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Background Acute kidney injury (AKI) is a serious complication following lung transplantation (LTx). We aimed to describe the incidence and outcomes associated with AKI following LTx. Methods A retrospective population-based cohort study of all adult recipients of LTx at the University of Alberta between 1990 and 2011. The primary outcome was AKI, defined and classified according to the Kidney Disease: Improving Global Outcomes (KDIGO) criteria, in the first 7 post-operative days. Secondary outcomes included risk factors, utilization of renal replacement therapy (RRT), occurrence of post-operative complications, mortality and kidney recovery. Results Of 445 LTx recipients included, AKI occurred in 306 (68.8%), with severity classified as Stage I in 38.9% (n = 173), Stage II in 17.5% (n = 78) and Stage III in 12.4% (n = 55). RRT was received by 36 (8.1%). Factors associated with AKI included longer duration of cardiopulmonary bypass [per minute, odds ratio (OR) 1.003; 95% confidence interval (CI), 1.001–1.006; P = 0.02], and mechanical ventilation [per hour (log-transformed), OR 5.30; 95% CI, 3.04–9.24; P < 0.001], and use of cyclosporine (OR 2.03; 95% CI, 1.13–3.64; P = 0.02). In-hospital and 1-year mortality were significantly higher in those with AKI compared with no AKI (7.2 versus 0%; adjusted P = 0.001; 14.4 versus 5.0%; adjusted P = 0.02, respectively). At 3 months, those with AKI had greater sustained loss of kidney function compared with no AKI [estimated glomerular filtration rate, mean (SD): 68.9 (25.7) versus 75.3 (22.1) mL/min/1.73 m2, P = 0.01]. Conclusions By the KDIGO definition, AKI occurred in two-thirds of patients following LTx. AKI portended greater risk of death and loss of kidney function. [ABSTRACT FROM AUTHOR]

The article focuses on the prevention of acute kidney injury (AKI) components of cardio-renal syndromes (CRS). It states that type 1 acute cardio renal failure, which is characterized by an initial abrupt change in cardiovascular function, is prevented through blood pressure control, use of beta-adrenergic blockers (BB), and avoidance of non-steroidal anti-inflammatory agents. Furthermore, type 2 chronic CRS can be prevented through optimal intake of sodium and extracellular fluid volume.

Background.There are no suitably powered epidemiological studies of ‘transient azotaemia’ (TA). The objective of this study was to describe the epidemiology of TA and its independent association with hospital mortality. We hypothesized that TA would be associated with an independent increase in the risk of death. [ABSTRACT FROM PUBLISHER]