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association

    2013  Volume 28, Issue 5, Page(s) 1186–1190

    Abstract: Background: Optimal management of acute kidney injury (AKI) remains controversial, particularly with respect to acutely unwell patients in the intensive care unit (ICU). This is likely to be attributable to the currently poor evidence base. Attempts to ... ...

    Abstract Background: Optimal management of acute kidney injury (AKI) remains controversial, particularly with respect to acutely unwell patients in the intensive care unit (ICU). This is likely to be attributable to the currently poor evidence base. Attempts to introduce guidance and consistency have been made over recent years, such as the AKI Network (AKIN) staging system and, in the UK, recommendations from the 2009 National Confidential Enquiry into Patient Outcome and Death (NCEPOD) report into AKI. We wished to ascertain how AKI is investigated and managed in intensive care units in the UK, and whether these recent initiatives have made any difference to clinical practice.
    Methods: This is an online survey of all general adult UK ICUs between December 2009 and May 2010.
    Results: One hundred and eighty-eight out of two hundred and thirty-three units (80%) started the survey; 167 (72%) completed it. Only 19.2% of respondents routinely use AKIN or Risk, Injury, Failure, Loss, End-stage kidney disease (RIFLE) criteria for diagnosis and staging of AKI. A nephrologist is never or rarely consulted about patients with AKI in over 40% of the units. Only 46.4% have 24-h access to a renal ultrasound service. Continuous venovenous haemofiltration (CVVH) is the most commonly used form of renal replacement therapy (RRT) but intermittent haemodialysis (IHD) is used infrequently. Continuous RRTs (CRRTs) are managed almost exclusively by intensivists, whereas IHD is managed predominantly by nephrologists. The most frequently used criteria for initiating RRT are hyperkalaemia, fluid overload and pH. Most units have a standard RRT protocol and 35 mL/kg/h is the most frequently prescribed dose of CVVH. Only 51% of the units assess the delivered dose of RRT.
    Conclusions: Considerable variation exists in the investigation and management of AKI in UK ICUs. Despite increasing recognition of the importance of AKI, few ICUs are aware of RIFLE and AKIN criteria.
    MeSH term(s) Acute Kidney Injury/mortality ; Acute Kidney Injury/therapy ; Adult ; Follow-Up Studies ; Health Care Surveys/statistics & numerical data ; Hemofiltration/methods ; Hemofiltration/trends ; Hospital Mortality ; Humans ; Intensive Care Units ; Practice Patterns, Physicians' ; Prognosis ; Renal Dialysis/methods ; Renal Dialysis/trends ; Renal Replacement Therapy/methods ; Renal Replacement Therapy/trends ; Survival Rate
    Language English
    Publishing date 2013-05
    Publishing country England
    Document type Journal Article
    ZDB-ID 90594-x
    ISSN 1460-2385 ; 0931-0509
    ISSN (online) 1460-2385
    ISSN 0931-0509
    DOI 10.1093/ndt/gft015
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

    In stock of ZB MED Cologne/Königswinter

    Zs.A 2198: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (1.OG)
    ab Jg. 2022: Lesesaal (EG)
    Zs.MO 329: Show issues

    Order via subito

    This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.

  7. Article: Careers in academic medicine.

    Devonald, Mark A J

    Clinical medicine (London, England)

    2004  Volume 4, Issue 3, Page(s) 284–285

    MeSH term(s) Career Choice ; Career Mobility ; Education, Medical, Graduate/organization & administration ; Faculty, Medical/organization & administration ; Humans ; Research/organization & administration ; United Kingdom
    Language English
    Publishing date 2004-07-10
    Publishing country England
    Document type Congress
    ZDB-ID 2048646-7
    ISSN 1473-4893 ; 1470-2118
    ISSN (online) 1473-4893
    ISSN 1470-2118
    DOI 10.7861/clinmedicine.4-3-284
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

    In stock of ZB MED Cologne/Königswinter

    Zs.A 5439: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (2.OG)
    ab Jg. 2022: Lesesaal (EG)

    Order via subito

    This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.

  8. Article ; Online: Nanotechnology tracks to the renal ward.

    Gardner, David S / Welham, Simon J M / Devonald, Mark A J

    The Journal of physiology

    2013  Volume 591, Issue 23, Page(s) 5803

    MeSH term(s) Animals ; Biomarkers/urine ; Exosomes ; Humans ; Kidney Diseases/diagnosis ; Kidney Diseases/urine ; Nanoparticles/analysis ; Nanotechnology
    Chemical Substances Biomarkers
    Language English
    Publishing date 2013-11-29
    Publishing country England
    Document type Journal Article
    ZDB-ID 3115-x
    ISSN 1469-7793 ; 0022-3751
    ISSN (online) 1469-7793
    ISSN 0022-3751
    DOI 10.1113/jphysiol.2013.266544
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

    In stock of ZB MED Cologne/Königswinter

    Uc I Zs.65: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular
    ab Jg. 2022: Lesesaal (EG)

    Order via subito

    This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.

  9. Article ; Online: Micronutrient and Amino Acid Losses During Renal Replacement Therapy for Acute Kidney Injury.

    Oh, Weng C / Mafrici, Bruno / Rigby, Mark / Harvey, Daniel / Sharman, Andrew / Allen, Jennifer C / Mahajan, Ravi / Gardner, David S / Devonald, Mark A J

    Kidney international reports

    2019  Volume 4, Issue 8, Page(s) 1094–1108

    Abstract: ... respectively; : Conclusion: Micronutrient and amino acid losses are marked during RRT in patients with AKI ...

    Abstract Introduction: Malnutrition is common in patients with acute kidney injury (AKI), particularly in those requiring renal replacement therapy (RRT). Use of RRT removes metabolic waste products and toxins, but it will inevitably also remove useful molecules such as micronutrients, which might aggravate malnutrition. The RRT modalities vary in mechanism of solute removal; for example, intermittent hemodialysis (IHD) uses diffusion, continuous veno-venous hemofiltration (CVVH) uses convection, and sustained low-efficiency diafiltration (SLEDf) uses a combination of these.
    Methods: We assessed micronutrient and amino acid losses in 3 different RRT modalities in patients with AKI (IHD, n = 27; SLEDf, n = 12; CVVH, n = 21) after correction for dialysis dose and plasma concentrations.
    Results: Total losses were affected by modality; generally CVVH >> SLEDf > IHD (e.g., amino acid loss was 18.69 ± 3.04, 8.21 ± 4.07, and 5.13 ± 3.1 g, respectively;
    Conclusion: Micronutrient and amino acid losses are marked during RRT in patients with AKI, with variation between RRT modalities and micronutrients.
    Language English
    Publishing date 2019-05-23
    Publishing country United States
    Document type Journal Article
    ISSN 2468-0249
    ISSN (online) 2468-0249
    DOI 10.1016/j.ekir.2019.05.001
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

    Order via subito

    This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.

    Inter-library loan at ZB MED

    Your chosen title can be delivered directly to ZB MED Cologne location if you are registered as a user at ZB MED Cologne.

  10. Article: Hyperosmolar dehydration: A predictor of kidney injury and outcome in hospitalised older adults

    El-Sharkawy, Ahmed M / Devonald, Mark A.J / Humes, David J / Sahota, Opinder / Lobo, Dileep N

    Clinical nutrition. 2019 Nov. 14,

    2019  

    Abstract: Hospitalised older adults are vulnerable to dehydration. However, the prevalence of hyperosmolar dehydration (HD) and its impact on outcome is unknown. Serum osmolality is not measured routinely but osmolarity, a validated alternative, can be calculated ... ...

    Abstract Hospitalised older adults are vulnerable to dehydration. However, the prevalence of hyperosmolar dehydration (HD) and its impact on outcome is unknown. Serum osmolality is not measured routinely but osmolarity, a validated alternative, can be calculated using routinely measured serum biochemistry. This study aimed to use calculated osmolarity to measure the prevalence of HD (serum osmolarity >300 mOsm/l) and assess its impact on acute kidney injury (AKI) and outcome in hospitalised older adults.This retrospective cohort study used data from a UK teaching hospital retrieved from the electronic database relating to all medical emergency admissions of patients aged ≥ 65 years admitted between 1st May 2011 and 31st October 2013. Using these data, Charlson comorbidity index (CCI), National Early Warning Score (NEWS), length of hospital stay (LOS) and mortality were determined. Osmolarity was calculated using the equation of Krahn and Khajuria.A total of 6632 patients were identified; 27% had HD, 39% of whom had AKI. HD was associated with a median (Q1, Q3) LOS of 5 (1, 12) days compared with 3 (1, 9) days in the euhydrated group, P < 0.001. Adjusted Cox-regression analysis demonstrated that patients with HD were four-times more likely to develop AKI 12–24 h after admission [Hazards Ratio (95% Confidence Interval) 4.5 (3.5–5.6), P < 0.001], and had 60% greater 30-day mortality [1.6 (1.4–1.9), P < 0.001], compared with those who were euhydrated.HD is common in hospitalised older adults and is associated with increased LOS, risk of AKI and mortality. Further work is required to assess the validity of osmolality or osmolarity as an early predictor of AKI and the impact of HD on outcome prospectively.
    Keywords acute kidney injury ; blood chemistry ; blood serum ; cohort studies ; comorbidity ; confidence interval ; databases ; elderly ; equations ; hospitals ; kidneys ; mortality ; osmolality ; osmolarity ; patients ; regression analysis ; United Kingdom
    Language English
    Dates of publication 2019-1114
    Publishing place Elsevier Ltd
    Document type Article
    Note Pre-press version
    ZDB-ID 604812-2
    ISSN 1532-1983 ; 0261-5614
    ISSN (online) 1532-1983
    ISSN 0261-5614
    DOI 10.1016/j.clnu.2019.11.030
    Database NAL-Catalogue (AGRICOLA)

    More links

    Kategorien

    In stock of ZB MED Cologne/Königswinter

    Zs.A 1774: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (1.OG)
    ab Jg. 2022: Lesesaal (EG)

    Order via subito

    This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.

To top