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1. Pharmacokinetics of Intraperitoneal Vancomycin and Amikacin in Automated Peritoneal Dialysis Patients With Peritonitis

Author

dos Reis, Pâmela Falbo, Barretti, Pasqual, Marinho, Laudilene, Balbi, Andre Luís, Awdishu, Linda, and Ponce, Daniela

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Oncology and Carcinogenesis, peritonitis, peritoneal dialiysis, amikacin, vancomicyn, pharmacokinetics, Pharmacology and Pharmaceutical Sciences, Pharmacology and pharmaceutical sciences
Abstract

Objective: The study aimed to evaluate the vancomycin and amikacin concentrations in serum and dialysate for automatic peritoneal dialysis (APD) patients. Methods: A total of 558 serum and dialysate samples of 12 episodes of gram-positive and 18 episodes of gram-negative peritonitis were included to investigate the relationship between vancomycin and amikacin concentrations in serum and dialysate on the first and third days of treatment. Samples were analysed 30, 120 min, and 48 h after intraperitoneal administration of vancomycin in peritonitis caused by gram-positive agents and 30, 120 min, and 24 h after intraperitoneal administration of amikacin in peritonitis caused by gram-negative agents. Vancomycin was administered every 72 h and amikacin once a day. The target therapeutic concentration of amikacin was 25-35 mg/l at the peak moment and 4-8 mg/l at the trough moment; and after 48 h for vancomycin, 15-20 mg/l at the trough moment. Results: For peritonitis caused by gram-negative agents, at the peak moment, therapeutic levels of amikacin were reached in dialysate in 80.7% of patients with evolution to cure and in 50% of patients evaluated as non-cure (p = 0.05). At the trough moment, only 38% were in therapeutic concentrations in the dialysate in the cure group and 42.8% in the non-cure group (p = 1). Peak plasma concentrations were subtherapeutic in 98.4% of the samples in the cure group and in 100% of the non-cure group. At the trough moment, therapeutic concentrations were present in 74.4% of the cure group and 71.4% of the non-cure group (p = 1). Regarding vancomycin and among gram-positive agents, therapeutic levels were reached at the peak moment in 94% of the cure group and 6% of the non-cure group (p = 0.007). After 48 h, 56.8% of the cure group had a therapeutic serum concentration whereas for the non-cure group it was only 33.3% (p = 0.39). Conclusion: Despite a small sample size, we demonstrated peak dialysate amikacin level and peak serum vancomycin level correlates well with Gram-negative and Gram positve peritonitis cure, respectively. It is suggested to study the antibiotics pharmacodynamics for a better understanding of therapeutic success in a larger sample.

Published
2021

2. Pharmacokinetics of Intraperitoneal Vancomycin and Amikacin in Automated Peritoneal Dialysis Patients With Peritonitis.

Author

Falbo Dos Reis, Pâmela, Barretti, Pasqual, Marinho, Laudilene, Balbi, Andre Luís, Awdishu, Linda, and Ponce, Daniela

Subjects
amikacin, peritoneal dialiysis, peritonitis, pharmacokinetics, vancomicyn, Pharmacology and Pharmaceutical Sciences
Abstract

Objective: The study aimed to evaluate the vancomycin and amikacin concentrations in serum and dialysate for automatic peritoneal dialysis (APD) patients. Methods: A total of 558 serum and dialysate samples of 12 episodes of gram-positive and 18 episodes of gram-negative peritonitis were included to investigate the relationship between vancomycin and amikacin concentrations in serum and dialysate on the first and third days of treatment. Samples were analysed 30, 120 min, and 48 h after intraperitoneal administration of vancomycin in peritonitis caused by gram-positive agents and 30, 120 min, and 24 h after intraperitoneal administration of amikacin in peritonitis caused by gram-negative agents. Vancomycin was administered every 72 h and amikacin once a day. The target therapeutic concentration of amikacin was 25-35 mg/l at the peak moment and 4-8 mg/l at the trough moment; and after 48 h for vancomycin, 15-20 mg/l at the trough moment. Results: For peritonitis caused by gram-negative agents, at the peak moment, therapeutic levels of amikacin were reached in dialysate in 80.7% of patients with evolution to cure and in 50% of patients evaluated as non-cure (p = 0.05). At the trough moment, only 38% were in therapeutic concentrations in the dialysate in the cure group and 42.8% in the non-cure group (p = 1). Peak plasma concentrations were subtherapeutic in 98.4% of the samples in the cure group and in 100% of the non-cure group. At the trough moment, therapeutic concentrations were present in 74.4% of the cure group and 71.4% of the non-cure group (p = 1). Regarding vancomycin and among gram-positive agents, therapeutic levels were reached at the peak moment in 94% of the cure group and 6% of the non-cure group (p = 0.007). After 48 h, 56.8% of the cure group had a therapeutic serum concentration whereas for the non-cure group it was only 33.3% (p = 0.39). Conclusion: Despite a small sample size, we demonstrated peak dialysate amikacin level and peak serum vancomycin level correlates well with Gram-negative and Gram positve peritonitis cure, respectively. It is suggested to study the antibiotics pharmacodynamics for a better understanding of therapeutic success in a larger sample.

Published
2021

8. Successful Liberation from Acute Kidney Replacement Therapy in Critically Ill Patients: A Prospective Cohort Study.

Author

Suarez, Maria Irma Rodriguez, Ohara, Cristine Naomi, Kitawara, Koody Andre Hassemi, Zamoner, Welder, Balbi, Andre Luis, and Ponce, Daniela

Subjects
RENAL replacement therapy, CRITICALLY ill, COHORT analysis, LONGITUDINAL method, LOGISTIC regression analysis
Abstract

Introduction: Recovery of kidney function to liberate patients from acute kidney replacement therapy (AKRT) is recognized as a vital patient-centered outcome. The lack of specific guidelines providing specific recommendations on therapy interruption is an important obstacle. We aimed to determine the prevalence of successful discontinuation of AKRT and its predictive factors after the elaboration of clinical protocol with these recommendations. Methodology: A prospective cohort study was performed with 156 patients at a public Brazilian university hospital between July 2020 and July 2021. Results: Success and hospital discharge were achieved for most patients (84.6% and 89%, respectively). Multivariable logistic regression analysis showed that C-reactive protein (CRP), urine output, and creatinine clearance at the time of interruption were variables associated with discontinuation success (OR: 0.943, CI: 0.905–0.983, p = 0.006; OR: 1.078, CI: 1.008–1.173, p = 0.009 and OR: 1.091, CI: 1.012–1.213, p = 0.004; respectively). The areas under the curve for CRP, urine output, and creatinine clearance at the time of interruption were 0.78, 0.62, and 0.82, respectively. Both CRP and creatinine clearance were good predictors of successful liberation of AKRT. The optimal cutoff value of them had sensitivity and specificity of 0.88 and 0.87, 0.91 and 0.90, respectively. The use of noradrenalin at the time of interruption (OR: 0.143, CI: 0.047–0.441, p = 0.001) and successful discontinuation (OR: 3.745, CI: 1.047–13.393, p = 0.042) were identified as variables associated with hospital discharge. Conclusion: Our results show the factors related to success in discontinuing AKRT are the CRP, creatinine clearances, and urinary output at the time of AKRT interruption and it was associated with lower mortality. [ABSTRACT FROM AUTHOR]

Published
2024
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24. Colaboradores

Author

Melgar, Ángel Alonso, Miani, Pablo Amair, Iraola, Gema Ariceta, Rodulfo, J. Ildefonzo Arocha, Lezama, Javier Arrieta, Palma, Harold Ismael Ayala, Rubio, María Auxiliadora Bajo, Balbi, André Luis, Castellanos, Loreley Ana Betancourt, Ortega, Saioa Bilbao, Cabañas, Concepción Blasco, Sans, Mercè Borràs, Brandão, Fausto S., Fuster, Juan Manuel Buades, Cannata-Andía, Jorge B., Martínez, Araceli Caro, Carrero, Juan Jesús, Carrillo-López, Natalia, García, Diego Casas, Delgado, José Ignacio Cornago, Díaz, Francisco Coronel, Correa-Rotter, Ricardo, Sanabria, Laura Cortés, Hospital, Lourdes Craver, Manzano, Alfonso M. Cueto, Fernandes, Natália Maria da Silva, González, Mª Ángeles Daza, López, Edgar Dehesa, Gilsanz, Gloria del Peso, Espinosa-Cuevas, María de los Ángeles, Prado, Encarnación Fernández, Fonseca-Correa, Jorge I., Arnold, Cristina Fragío, Ríos, Francisco Javier Gainza de los, Múgica, María Galán, Massignan, Bianca Garcez, Erauzkin, Gorka García, Ledesma, Paula García, García-Llana, Helena, Martínez, Júlia Garro, Cunquero, José Manuel Gil, Casanova, Beatriz Gil-Casares, Bedat, María Carlota González, Cabrera, Fayna González, Peña, Olga González, Rico, Miguel González, Ríos, Carmen María González, Teruel, José Luis Górriz, Martínez, Eduardo Gutiérrez, García, Esther Hernández, Santana, Sergio Raúl Irízar, Heffernan, José A. Jiménez, García, Isabel Juan, Luengo, Manuel Lanuza, Santos, Juan Pablo Leiva, Lobbedez, Thierry, Cabrera, Manuel López, López-Gómez, Juan M., Canals, Francisco Maduell, Robayna, Silvia Marrero, Martin-Cleary, Catalina, Castelao, Alberto Martínez, Losa, Adoración Martínez, Calonge, Victorio Menoyo, Pesquera, José Ignacio Minguela, Martínez, Isabel Montenegro, Martínez, Jesús Montenegro, Ruiz, Enrique Morales, Silva, Jesús Eduardo Muñoz, Musso, Carlos Guido, Seijas, José Andrés Octavio, Arduan, Alberto Ortiz, González, Marta Ossorio, Gómez, Victoria Oviedo, Acero, Jesús Ángel Padierna, Panizo-García, Sara, Filho, Roberto Pecoits, Díaz, Vicente Pérez, Fontán, Miguel Pérez, García, Rafael Pérez, Petraglia, Lucas, Gabriel, Daniela Ponce, Clemente, Esther Ponz, Pérez, José M. Portolés, Velasco, Mario Alfredo Prieto, Moraes, Thyago Proença de, Montesa, María Jesús Puchades, Ganga, Pedro Luis Quirós, Rodríguez, César Remón, Riella, Miguel Carlos, Gorrín, Maite Rivera, Benítez, María Patrocinio Rodríguez, Suárez, Carmen Rodríguez, Rodríguez-Carmona de la Torre, Ana, Campos, Enrique Rojas, Díez, Guillermo Rosa, Álvarez, José Emilio Sánchez, García, Luisa Sánchez, González, Carmen Sánchez, Hernández, Rosa Sánchez, Moreno, Ana Sánchez, Rotaeche, Ramón Saracho, Morena, Julián Segura de la, Gutiérrez, Rafael Selgas, Solís Salguero, Miguel Ángel, Marenco, Mercedes Tejuca, Molina, Fernando Tornero, Romero, Fernando Tornero, Maicas, Isidro Torregrosa, Torres, Pablo Ureña, Díaz, Nicanor Jesús Vega, and Rivera, Manel Vera

Published
2021
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27. Acute kidney injury: risk factors and management challenges in developing countries

Author

Ponce, Daniela and Balbi,Andre

Subjects
urogenital system, International Journal of Nephrology and Renovascular Disease, urologic and male genital diseases, female genital diseases and pregnancy complications
Abstract

Daniela Ponce,Andre Balbi Department of Medicine, Botucatu School of Medicine, Sao Paulo, Brazil Abstract: Acute kidney injury (AKI) is a major global health problem in both developed and developing nations, negatively affecting patient morbidity and responsible for an estimated 1.4 million deaths per year. Although the International Society of Nephrology set a goal of eliminating preventable deaths from AKI by 2025, implementation of this program in developing countries presents major challenges not only because of the lack of resources but also because of the scarce data addressing the epidemiology and causes of AKI in developing countries, the limited health care resources to diagnose and treat AKI, and the poor awareness of the impact of AKI on patient outcomes. Keywords: acute kidney injury, developing world, treatment

Published
2016

31. The long-term outcome after acute kidney injury: a narrative review

Author

Pôncio, Luana, Balbi, Andre Luis, Rocha, Érica Pires da, Dias, Dayana Bitencourt, and Ponce, Daniela

Subjects
clinical evolution, mortalidade, acute kidney injury, fatal outcome, evolução fatal, recovery of function, evolução clínica, urologic and male genital diseases, lesão renal aguda, recuperação de função fisiológica, mortality
Abstract

This review will focus on long-term outcomes after acute kidney injury (AKI). Surviving AKI patients have a higher late mortality compared with those admitted without AKI. Recent studies have claimed that long-term mortality in patients after AKI varied from 15% to 74% and older age, presence of previous co-morbidities, and the incomplete recovery of renal function have been identified as risk factors for reduced survival. AKI is also associated with progression to chronic kidney (CKD) disease and the decline of renal function at hospital discharge and the number and severity of AKI episodes have been associated with progression to CKD. IN the most studies, recovery of renal function is defined as non-dependence on renal replacement therapy which is probably too simplistic and it is expected in 60-70% of survivors by 90 days. Further studies are needed to explore the long-term prognosis of AKI patients. Esta revisão tem como objetivo focar o prognóstico em longo prazo de pacientes após episódio de lesão renal aguda (LRA). Pacientes sobreviventes à LRA apresentam maior mortalidade tardia quando comparados com aqueles internados sem LRA. Estudos recentes mostram mortalidade em logo prazo após LRA entre 15 e 74% e, de modo geral, são fatores que contribuem para essa mortalidade a idade avançada, a presença de comorbidades preexistentes e a recuperação incompleta da função renal. LRA também está associada com evolução para doença renal crônica, sendo a queda de função renal na alta hospitalar e número e intensidade dos episódios de LRA fatores associados com a evolução para DRC. A recuperação da função renal é definida pela maioria dos estudos como a não dependência de diálise e ocorre em 60 a 70% dos pacientes em até 90 dias. Futuros estudos são necessários para explorar o prognóstico tardio desses pacientes.

Published
2015

32. Acute kidney injury: risk factors and management challenges in developing countries

Author

Ponce,Daniela, Balbi,Andre, Ponce,Daniela, and Balbi,Andre

Abstract

Daniela Ponce, Andre Balbi Department of Medicine, Botucatu School of Medicine, Sao Paulo, Brazil Abstract: Acute kidney injury (AKI) is a major global health problem in both developed and developing nations, negatively affecting patient morbidity and responsible for an estimated 1.4 million deaths per year. Although the International Society of Nephrology set a goal of eliminating preventable deaths from AKI by 2025, implementation of this program in developing countries presents major challenges not only because of the lack of resources but also because of the scarce data addressing the epidemiology and causes of AKI in developing countries, the limited health care resources to diagnose and treat AKI, and the poor awareness of the impact of AKI on patient outcomes. Keywords: acute kidney injury, developing world, treatment

Published
2016

39. Acute PD: Evidence, Guidelines, and Controversies☆.

Author

Ponce, Daniela, Balbi, Andre, and Cullis, Brett

Subjects
TREATMENT of acute kidney failure, HEMODIALYSIS, MEDICAL protocols, PERITONEAL dialysis, TREATMENT effectiveness
Abstract

Peritoneal dialysis (PD) may be a feasible, safe, and complementary alternative to hemodialysis not only in the chronic setting, but also in the acute setting. It previously was widely accepted for acute kidney injury (AKI) treatment, but its practice decreased in favor of other types of extracorporeal therapies. The interest in PD to manage AKI patients has been reignited and PD now frequently is used in developing countries because of its lower cost and minimal infrastructural requirements. Studies from these countries have shown that, with careful thought and planning, critically ill patients can be treated successfully using PD. Some of the classic limitations of PD use in AKI, such as a high chance of infectious and mechanical complications and poor metabolic control, have been overcome with the use of cyclers, flexible catheters, and a high volume of dialysis fluid. However, in developing countries the infrastructure for quality research often is lacking and the result has been limited evidence on standardized treatment regimens such as indications, dosing, and technical failure and mortality. The recent publication of the International Society for Peritoneal Dialysis guidelines for PD in AKI have tried to address these issues and provide an evidence-based standard by which to initiate therapy. In this article, advances in technical aspects and the advantages and limitations of PD are discussed, and recent literature on clinical experience with PD for the treatment of AKI patients is reviewed. [ABSTRACT FROM AUTHOR]

Published
2017
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41. Peritoneal Dialysis for Acute Kidney Injury

Author

Cullis, Brett, primary, Abdelraheem, Mohamed, additional, Abrahams, Georgi, additional, Balbi, Andre, additional, Cruz, Dinna N., additional, Frishberg, Yaacov, additional, Koch, Vera, additional, McCulloch, Mignon, additional, Numanoglu, Alp, additional, Nourse, Peter, additional, Pecoits-Filho, Roberto, additional, Ponce, Daniela, additional, Warady, Bradley, additional, Yeates, Karen, additional, and Finkelstein, Fredric O., additional

Published
2014
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49. Contributors

Author

Abaterusso, Cataldo, Ahern, Stéphane P., Aisa, Maria Cristina, Albright, Robert C., Jr., Alfaro, Vicente, Al-Khafaji, Ali, Allo, Jean-Christophe, Amerling, Richard, Amore, Alessandro, Anderson, Robert J., Andreucci, Michele, Andreucci, Vittorio E., Andrikos, Emilios, Arroyo, Vicente, Arthur, John M., Ash, Stephen R., Assanelli, Emilio, Aucella, Filippo, Bagshaw, Sean M., Balafa, Olga, Balbi, André Luís, Baldwin, Ian, Ballestri, Marco, Bargman, Joanne M., Barletta, Gina-Marie, Barletta, Jeffrey F., Barozzi, Libero, Barsoum, Rashad S., Beaulieu, Monica, Beer-Stolz, Donna, Bellomo, Rinaldo, Bernardo, Jose, Bertolotto, Michele, Bestoso, John T., Betro, Gerard A., Bhattacharya, Mallar, Bihl, Geoffrey R., Blot, Stijn I., Boer, Willem, Boim, Mirian A., Bonello, Monica, Bonventre, Joseph V., Booth, A.D., Bourke, Edmund, Braitberg, George, Brancaccio, Diego, Brendolan, Alessandra, Brezzi, Brigida, Brodie, James C., Brophy, Patrick D., Brown, Ryan, Bucala, Richard, Buckmaster, Jonathan, Budisavljevic, Milos N., Bunchman, Timothy E., Burdmann, Emmanuel A., Bussolati, Benedetta, Butkus, Matthew A., Buzzelli, Daniela, Calzavacca, Paolo, Camussi, Giovanni, Canaud, Bernard, Cano, Noël J.M., Cantaluppi, Vincenzo, Capasso, Giovambattista, Cappelli, Gianni, Carlesso, Eleonora, Casino, Francesco G., Castillo, Leticia, Cerutti, Roberta, Chawla, Lakhmir S., Chionh, Chang Yin, Chiu, Alexander, Chow, May T., Chugh, Kirpal S., Cianciaruso, Bruno, Cignarelli, Mauro, Claessens, Yann-Erick, Clark, John A., Clark, William R., Cohen, David J., Cohen, Scott D., Constable, Peter, Coppo, Rosanna, Corey, Howard E., Cozzolino, Mario, Craig, Maureen, Cramer, Carl H., II, Crandall, Mark, Cravedi, Paolo, Crepaldi, Carlo, Crew, R. John, Cronin, Donald F., Cruz, Dinna N., Canton, Antonio Dal, Dan, Maurizio, D'Angelo, Angela, Davenport, Andrew, Davies, Andrew R., Dear, James W., Gasperi, Andrea De, Dell'Aquila, Roberto, Rocca, Giorgio Della, Prete, Dorella Del, Delude, Russell L., Depner, Thomas, Derchi, Lorenzo E., Devarajan, Prasad, Waele, Jan J. De, Dhainaut, Jean-François, Diaz-Buxo, José A., Micco, Lucia Di, Divino-Filho, José Carolina, Doernberg, Sarah, Doig, Gordon S., Dries, David J., Drudi, Francesco Maria, Druml, Wilfred, Duke, Graeme, Durward, Andrew, Egi, Moritoki, Esposito, Ciro, Evenepoel, Pieter, Faga, Teresa, Fan, Sheung Tat, Feinfeld, Donald A., Féraille, Eric, Fernández, Javier, Finfer, Simon, Fink, Mitchell P., Finkel, Kevin W., Flessner, Michael F., Formica, Marco, Forni, Lui G., Fortenberry, James D., French, Craig, Fumagalli, Roberto, Furlanut, Mario, Fute, Micheline Djouguela, Gabriel, Daniela Ponce, Galassi, Andrea, Galbusera, Miriam, Galli, Francesco, Galli, Giovanni, Gallieni, Maurizio, Gallo, Giampiero, Gambaro, Giovanni, Gammill, Hilary S., Gangemi, Ezio Nicola, Gao, Dayong, Garwood, Susan, Garzotto, Francesco, Gatti, Antonietta M., Gattinoni, Luciano, Geibel, John P., George, Stephen, Gesualdo, Loreto, Gibney, R.T. Noel, Gipson, Debbie S., Glezerman, Ilya G., Glorieux, Griet, Goldstein, Stuart L., Golper, Thomas A., Gowrishankar, Manjula, Grandi, Fabio, Gregoretti, Cesare, Grinnell, Brian W., Groeneveld, A.B. Johan, Gruber, Steven J., Guadagni, Gualtiero, Gunnerson, Kyle J., Gupta, Akanksha, Gura, Victor, Guzzo, Isabella, Hackbarth, Richard, Halperin, Mitchell L., Harbord, Nikolas, Haymann, Jean-Philippe, Heffner, Alan C., Hennessy, Anthony J., Heyman, Samuel N., Hill, Graham L., Hilton, Philip J., Himmelfarb, Jonathan, Hirasawa, Hiroyuki, Hoenich, Nicholas A., Holdsworth, Stephen R., Holley, Anthony, Honoré, Patrick M., Hoste, Eric A.J., House, Andrew A., Huang, David T., Huang, Zhongping, Hubmayr, Rolf D., Hughes, Alun D., Humes, H. David, Ikizler, T. Alp, Imberti, Barbara, Ing, Todd S., Jaber, Bertrand L., Janvier, Gérard, Jeyabalan, Arundhathi, Jha, Vivekanand, Joannes-Boyau, Olivier, Joannidis, Michael, Jones, Daryl A., Jörres, Achim, Kamel, Kamel S., Kamp, Ryan C., Kannan, Neeta, Kaplan, Lewis J., Karacan, Özgür, Karajala-Subramanyam, Vijay, Kaushal, Gur P., Kellum, John A., Kemper, Markus J., Khan, Asjad, Khanna, Ramesh, Kher, Vijay, Kimmel, Paul L., Kindgen-Milles, Detlef, Kitching, A. Richard, Kjellstrand, Carl M., Kohn, Orly F., Kooienga, Laura A., Kooman, Jeroen P., Kotanko, Peter, Krediet, Raymond T., Kroon, A.A., Kuang, Dingwei, Kuhlmann, Martin K., Kuiper, Jan Willem, Lam, Man-Fai, Lamacchia, Olga, Lameire, Norbert, Langenberg, Christoph, Lauri, Gianfranco, Leblanc, Martine, Ledebo, Ingrid, Lentini, Paolo, Leonard, Edward F., Letteri, Jeffrey J., Leunissen, Karel M., Leverve, Xavier M., Levin, Adeera, Leypoldt, John K., Liangos, Orfeas, Licari, Elisa, Lieberthal, Wilfred, Linden, Peter K., Lipman, Jeffrey, Liu, Kathleen D., Liu, Shiguang, Livigni, Sergio, Lo, Wai-Kei, Lugano, Manuela, Lui, Sing-Leung, Lupo, Antonio, Luyckx, Valerie A., Macias, William L., Madden, Nicholas, Madore, François, Majors, Daniel S., Mancini, Elena, Mangione, Filippo, Mankad, Sunil, Manzini, Pier Paolo, Marangella, Martino, Marenzi, Giancarlo, Mariano, Filippo, Marik, Paul E., Marini, John J., Marquis, François, Marshall, John C., Marshall, Mark R., Mathew, Roy, Matsuda, Kenichi, Matthay, Michael A., Maxvold, Norma J., May, Clive N., McCauley, Jerry, McCunn, Maureen, McKenna, Joseph, Mehta, Ravindra L., Mele, Caterina, Merouani, Aicha, Mesnard, Laurent, Messa, Piergiorgio, Metnitz, Philipp G.H., Misra, Madhukar, Mitzner, Steffen R., Mizock, Barry A., Mokhlesi, Babak, Molitoris, Bruce A., Morelli, Andrea, Morgan, Thomas John, Morigi, Marina, Mount, Peter, Mucelli, Roberto Pozzi, Mueller, Bruce A., Murray, Patrick, Murugan, Raghavan, Nakamura, Masataka, Nalesso, Federico, Nester, Carla M., Nissenson, Allen, Nolph, Karl, Ocampo, Catalina, Oda, Shigeto, Okusa, Mark D., Opal, Steven M., Opdam, Helen, Osswald, Hartmut, Straaten, Heleen M. Oudemans–van, Padalino, Massimo A., Paden, Matthew L., Paganini, Emil P., Palevsky, Paul M., Panat, Mani John, Paolini, Francesco, Parikh, Dipen, Patroniti, Nicolò, Pavlica, Pietro, de La Garanderie, Didier Payen, Pea, Federico, Peng, Zhiyong, Perazella, Mark A., Perego, Angelo F., Pereira, Estela Regina, Pérez, Evans R. Fernández, Perico, Norberto, Pertica, Nicoletta, Pertosa, Giovanni, Peruzzi, Licia, Petras, Dimitris, Pham, Phuong-Chi, Pham, Phuong-Thu, Phoon, Richard K.S., Picca, Stefano, Piccinni, Pasquale, Pinsk, Maury N., Pinsky, Michael R., Piroddi, Marta, Plamondon, Isabelle, Plank, Lindsay D., Plötz, Frans B., Poghosyan, Lusine, Polanco, Natalia, Polanco, Patricio M., Polaschegg, Hans Dietrich, Ponikvar, Rafael, Porecca, Silvia, Portilla, Didier, Powell, T. Brian, Quigley, Raymond, Rabb, Hamid, Ragaller, Maximilian, Rampino, Teresa, Ranpuria, Reena, Rastogi, Anjay, Ratanarat, Ranistha, Raza, Naem, Reade, Michael C., Reeves, John H., Reiter, Karl, Remuzzi, Giuseppe, Ricci, Zaccaria, Ricksten, Sven-Erik, Ridel, Christophe, Rifai, Kinan, Ring, Troels, Riopel, Julie, Rocha, Eduardo, Roessler, Eric, Rona, Roberto, Ronco, Claudio, Rondeau, Eric, Rosen, Seymour, Rosenberger, Christian, Rowan, Shane, Roy, Thomas, Saab, Georges, Sadahiro, Tomohito, Sala, Carla, Sala, Chiara, Salama, Alan D., Salmon, Adrian, Salvatori, Gabriela, Sam, Ramin, Sandoval, Ruben M., Santoro, Antonio, Saotome, Takao, Sappington, Penny L., Sarma, J. Vidya, Savige, Judy, Schena, Francesco Paolo, Schepers, Eva, Schetz, Miet, Schmidt, Gregory A., Schor, Nestor, Schusterschitz, Nicola, Segoloni, Giuseppe, Shah, Nirva, Shah, Shamik H., Shah, Sudhir V., Sharfuddin, Asif A., Shaw, Andrew, Shiga, Hidetoshi, Shoji, Hisataka, Shukla, Ashutosh, Simpson, Fiona, Singbartl, Kai, Singer, Mervyn, Solez, Kim, Sowinski, Kevin M., Stafford-Smith, Mark, Stange, Jan, Stefanelli, Luca, Stein, Deborah M., Stella, Maurizio, Stellin, Giovanni, Story, David A., Subramanian, Sanjay, Swärd, Kristina, Symons, Jordan M., Tai, Kian Bun, Tattersall, James, Tedeschi, Luisa, Teitelbaum, Isaac, Teixeira, Vicente P. Castro, Tetta, Ciro, Thakar, Charuhas V., Theilen, Hermann, Thomas, Karl W., Tolwani, Ashita, Trepiccione, Francesco, Triolo, Giorgio, Tsang, Jennifer L.Y., Tutal, Emre, Uchino, Shigehiko, Unruh, Mark, Vail, G. Matthew, Valentino, Massimo, Vallon, Volker, Van Biesen, Wim, van der Sande, Frank M., Vandijck, Dominique M., Vanholder, Raymond, Varghese, Sanju A., Venkataraman, Ramesh, Venkatesh, Bala, Verbine, Anton, Vincent, Jean-Louis, Vinsonneau, Christophe, Visvanathan, Ravindran, Voinescu, Alexandra, Walters, Scott, Wan, Li, Ward, Peter A., Ward, Richard A., Warrillow, Stephen, Webb, Steve, Whitlow, Kenneth Scott, Wieslander, Anders, Wilkinson, Alan H., Wille, Keith, Winchester, James Frank, Wu, Christine, Yassin, James, Yeun, Jane Y., Yip, Terence Pok-Siu, Yu, Alex W., Zacchia, Miriam, Zaida, Najam, Zamperetti, Nereo, Zappitelli, Michael, and Zarbock, Alexander

Published
2009
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50. Acute Renal Failure in Renal Allograft Recipients and Patients with Native Kidneys

Author

Carvalho, Maria Fernanda Cordeiro, Barretti, Pasqual, Inuzuka, Luciana Midori, Sueto, Milena, Nishimura, Marcia Regina, Caramori, Jaqueline Costa Teixeira, Balbi, Andre Luis, Correa, Luiz Antonio, and Soares, Vitor Augusto

Abstract

In order to evaluate the role of underlying disease in the high mortality observed in acute renal failure (ARF) and risk factors related to the development of oliguric ARF in renal allograft recipients, two groups were selected: 34 patients with native kidneys, aged 16 and 57 years, and presenting ischemic ARF caused by cardiovascular collapse, with no signs of infection at the time of diagnosis; and 34 renal allograft recipients who developed ARF immediately after transplantation, without rejection. ARF was defined either as 30% increase of basal plasmatic creatinine in patients with native kidneys or non-normalization of plasmatic creatinine at day 5 after transplantation in renal allograft recipients; oliguria as diuresis ≤ 400 mL/24 h. There were no differences in age, male frequency, oliguria presence and duration, need for dialysis, and infection episodes for renal allograft recipients and patients with native kidneys. The development of sepsis (3% and 41%) and death rate (3% and 44%) were higher in patients with native kidneys (p < 0.01). The renal allograft recipients with both oliguric (n = 18) and nonoliguric (n = 16) ARF were evaluated and no difference was observed in the recipient's age, donor's age, cold ischemia time, time elapsed until plasmatic creatinine normalization, donor's plasmatic creatinine or urea, and mean arterial pressure. No differences were observed between the groups regarding frequency of infection episodes during ARF and frequency of death. In conclusion, renal allograft recipients presented a lower death rate and were less susceptible to sepsis. Cold ischemia time, age, and hemodynamic characteristics of the donor did not affect the development of oliguria.

Published
1997
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