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Mayerhöfer T, Perschinka F, Joannidis M. [Recent developments in acute kidney injury : Definition, biomarkers, subphenotypes, and management]. Med Klin Intensivmed Notfmed 2024; 119:339-345. [PMID: 38683229 PMCID: PMC11130018 DOI: 10.1007/s00063-024-01142-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Accepted: 03/26/2024] [Indexed: 05/01/2024]
Abstract
Acute kidney injury (AKI) is a common problem in critically ill patients and is associated with increased morbidity and mortality. Since 2012, AKI has been defined according to the KDIGO (Kidney Disease Improving Global Outcome) guidelines. As some biomarkers are now available that can provide useful clinical information, a new definition including a new stage 1S has been proposed by an expert group of the Acute Disease Quality Initiative (ADQI). At this stage, classic AKI criteria are not yet met, but biomarkers are already positive defining subclinical AKI. This stage 1S is associated with a worse patient outcome, regardless of the biomarker chosen. The PrevAKI and PrevAKI-Multicenter trial also showed that risk stratification with a biomarker and implementation of the KDIGO bundle (in the high-risk group) can reduce the rate of moderate and severe AKI. In the absence of a successful clinical trial, conservative management remains the primary focus of treatment. This mainly involves optimization of hemodynamics and an individualized (restrictive) fluid management. The STARRT-AKI trial has shown that there is no benefit from accelerated initiation of renal replacement therapy. However, delaying too long might be associated with potential harm, as shown in the AKIKI2 study. Prospective studies are needed to determine whether artificial intelligence will play a role in AKI in the future, helping to guide treatment decisions and improve outcomes.
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Affiliation(s)
- Timo Mayerhöfer
- Gemeinsame Einrichtung für Intensiv- und Notfallmedizin, Department für Innere Medizin, Medizinische Universität Innsbruck, Innsbruck, Österreich
| | - Fabian Perschinka
- Gemeinsame Einrichtung für Intensiv- und Notfallmedizin, Department für Innere Medizin, Medizinische Universität Innsbruck, Innsbruck, Österreich
| | - Michael Joannidis
- Gemeinsame Einrichtung für Intensiv- und Notfallmedizin, Department für Innere Medizin, Medizinische Universität Innsbruck, Innsbruck, Österreich.
- Gemeinsame Einrichtung für Intensiv- und Notfallmedizin, Department für Innere Medizin, Medizinische Universität Innsbruck, Anichstr. 35, 6020, Innsbruck, Österreich.
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2
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Zhang Q, Wang X, Chao Y, Liu L. Focus on oliguria during renal replacement therapy. J Anesth 2024:10.1007/s00540-024-03342-4. [PMID: 38777933 DOI: 10.1007/s00540-024-03342-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 04/29/2024] [Indexed: 05/25/2024]
Abstract
Oliguria is a clinical symptom characterized by decreased urine output, which can occur at any stage of acute kidney injury and also during renal replacement therapy. In some cases, oliguria may resolve with adjustment of blood purification dose or fluid management, while in others, it may suggest a need for further evaluation and intervention. It is important to determine the underlying cause of oliguria during renal replacement therapy and to develop an appropriate treatment plan. This review looks into the mechanisms of urine production to investigate the mechanism of oliguria during renal replacement therapy from two aspects: diminished glomerular filtration rate and tubular abnormalities. The above conditions all implying a renal oxygen supply-demand imbalance, which is the signal of worsening kidney injury. It also proposes a viable clinical pathway for the treatment and management of patients with acute kidney injury receiving renal replacement therapy.
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Affiliation(s)
- Qian Zhang
- Department of Intensive Care Unit (ICU), The Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou, 550004, People's Republic of China
| | - Xiaoting Wang
- Department of Intensive Care Unit (ICU), Peking Union Medical College Hospital, Beijing, 100005, People's Republic of China
| | - Yangong Chao
- Department of Intensive Care Unit (ICU), The First Affiliated Hospital of Tsinghua University, Beijing, 100016, People's Republic of China
| | - Lixia Liu
- Department of Intensive Care Unit (ICU), The Fourth Hospital of Hebei Medical University, Shijiazhuang, Hebei, 050011, People's Republic of China.
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3
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Li H, Liu X, Huang S, Wen Y. Impacts of continuous quality improvement on wound pain in the puncture site of arteriovenous fistula in haemodialysis patient. Int Wound J 2024; 21:e14697. [PMID: 38468432 PMCID: PMC10928246 DOI: 10.1111/iwj.14697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Accepted: 01/05/2024] [Indexed: 03/13/2024] Open
Abstract
This study analyses the effects of a continuous quality improvement nursing model on wound pain at the arteriovenous fistula (AVF) puncture site in patients undergoing haemodialysis. Forty haemodialysis patients from the First Affiliated Hospital of Chongqing Medical University, from September 2020 to December 2022, were selected as study subjects. They were randomly divided into an observation group and a control group. The control group received conventional nursing care, while the observation group was treated with a continuous quality improvement nursing model. The study compared the impact of these nursing approaches on pain intensity post-AVF puncture, wound visual analogue scale scores, self-rating anxiety scale, self-rating depression scale, quality of life scores and patient satisfaction with nursing care. In the observation group, the proportion of patients experiencing moderate to severe pain during AVF puncture was lower than that in the control group, whereas the proportion of patients with no pain or mild pain was higher (P = 0.008). After nursing, the observation group exhibited significantly lower wound visual analogue scale scores, self-rating anxiety scale scores, and self-rating depression scale scores compared to the control group (P < 0.001), with a significantly higher quality of life score (P < 0.05). The nursing satisfaction rate was 95.00% in the observation group, significantly higher than the 65.00% in the control group (P = 0.018). The continuous quality improvement nursing model significantly reduces wound pain at the AVF puncture site in haemodialysis patients, alleviates negative emotions, enhances the quality of life, and achieves high patient satisfaction. It is thus a highly recommendable approach in nursing practice.
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Affiliation(s)
- Hui Li
- Department of NephrologyThe First Affiliated Hospital of Chongqing Medical UniversityChongqingChina
| | - Xian‐Li Liu
- Department of NephrologyThe First Affiliated Hospital of Chongqing Medical UniversityChongqingChina
| | - Si‐Feng Huang
- Department of NursingThe First Affiliated Hospital of Chongqing Medical UniversityChongqingChina
| | - Yi‐Jun Wen
- Department of NursingThe First Affiliated Hospital of Chongqing Medical UniversityChongqingChina
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4
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Fuhrman DY, Stenson EK, Alhamoud I, Alobaidi R, Bottari G, Fernandez S, Guzzi F, Haga T, Kaddourah A, Marinari E, Mohamed TH, Morgan CJ, Mottes T, Neumayr TM, Ollberding NJ, Raggi V, Ricci Z, See E, Stanski NL, Zang H, Zangla E, Gist KM. Major Adverse Kidney Events in Pediatric Continuous Kidney Replacement Therapy. JAMA Netw Open 2024; 7:e240243. [PMID: 38393726 PMCID: PMC10891477 DOI: 10.1001/jamanetworkopen.2024.0243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 12/26/2023] [Indexed: 02/25/2024] Open
Abstract
Importance Continuous kidney replacement therapy (CKRT) is increasingly used in youths with critical illness, but little is known about longer-term outcomes, such as persistent kidney dysfunction, continued need for dialysis, or death. Objective To characterize the incidence and risk factors, including liberation patterns, associated with major adverse kidney events 90 days after CKRT initiation (MAKE-90) in children, adolescents, and young adults. Design, Setting, and Participants This international, multicenter cohort study was conducted among patients aged 0 to 25 years from The Worldwide Exploration of Renal Replacement Outcomes Collaborative in Kidney Disease (WE-ROCK) registry treated with CKRT for acute kidney injury or fluid overload from 2015 to 2021. Exclusion criteria were dialysis dependence, concurrent extracorporeal membrane oxygenation use, or receipt of CKRT for a different indication. Data were analyzed from May 2 to December 14, 2023. Exposure Patient clinical characteristics and CKRT parameters were assessed. CKRT liberation was classified as successful, reinstituted, or not attempted. Successful liberation was defined as the first attempt at CKRT liberation resulting in 72 hours or more without return to dialysis within 28 days of CKRT initiation. Main Outcomes and Measures MAKE-90, including death or persistent kidney dysfunction (dialysis dependence or ≥25% decline in estimated glomerular filtration rate from baseline), were assessed. Results Among 969 patients treated with CKRT (529 males [54.6%]; median [IQR] age, 8.8 [1.7-15.0] years), 630 patients (65.0%) developed MAKE-90. On multivariable analysis, cardiac comorbidity (adjusted odds ratio [aOR], 1.60; 95% CI, 1.08-2.37), longer duration of intensive care unit admission before CKRT initiation (aOR for 6 days vs 1 day, 1.07; 95% CI, 1.02-1.13), and liberation pattern were associated with MAKE-90. In this analysis, patients who successfully liberated from CKRT within 28 days had lower odds of MAKE-90 compared with patients in whom liberation was attempted and failed (aOR, 0.32; 95% CI, 0.22-0.48) and patients without a liberation attempt (aOR, 0.02; 95% CI, 0.01-0.04). Conclusions and Relevance In this study, MAKE-90 occurred in almost two-thirds of the population and patient-level risk factors associated with MAKE-90 included cardiac comorbidity, time to CKRT initiation, and liberation patterns. These findings highlight the high incidence of adverse outcomes in this population and suggest that future prospective studies are needed to better understand liberation patterns and practices.
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Affiliation(s)
- Dana Y. Fuhrman
- University of Pittsburgh Medical Center Children’s Hospital of Pittsburgh, Pittsburgh, Pennsylvania
| | - Erin K. Stenson
- Children’s Hospital Colorado, University of Colorado School of Medicine, Aurora
| | - Issa Alhamoud
- University of Iowa Stead Family Children’s Hospital, Carver College of Medicine, Iowa City
| | | | | | - Sarah Fernandez
- Gregorio Marañón University Hospital, School of Medicine, Madrid, Spain
| | | | - Taiki Haga
- Osaka City General Hospital, Osaka, Japan
| | - Ahmad Kaddourah
- Sidra Medicine, Doha, Qatar
- Weill Cornell Medical College, Ar-Rayyan, Qatar
| | | | - Tahagod H. Mohamed
- Nationwide Children’s Hospital, The Heart Center, The Ohio State University College of Medicine, Columbus
| | | | - Theresa Mottes
- Ann and Robert H. Lurie Children’s Hospital of Chicago, Chicago, Illinois
| | - Tara M. Neumayr
- Washington University School of Medicine, St Louis Children’s Hospital, St Louis, Missouri
| | - Nicholas J. Ollberding
- Cincinnati Children’s Hospital Medical Center; University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Valeria Raggi
- Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | | | - Emily See
- Royal Children’s Hospital, University of Melbourne, Murdoch Children’s Research Institute, Melbourne, Victoria, Australia
| | - Natalja L. Stanski
- Cincinnati Children’s Hospital Medical Center; University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Huaiyu Zang
- Cincinnati Children’s Hospital Medical Center; University of Cincinnati College of Medicine, Cincinnati, Ohio
| | | | - Katja M. Gist
- Cincinnati Children’s Hospital Medical Center; University of Cincinnati College of Medicine, Cincinnati, Ohio
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5
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Pickkers P, Angus DC, Bass K, Bellomo R, van den Berg E, Bernholz J, Bestle MH, Doi K, Doig CJ, Ferrer R, Francois B, Gammelager H, Pedersen UG, Hoste E, Iversen S, Joannidis M, Kellum JA, Liu K, Meersch M, Mehta R, Millington S, Murray PT, Nichol A, Ostermann M, Pettilä V, Solling C, Winkel M, Young PJ, Zarbock A. Phase-3 trial of recombinant human alkaline phosphatase for patients with sepsis-associated acute kidney injury (REVIVAL). Intensive Care Med 2024; 50:68-78. [PMID: 38172296 PMCID: PMC10810941 DOI: 10.1007/s00134-023-07271-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 11/09/2023] [Indexed: 01/05/2024]
Abstract
PURPOSE Ilofotase alfa is a human recombinant alkaline phosphatase with reno-protective effects that showed improved survival and reduced Major Adverse Kidney Events by 90 days (MAKE90) in sepsis-associated acute kidney injury (SA-AKI) patients. REVIVAL, was a phase-3 trial conducted to confirm its efficacy and safety. METHODS In this international double-blinded randomized-controlled trial, SA-AKI patients were enrolled < 72 h on vasopressor and < 24 h of AKI. The primary endpoint was 28-day all-cause mortality. The main secondary endpoint was MAKE90, other secondary endpoints were (i) days alive and free of organ support through day 28, (ii) days alive and out of the intensive care unit (ICU) through day 28, and (iii) time to death through day 90. Prior to unblinding, the statistical analysis plan was amended, including an updated MAKE90 definition. RESULTS Six hundred fifty patients were treated and analyzed for safety; and 649 for efficacy data (ilofotase alfa n = 330; placebo n = 319). The observed mortality rates in the ilofotase alfa and placebo groups were 27.9% and 27.9% at 28 days, and 33.9% and 34.8% at 90 days. The trial was stopped for futility on the primary endpoint. The observed proportion of patients with MAKE90A and MAKE90B were 56.7% and 37.4% in the ilofotase alfa group vs. 64.6% and 42.8% in the placebo group. Median [interquartile range (IQR)] days alive and free of organ support were 17 [0-24] and 14 [0-24], number of days alive and discharged from the ICU through day 28 were 15 [0-22] and 10 [0-22] in the ilofotase alfa and placebo groups, respectively. Adverse events were reported in 67.9% and 75% patients in the ilofotase and placebo group. CONCLUSION Among critically ill patients with SA-AKI, ilofotase alfa did not improve day 28 survival. There may, however, be reduced MAKE90 events. No safety concerns were identified.
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Affiliation(s)
- Peter Pickkers
- Department of Intensive Care, Radboudumc, Nijmegen, The Netherlands.
| | - Derek C Angus
- Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | | | - Rinaldo Bellomo
- Department of Intensive Care, Austin Hospital, Melbourne, VIC, Australia
- Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, VIC, Australia
| | | | | | - Morten H Bestle
- Department of Anesthesiology and Intensive Care, Copenhagen University Hospital-North Zealand, Hilleroed, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Kent Doi
- Department of Emergency and Critical Care Medicine, The University of Tokyo, Tokyo, Japan
| | - Chistopher J Doig
- Department of Critical Care Medicine, Medicine and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Ricard Ferrer
- Department of Intensive Care Medicine, SODIR-VHIR Research Group, Val d'Hebron University Hospital, Barcelona, Spain
| | - Bruno Francois
- Intensive Care, Inserm CIC 1435 & UMR 1092, CHU Limoges, Limoges, France
| | - Henrik Gammelager
- Department of Intensive Care Medicine, Aarhus University Hospital, Aarhus, Denmark
| | | | - Eric Hoste
- Department of Internal Medicine and Pediatrics, Intensive Care Unit, Ghent University Hospital, Ghent University, Ghent, Belgium
- Research Foundation-Flanders, (FWO), Brussels, Belgium
| | - Susanne Iversen
- Department of Anaesthesiology and Intensive Care, Slagelse Hospital, Slagelse, Denmark
| | - Michael Joannidis
- Division of Intensive Care and Emergency Medicine, Department of Internal Medicine, Medical University of Innsbruck, Innsbruck, Austria
| | - John A Kellum
- Center for Critical Care Nephrology, Department of Critical Care Medicine, University of Pittsburgh, Pittsburgh, USA
| | - Kathleen Liu
- Division of Nephrology, Department of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Melanie Meersch
- Department of Anesthesiology, Intensive Care and Pain Medicine, University Hospital Münster, Münster, Germany
| | - Ravindra Mehta
- Department of Medicine, University of California San Diego, La Jolla, CA, USA
| | | | | | - Alistair Nichol
- Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, VIC, Australia
- University College Dublin-Clinical Research Centre at St Vincent's University Hospital, Dublin, Ireland
| | - Marlies Ostermann
- Department of Critical Care, Guys & St Thomas' Foundation Trust, London, UK
| | - Ville Pettilä
- Department of Perioperative and Intensive Care, University of Helsinki and Helsinki University Hospital, HUS, Helsinki, Finland
| | - Christoffer Solling
- Department of Anaestesiology and Intensive Care, Viborg Regional Hospital, Viborg, Denmark
| | | | - Paul J Young
- Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, VIC, Australia
- Intensive Care Unit, Wellington Hospital, Wellington, New Zealand
- Medical Research Institute of New Zealand, Wellington, New Zealand
- Department of Critical Care, University of Melbourne, Melbourne, VIC, Australia
| | - Alexander Zarbock
- Department of Anesthesiology, Intensive Care and Pain Medicine, University Hospital Münster, Münster, Germany
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6
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White KC, Serpa-Neto A, Hurford R, Clement P, Laupland KB, See E, McCullough J, White H, Shekar K, Tabah A, Ramanan M, Garrett P, Attokaran AG, Luke S, Senthuran S, McIlroy P, Bellomo R. Sepsis-associated acute kidney injury in the intensive care unit: incidence, patient characteristics, timing, trajectory, treatment, and associated outcomes. A multicenter, observational study. Intensive Care Med 2023; 49:1079-1089. [PMID: 37432520 PMCID: PMC10499944 DOI: 10.1007/s00134-023-07138-0] [Citation(s) in RCA: 20] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 06/09/2023] [Indexed: 07/12/2023]
Abstract
PURPOSE The Acute Disease Quality Initiative (ADQI) Workgroup recently released a consensus definition of sepsis-associated acute kidney injury (SA-AKI), combining Sepsis-3 and Kidney Disease Improving Global Outcomes (KDIGO) AKI criteria. This study aims to describe the epidemiology of SA-AKI. METHODS This is a retrospective cohort study carried out in 12 intensive care units (ICUs) from 2015 to 2021. We studied the incidence, patient characteristics, timing, trajectory, treatment, and associated outcomes of SA-AKI based on the ADQI definition. RESULTS Out of 84,528 admissions, 13,451 met the SA-AKI criteria with its incidence peaking at 18% in 2021. SA-AKI patients were typically admitted from home via the emergency department (ED) with a median time to SA-AKI diagnosis of 1 day (interquartile range (IQR) 1-1) from ICU admission. At diagnosis, most SA-AKI patients (54%) had a stage 1 AKI, mostly due to the low urinary output (UO) criterion only (65%). Compared to diagnosis by creatinine alone, or by both UO and creatinine criteria, patients diagnosed by UO alone had lower renal replacement therapy (RRT) requirements (2.8% vs 18% vs 50%; p < 0.001), which was consistent across all stages of AKI. SA-AKI hospital mortality was 18% and SA-AKI was independently associated with increased mortality. In SA-AKI, diagnosis by low UO only, compared to creatinine alone or to both UO and creatinine criteria, carried an odds ratio of 0.34 (95% confidence interval (CI) 0.32-0.36) for mortality. CONCLUSION SA-AKI occurs in 1 in 6 ICU patients, is diagnosed on day 1 and carries significant morbidity and mortality risk with patients mostly admitted from home via the ED. However, most SA-AKI is stage 1 and mostly due to low UO, which carries much lower risk than diagnosis by other criteria.
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Affiliation(s)
- Kyle C White
- Intensive Care Unit, Princess Alexandra Hospital, 199 Ipswich Road, Woolloongabba, Brisbane, QLD, 4102, Australia.
- Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia.
- Queensland University of Technology (QUT), Brisbane, QLD, Australia.
| | - Ary Serpa-Neto
- Australian and New Zealand Intensive Care Research Centre (ANZIC-RC), School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
- Department of Critical Care Medicine, Hospital Israelita Albert Einstein, São Paulo, Brazil
| | - Rod Hurford
- Intensive Care Unit, Princess Alexandra Hospital, 199 Ipswich Road, Woolloongabba, Brisbane, QLD, 4102, Australia
| | - Pierre Clement
- Department of Intensive Care Services, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia
| | - Kevin B Laupland
- Queensland University of Technology (QUT), Brisbane, QLD, Australia
- Department of Intensive Care Services, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia
| | - Emily See
- School of Medicine, University of Melbourne, Melbourne, Australia
- Department of Critical Care, University of Melbourne, Melbourne, Australia
- Department of Intensive Care, Austin Hospital, Heidelberg, Australia
- Department of Nephrology, The Royal Melbourne Hospital, Parkville, Australia
- Department of Nephrology, The Royal Children's Hospital, Parkville, Australia
| | - James McCullough
- Intensive Care Unit, Gold Coast University Hospital, Southport, QLD, Australia
| | - Hayden White
- Intensive Care Unit, Logan Hospital, Logan, QLD, Australia
- School of Medicine and Dentistry, Griffith University, Mount Gravatt, QLD, Australia
| | - Kiran Shekar
- Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia
- Queensland University of Technology (QUT), Brisbane, QLD, Australia
- Adult Intensive Care Services, The Prince Charles Hospital, Brisbane, QLD, Australia
| | - Alexis Tabah
- Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia
- Queensland University of Technology (QUT), Brisbane, QLD, Australia
- Intensive Care Unit, Redcliffe Hospital, Brisbane, QLD, Australia
| | - Mahesh Ramanan
- Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia
- Intensive Care Unit, Caboolture Hospital, Caboolture, QLD, Australia
- Critical Care Division, The George Institute for Global Health, University of New South Wales, Sydney, Australia
| | - Peter Garrett
- Department of Critical Care Medicine, Hospital Israelita Albert Einstein, São Paulo, Brazil
- Intensive Care Unit, Sunshine Coast University Hospital, Birtinya, QLD, Australia
| | - Antony G Attokaran
- Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia
- Intensive Care Unit, Rockhampton Hospital, The Range, QLD, Australia
| | - Stephen Luke
- Intensive Care Services, Mackay Base Hospital, Mackay, QLD, Australia
- College of Medicine and Dentistry, James Cook University, Townsville, QLD, Australia
| | - Siva Senthuran
- College of Medicine and Dentistry, James Cook University, Townsville, QLD, Australia
- Intensive Care Unit, Townsville Hospital, Townsville, QLD, Australia
| | | | - Rinaldo Bellomo
- Australian and New Zealand Intensive Care Research Centre (ANZIC-RC), School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
- Department of Critical Care, University of Melbourne, Melbourne, Australia
- Department of Intensive Care, Austin Hospital, Heidelberg, Australia
- Department of Intensive Care,, Royal Melbourne Hospital, Melbourne, Australia
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7
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Joannidis M, Meersch-Dini M, Forni LG. Acute kidney injury. Intensive Care Med 2023; 49:665-668. [PMID: 37071135 DOI: 10.1007/s00134-023-07061-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Accepted: 03/28/2023] [Indexed: 04/19/2023]
Affiliation(s)
- Michael Joannidis
- Division of Intensive Care and Emergency Medicine, Department of Internal Medicine, Medical University Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria.
| | - Melanie Meersch-Dini
- Department of Anesthesiology, Intensive Care and Pain Medicine, University Hospital Münster, Münster, Germany
| | - Lui G Forni
- Department of Critical Care, Royal Surrey Hospital Foundation Trust, Guildford, Surrey, UK
- Faculty of Health Sciences, University of Surrey, Guildford, Surrey, UK
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