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  1. Article ; Online: New Insights Into Diuretic Use to Treat Congestion in the ICU: Beyond Furosemide.

    Escudero, Victor Joaquin / Mercadal, Jordi / Molina-Andújar, Alícia / Piñeiro, Gaston J / Cucchiari, David / Jacas, Adriana / Carramiñana, Albert / Poch, Esteban

    Frontiers in nephrology

    2022  Volume 2, Page(s) 879766

    Abstract: Diuretics are commonly used in critically ill patients with acute kidney injury (AKI) and fluid overload in intensive care units (ICU), furosemide being the diuretic of choice in more than 90% of the cases. Current evidence shows that other diuretics ... ...

    Abstract Diuretics are commonly used in critically ill patients with acute kidney injury (AKI) and fluid overload in intensive care units (ICU), furosemide being the diuretic of choice in more than 90% of the cases. Current evidence shows that other diuretics with distinct mechanisms of action could be used with good results in patients with selected profiles. From acetazolamide to tolvaptan, we will discuss recent studies and highlight how specific diuretic mechanisms could help to manage different ICU problems, such as loop diuretic resistance, hypernatremia, hyponatremia, or metabolic alkalosis. The current review tries to shed some light on the potential use of non-loop diuretics based on patient profile and give recommendations for loop diuretic treatment performance focused on what the intensivist and critical care nephrologist need to know based on the current evidence.
    Language English
    Publishing date 2022-07-08
    Publishing country Switzerland
    Document type Journal Article ; Review
    ISSN 2813-0626
    ISSN (online) 2813-0626
    DOI 10.3389/fneph.2022.879766
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Impact of cardiac surgery associated acute kidney injury on 1-year major adverse kidney events.

    Molina Andújar, Alícia / Escudero, Victor Joaquin / Piñeiro, Gaston J / Lucas, Alvaro / Rovira, Irene / Matute, Purificación / Ibañez, Cristina / Blasco, Miquel / Quintana, Luis F / Sandoval, Elena / Sánchez, Marina Chorda / Quintana, Eduard / Poch, Esteban

    Frontiers in nephrology

    2023  Volume 3, Page(s) 1059668

    Abstract: Background: The incidence of acute kidney injury following cardiac surgery (CSA-AKI) is up to 30%, and the risk of chronic kidney disease (CKD) has been found to be higher in these patients compared to the AKI-free population. The aim of our study was ... ...

    Abstract Background: The incidence of acute kidney injury following cardiac surgery (CSA-AKI) is up to 30%, and the risk of chronic kidney disease (CKD) has been found to be higher in these patients compared to the AKI-free population. The aim of our study was to assess the risk of major adverse kidney events (MAKE) [25% or greater decline in estimated glomerular filtration rate (eGFR), new hemodialysis, and death] after cardiac surgery in a Spanish cohort and to evaluate the utility of the score developed by Legouis D et al. (CSA-CKD score) in predicting the occurrence of MAKE.
    Methods: This was a single-center retrospective study of patients who required cardiac surgery with cardiopulmonary bypass (CPB) during 2015, with a 1-year follow-up after the intervention. The inclusion criteria were patients over 18 years old who had undergone cardiac surgery [i.e., valve substitution (VS), coronary artery bypass graft (CABG), or a combination of both procedures].
    Results: The number of patients with CKD (eGFR < 60 mL/min) increased from 74 (18.3%) to 97 (24%) within 1 year after surgery. The median eGFR declined from 85 to 82 mL/min in the non-CSA-AKI patient group and from 73 to 65 mL/min in those with CSA-AKI (
    Conclusion: Any-stage CSA-AKI is associated with a risk of MAKE after 1 year. Further research into new measures that identify at-risk patients is needed so that appropriate patient follow-up can be carried out.
    Language English
    Publishing date 2023-04-24
    Publishing country Switzerland
    Document type Journal Article
    ISSN 2813-0626
    ISSN (online) 2813-0626
    DOI 10.3389/fneph.2023.1059668
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Order via subito

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    Inter-library loan at ZB MED

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  3. Article: Risk Factors for Acute Kidney Injury Following Cardiac Surgery and Performance of Leicester Score in a Spanish Cohort.

    Molina Andújar, Alícia / Lucas, Alvaro / Escudero, Victor Joaquin / Rovira, Irene / Matute, Purificación / Ibañez, Cristina / Blasco, Miquel / Sandoval, Elena / Ruiz, Jesús / Chorda Sánchez, Marina / Piñeiro, Gaston J / Quintana, Eduard / Poch, Esteban

    Journal of clinical medicine

    2022  Volume 11, Issue 4

    Abstract: The incidence of acute kidney injury following cardiac surgery (CSA-AKI) is up to 30%, and it places patients at an increased risk of death. The Leicester score (LS) is a new score that predicts CSA-AKI of any stage with better discrimination compared to ...

    Abstract The incidence of acute kidney injury following cardiac surgery (CSA-AKI) is up to 30%, and it places patients at an increased risk of death. The Leicester score (LS) is a new score that predicts CSA-AKI of any stage with better discrimination compared to previous scores. The aim of this study was to identify risk factors for CSA-AKI and to assess the performance of LS. A unicentric retrospective study of patients that required cardiac surgery with cardio-pulmonary bypass (CPB) in 2015 was performed. The inclusion criteria were patients over 18 years old who were operated on for cardiac surgery (valve substitution (VS), Coronary Artery Bypass Graft (CABG), or a combination of both procedures and requiring CPB). CSA-AKI was defined with the Kidney Disease Improving Global Outcomes (KDIGO) criteria. In the multivariate analysis, hypertension (odds ratio 1.883), estimated glomerular filtration rate (EGFR) <60 mL/min (2.365), and peripheral vascular disease (4.66) were associated with the outcome. Both discrimination and calibration were better when the LS was used compared to the Cleveland Clinic Score and Euroscore II, with an area under the curve (AUC) of 0.721. In conclusion, preoperative hypertension in patients with CKD with or without peripheral vasculopathy can identify patients who are at risk of CSA-AKI. The LS was proven to be a valid score that could be used to identify patients who are at risk and who could benefit from intervention studies.
    Language English
    Publishing date 2022-02-09
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2662592-1
    ISSN 2077-0383
    ISSN 2077-0383
    DOI 10.3390/jcm11040904
    Database MEDical Literature Analysis and Retrieval System OnLINE

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