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Srisawat N, Lumlertgul N, Kulvichit W, Thamrongsat N, Peerapornratana S, Eiam-Ong S, Tungsanga K. Diagnostic Challenges of Acute Kidney Injury in Asia. Semin Nephrol 2020; 40:468-476. [PMID: 33334460 DOI: 10.1016/j.semnephrol.2020.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Early diagnosis of acute kidney injury (AKI) is an important step to improve AKI outcome. In Asia, several distinct conditions of this region such as environment (tropical climate), socioeconomic status (high-resource and low-resource settings), process of care (shortage of nephrologists), exposure factors (specific tropical infections such as leptospirosis, malaria, dengue), and inherent factor (aging) make the diagnosis of AKI in Asia more challenging than in other parts of the world. To improve the diagnosis of AKI, novel tools such as clinical risk scores, AKI alert systems, and telemedicine should be implemented into current clinical practice.
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Affiliation(s)
- Nattachai Srisawat
- Division of Nephrology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, Bangkok, Thailand; Center for Critical Care Nephrology, The Clinical Research, Investigation, and Systems Modeling of Acute Illness Center, Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania; Research Unit in Critical Care Nephrology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; Academy of Science, Royal Society of Thailand, Bangkok, Thailand; Tropical Medicine Cluster, Chulalongkorn University, Bangkok, Thailand.
| | - Nuttha Lumlertgul
- Division of Nephrology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, Bangkok, Thailand; Research Unit in Critical Care Nephrology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; Tropical Medicine Cluster, Chulalongkorn University, Bangkok, Thailand
| | - Win Kulvichit
- Division of Nephrology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, Bangkok, Thailand; Center for Critical Care Nephrology, The Clinical Research, Investigation, and Systems Modeling of Acute Illness Center, Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania; Research Unit in Critical Care Nephrology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; Tropical Medicine Cluster, Chulalongkorn University, Bangkok, Thailand
| | - Nicha Thamrongsat
- Division of Nephrology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| | - Sadudee Peerapornratana
- Division of Nephrology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, Bangkok, Thailand; Center for Critical Care Nephrology, The Clinical Research, Investigation, and Systems Modeling of Acute Illness Center, Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania; Research Unit in Critical Care Nephrology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; Tropical Medicine Cluster, Chulalongkorn University, Bangkok, Thailand
| | - Somchai Eiam-Ong
- Division of Nephrology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| | - Kriang Tungsanga
- Division of Nephrology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
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Schuster AH, Reimann N. [Biopsies of kidney lesions: when and how?]. Radiologe 2018; 58:906-913. [PMID: 30291407 DOI: 10.1007/s00117-018-0459-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
The demand for image-guided renal biopsy has increased due to the better detection of renal lesions; however, despite modern imaging techniques many small renal tumors cannot be classified as benign because they cannot be differentiated from renal cell carcinoma. Ultrasound and computed tomography (CT)-guided kidney biopsy is a safe and accurate method in the diagnostics of renal lesions and can be helpful in the selection of new ablative and pharmaceutical forms of treatment and avoid unnecessary operations. This article describes the clinical indications for an image-guided biopsy and discusses factors which should be considered when performing a biopsy.
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Affiliation(s)
- A H Schuster
- Lehrabteilung der Universität Innsbruck, Abteilung Radiologie, University of Innsbruck and Medical University of Innsbruck, Landeskrankenhaus Bregenz, Akademisches Lehrkrankenhaus, Carl-Pedenz-Straße 2, 6900, Bregenz, Österreich.
| | - N Reimann
- Lehrabteilung der Universität Innsbruck, Abteilung Radiologie, University of Innsbruck and Medical University of Innsbruck, Landeskrankenhaus Bregenz, Akademisches Lehrkrankenhaus, Carl-Pedenz-Straße 2, 6900, Bregenz, Österreich
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Cerdá J, Mohan S, Garcia-Garcia G, Jha V, Samavedam S, Gowrishankar S, Bagga A, Chakravarthi R, Mehta R. Acute Kidney Injury Recognition in Low- and Middle-Income Countries. Kidney Int Rep 2017; 2:530-543. [PMID: 29034358 PMCID: PMC5637391 DOI: 10.1016/j.ekir.2017.04.009] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Acute kidney injury (AKI) is increasingly common around the world. Because of the low availability of effective therapies and resource limitations, early preventive and therapeutic measures are essential to decrease morbidity, mortality, and cost. Timely recognition and diagnosis of AKI requires a heightened degree of suspicion in the appropriate clinical and environmental context. In low- and middle-income countries (LMICs), early detection is impaired by limited resources and low awareness. In this article, we report the consensus recommendations of the 18th Acute Dialysis Quality Initiative meeting in Hyderabad, India, on how to improve recognition of AKI. We expect these recommendations will lead to an earlier and more accurate diagnosis of AKI, and improved research to promote a better understanding of the epidemiology, etiology, and histopathology of AKI in LMICs.
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Affiliation(s)
- Jorge Cerdá
- Department of Medicine, Division of Nephrology, Albany Medical College, Albany, New York, USA
- Correspondence: Jorge Cerdá, MD, MS, FACP, FASN, Division of Nephrology, Department of Medicine, Albany Medical College, Albany, NY 12209.Division of NephrologyDepartment of MedicineAlbany Medical CollegeAlbanyNY 12209
| | - Sumit Mohan
- Department of Medicine, Columbia University College of Physicians and Surgeons, New York, New York, USA
| | - Guillermo Garcia-Garcia
- Nephrology Service, Hospital Civil de Guadalajara “Fray Antonio Alcalde,” Hospital 278, Guadalajara, Mexico
| | - Vivekanand Jha
- George Institute for Global Health India, New Delhi and University of Oxford, Oxford, UK
| | | | | | - Arvind Bagga
- Division of Nephrology, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | | | - Ravindra Mehta
- Division of Nephrology and Hypertension, Department of Medicine, University of California San Diego, San Diego, California, USA
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