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15. Additional file 1 of Evolution of chronic renal impairment and long-term mortality after de novo acute kidney injury in the critically ill; a Swedish multi-centre cohort study

Author

Rimes-Stigare, Claire, Frumento, Paolo, Bottai, Matteo, Mårtensson, Johan, Martling, Claes-Roland, Walther, Sten M, Karlström, Göran, and Bell, Max

Subjects
urogenital system, urologic and male genital diseases, female genital diseases and pregnancy complications
Abstract

Part A. Details of the Swedish Intensive Care Register. Part B. Summary of details of excluded cases. Table S1. Comparison of characteristics and outcome of excluded patients. Part C. Table S2. Time-specific survival probability according to acute kidney injury (AKI) status. Table S3. Time-specific probability of developing end-stage renal disease (ESRD) and chronic kidney disease (CKD) in the AKI and no-AKI groups. Table S4. Adjusted survival centiles. Figure S1. Estimates of cumulative risk of developing CKD, ESRD or of death in patients with AKI.

Published
2021
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16. Additional file 2 of Long-term mortality and risk factors for development of end-stage renal disease in critically ill patients with and without chronic kidney disease

Author

Rimes-Stigare, Claire, Frumento, Paolo, Bottai, Matteo, Mårtensson, Johan, Martling, Claes-Roland, and Bell, Max

Subjects
health services administration, mental disorders, urologic and male genital diseases
Abstract

ICD-10 codes Charlson Comorbidity renal disease. List of ICD-10 codes used in Charlson Comorbidity Index to define (moderate to severe) renal disease. (DOCX 16 kb)

Published
2021
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18. Continuous renal replacement therapy is associated with less chronic renal failure than intermittent haemodialysis after acute renal failure

Author

Bell, Max, Granath, Fredrik, Schon, Staffan, Ekbom, Anders, and Martling, Claes-Roland

Subjects
Acute renal failure -- Research -- Care and treatment, Health care industry
Abstract

Objective: Acute renal failure can be treated with continuous renal replacement therapy (CRRT) or intermittent haemodialysis (IHD). Whether this choice affects renal recovery has been debated, since it has implications on quality of life and costs. Our objective was to determine the impact of CRRT and IHD on renal recovery. Design: Nationwide retrospective cohort study between the years 1995 and 2004. Follow-up ranged between 3 months and 10 years. Setting: Thirty-two Swedish intensive care units. Patients and participants: Eligible subjects were adults treated in Swedish general intensive care units with RRT. A total of 2,642 patients from 32 ICUs were included. We then excluded patients with end-stage renal disease (252) and patients lacking a diagnosis in the in-patient register (188). Thus, 2,202 patients were studied. Follow-up was complete. Interventions: None. Measurements and results: The primary outcome was renal recovery. Secondarily we studied the mortality of the cohort. There were no differences between IHD and CRRT patients regarding baseline characteristics, such as age, sex and comorbidities. Of the 1,102 patients surviving 90 days after inclusion in the cohort, 944 (85.7%) were treated with CRRT and 158 (14.3%) were treated with IHD. Seventy-eight patients (8.3%; confidence interval, CI, 6.6-10.2), never recovered their renal function in the CRRT group. The proportion was significantly higher among IHD patients, where 26 subjects or 16.5% (CI 11.0-23.2) developed need for chronic dialysis. Conclusions: The use of CRRT is associated with better renal recovery than IHD, but mortality does not differ between the groups. Keywords Kidney failure, acute * Kidney failure, chronic * Hemodialysis * Intensive care * Outcome studies, Introduction Acute renal failure (ARF) requiring renal replacement therapy (RRT) is common in critically ill patients treated in the intensive care unit (ICU) [1]. The condition often develops as one [...]

Published
2007
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25. CKD and AKD after AKI v1

Author

Stigare, Claire, primary, Ravn, Bo, additional, Awad, Aki, additional, Torlén, Klara, additional, Bottai, Matteo, additional, Mårtensson, Johan, additional, Martling, Claes-Roland, additional, and Bell, Max, additional

Published
2017
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28. Abstracts

Author

Abdullah, Lubna H., Buchanan, K. D., Akopyan, T. N., Arzumanyan, A. M., Arutunyan, A. A., Berger, H., Oehme, P., Atkinson, M. E., Chaggar, J. S., Bailey, S. J., Featherstone, R. L., Jordan, C. C., Morton, I. K. M., Balfe, A., Skrabanek, P., Powell, D., Barja, F., Mathison, R., Huggel, H., Bittiger, H., Heid, J., Björkroth, Ulla, Rosell, Sune, Boyd, N. D., Anthony, M. P., Leeman, S. E., Briggs, I., Growcott, J. W., Jamieson, A., Tarpey, Ann V., Brodin, E., Meyerson, B. A., Brown, J. R., Hayes, A. G., Meecham, K. G., Tyers, M. B., Burcher, E., Bynke, G., Håkanson, R., Hörig, J., Cann, John R., Rahim, Iffat, Vatter, Albert, Stewart, John M., Cascieri, Margaret A., Liang, Tehming, Cheeseman, H. J., Pinnock, R. O., Henderson, G., Constantinidis, J., Bouras, C., Taban, C. H., Guntern, R., Couture, R., Cuello, A. C., Dalsgaard, C. -J., Jonsson, C. -E., Arvidsson, J., Risling, M., Hökfelt, T., Schultzberg, M., Vincent, S. R., Elfvin, L. -G., de Beaurepaire, R., Iversen, S. D., Delbro, D., Lisander, B., Fändriks, L., Andersson, S. A., Del Fiacco, M., Dessi, M. L., Levarvti, M. C., Del Rio, J., Naranjo, J. R., Domschke, S., Bloom, S. R., Adrian, T. E., Lux, G., Bryant, M. G., McGregor, G. P., Domschke, W., Donnerer, J., Barthó, L., Holzer, P., Lembeck, F., Skofitsch, G., Elliott, P. J., Bannon, M. J., Alpert, J. E., Ferri, G. -L, McGregor, G., Vezzadini, P., Labo, G., Polak, J. M., Fontaine-Perus, J. C., Chanconie, M., Foreman, J. C., Piotrowski, W., Fox, J. E. T., Daniel, E. E., Jury, J., Domoto, T., Berezin, I., Gaudino, G., Mondardini, L., Fasolo, A., Gazelius, B., Kahan, T., Panopoulos, P., Olgart, L., Gintzler, Alan R., Jaffe, Bernard M., Baron, Sheri A., GrÖnstad, K. O., Ahlman, H., Zinner, M. J., Jaffe, B. M., Yeo, C., Gu, J., Huang, W. M., lslam, K. N., Terenghi, G., Morrison, J., Güllner, H. -G., Haeusler, Guenther, Handelmann, Gail E., Selsky, Joyce H., Helme, R. D., White, D. M., Höfler, H., Heitzt, Ph. U., Auböck, L., Petsche, Ulrike, Lippe, Irmgard, Hylden, Janice L. K., Wilcox, George L., Inoue, Atsuko, Nakata, Yoshihiro, Segawa, Tomio, Jakubowska-Naziemblo, B., Potargowicz, E., Traczyk, W. Z., Cannon, D., Rohde, W., JancsÓ, G., Király, E., Karcsú, S., Szebeni, A., Bácsy, E., Jones, R. S. G., Olpe, H. -R., Wrightt, D. M., Jurna, I., Kerdelhué, B., Lenoir, V., Pasqualini, C., El Abed, A., Morel, G., Dubois, P., Hublot, P., Tartar, A., Klingmúller, D., Waltz, C., Kramer, H. J., Koop, H., Luster, W., Gropp, C., Havemenn, K., Arnold, R., Krause, James E., McKelvy, Jeffrey F., Krivoy, W., Couch, J., Strand, F., Leander, S., Folkers, K., Lee, C. M., Snyder, S. H., Lindberg, P., Dahlström, A., Lundberg, J. M., Lindefors, N., Ungerstedt, U., Liu-Chen, L. -Y., Liszczak, T., Mayberg, M. R., Moskowitz, M. A., Lundberg, Jan M., Saria, Alois, Brodin, Ernst, Martling, Claes-Roland, Hökfelt, Tomas, Lundblad, Lars, Änggård, Anders, McGeeney, K. F., O'Donnell, M. D., Blank, M. A., Manolas, K., Linger, W. G., Allen, J. M., Maggio, J. E., Sandberg, B. E. B., Bradley, C. V., Iversen, L. L., Santikarn, S., Williams, D. H., Hunter, J. C., Hanley, M. R., Magnusson, I., Thulin, L., Mandahl, Agneta, Bill, Anders, Manning, Maurice, Martensson, H., Akande, B., Stofer, P., Chappuis, G., Immer, H., Groog, P., Matthews, Margaret R., Connaughton, M., Moratalla, R., Nobin, Anders, Emson, Piers, Sundler, Frank, O'Donohue, T. L., Shults, C. W., Quirion, R., Moody, T. W., Chase, T. N., Otsuka, M., Konishi, S., Yanagisawa, M., Akagi, H., Otten, U., Rüegg, U. T., Pawlik, W., Konturek, S. J., Kania, J., Gustaw, P., Cosgrove, Patricia G., Pazoles, Christopher J., Priestley, J. V., Jensen, R. T., Pert, C. B., Regoli, D., Mizrahi, J., D'Orléans-Juste, P., Caranikas, S., Escher, E., Folkers, Karl, Rüegg, Urs T., Bishai, W. R., Saria, A., Rama Sastry, B. V., Jaiswal, Neelam, Tayeb, Osama S., Schultheiss, Hartmut, Hörig, Joachim, Scott, T. M., Shanahan, F., Befus, A. D., Fox, J., Denburg, J. A., Bienenstock, J., Sheppard, M. N., Kurian, S. S., Siegel, R. A., Weidenfeld, J., Globus, M., Melamed, E., Sjödin, L., Srivastava, G., Hall, Michael E., Suhar, A., Turk, V., Marks, N., Szkudlarek, U., Tarkkanen, A., Tervo, T., Tervo, K., Eränkö, L., Eränkö, O., Huang, W. -M., Morrison, J. F. B., Unger, W. G., Tessler, A., Himes, B. T., Murray, M., Goldberger, M. E., Torrens, Y., Beaujouan, J. C., Viger, A., Glowinski, J., Casanueva, F. F., Knuth, E., Havlicek, V., Friesen, H. G., Triepel, J., Weindl, A., Reinecke, M., Mader, J., Forssmann, W. G., Unger, Thomas, Becker, Hans, König, Manfred, Ganten, Detlev, Lang, Rudolf E., Vacca, L. L., Naftchi, N. E., Guan, X. -M., Ai, M. -K., Vijayan, E., Wang, Y. M., Mashford, M. L., Watson, Stephen P., Sandberg, Bengt E. B., Iversen, Leslie L., Weihe, E., Hartschuh, W., Kuchling, G., Winter, E. A., Keen, P., Yeo, C. J., Ylikoski, Jukka, Tervo, Timo, Tervo, Kaarina, Eränko, Liisa, and Cuello, Claudio

Published
1983
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29. The Outcome of Neutrophil Gelatinase-Associated Lipocalin-Positive Subclinical Acute Kidney Injury A Multicenter Pooled Analysis of Prospective Studies

Author

Haase, Michael, Devarajan, Prasad, Haase-Fielitz, Anja, Bellomo, Rinaldo, Cruz, Dinna N., Wagener, Gebhard, Krawczeski, Catherine D., Koyner, Jay L., Murray, Patrick, Zappitelli, Michael, Goldstein, Stuart L., Makris, Konstantinos, Ronco, Claudio, Martensson, Johan, Martling, Claes-Roland, Venge, Per, Siew, Edward, Ware, Lorraine B., Ikizler, T. Alp, and Mertens, Peter R.

Subjects
renal replacement therapy (RRT), neutrophil gelatinase-associated lipocalin (NGAL), creatinine, biomarker, acute kidney injury (AKI), mortality
Abstract

ObjectivesThe aim of this study was to test the hypothesis that, without diagnostic changes in serum creatinine, increased neutrophil gelatinase-associated lipocalin (NGAL) levels identify patients with subclinical acute kidney injury (AKI) and therefore worse prognosis.BackgroundNeutrophil gelatinase-associated lipocalin detects subclinical AKI hours to days before increases in serum creatinine indicate manifest loss of renal function.MethodsWe analyzed pooled data from 2,322 critically ill patients with predominantly cardiorenal syndrome from 10 prospective observational studies of NGAL. We used the terms NGAL(−) or NGAL(+) according to study-specific NGAL cutoff for optimal AKI prediction and the terms sCREA(−) or sCREA(+) according to consensus diagnostic increases in serum creatinine defining AKI. A priori-defined outcomes included need for renal replacement therapy (primary endpoint), hospital mortality, their combination, and duration of stay in intensive care and in-hospital.ResultsOf study patients, 1,296 (55.8%) were NGAL(−)/sCREA(−), 445 (19.2%) were NGAL(+)/sCREA(−), 107 (4.6%) were NGAL(−)/sCREA(+), and 474 (20.4%) were NGAL(+)/sCREA(+). According to the 4 study groups, there was a stepwise increase in subsequent renal replacement therapy initiation—NGAL(−)/sCREA(−): 0.0015% versus NGAL(+)/sCREA(−): 2.5% (odds ratio: 16.4, 95% confidence interval: 3.6 to 76.9, p < 0.001), NGAL(−)/sCREA(+): 7.5%, and NGAL(+)/sCREA(+): 8.0%, respectively, hospital mortality (4.8%, 12.4%, 8.4%, 14.7%, respectively) and their combination (4-group comparisons: all p < 0.001). There was a similar and consistent progressive increase in median number of intensive care and in-hospital days with increasing biomarker positivity: NGAL(−)/sCREA(−): 4.2 and 8.8 days; NGAL(+)/sCREA(−): 7.1 and 17.0 days; NGAL(−)/sCREA(+): 6.5 and 17.8 days; NGAL(+)/sCREA(+): 9.0 and 21.9 days; 4-group comparisons: p = 0.003 and p = 0.040, respectively. Urine and plasma NGAL indicated a similar outcome pattern.ConclusionsIn the absence of diagnostic increases in serum creatinine, NGAL detects patients with likely subclinical AKI who have an increased risk of adverse outcomes. The concept and definition of AKI might need re-assessment.

Published
2011

30. Association of plasma neutrophil gelatinase-associated lipocalin (NGAL) with sepsis and acute kidney dysfunction

Author

Martensson, Johan, Bell, Max, Xu, Shengyuan, Bottai, Matteo, Ravn, Bo, Venge, Per, Martling, Claes-Roland, Martensson, Johan, Bell, Max, Xu, Shengyuan, Bottai, Matteo, Ravn, Bo, Venge, Per, and Martling, Claes-Roland

Abstract

Objective: Neutrophil gelatinase-associated lipocalin (NGAL) is secreted by injured kidney cells as well as by activated neutrophils in response to bacterial infections. We assessed the influence of acute renal dysfunction on the association between plasma NGAL and sepsis. Methods: NGAL was measured daily in 138 critically ill patients. Simultaneous recordings of sepsis status and fluctuations in renal function were made. Results: Elevated NGAL was associated with sepsis independent of level of acute renal dysfunction. A cut-off value of 98 ng/mL distinguished sepsis from systemic inflammation with high sensitivity (0.77) and specificity (0.79). Conclusions: Plasma NGAL can help clinicians to identify bacterial infections in critically ill patients.

Published
2013
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32. Short- and long-term follow-up of intensive care unit patients after sedation with isoflurane and midazolam : A pilot study

Author

Sackey, Peter, Martling, Claes-Roland, Carlswärd, Christine, Sundin, Örjan, Radell, Peter, Sackey, Peter, Martling, Claes-Roland, Carlswärd, Christine, Sundin, Örjan, and Radell, Peter

Abstract

OBJECTIVE: To compare memories from the intensive care unit (ICU) and short- and long-term psychological morbidity in patients after sedation with intravenous midazolam or inhaled isoflurane. DESIGN: Prospective long-term follow-up after randomized controlled trial. SETTING: General ICU at Karolinska University Hospital, Solna, Stockholm. PATIENTS: Forty patients in need of sedation during ventilator treatment. INTERVENTIONS: Patients were randomized to receive isoflurane or midazolam for goal-directed sedation until extubation or for a maximum of 96 hrs. MEASUREMENTS AND MAIN RESULTS: For short-term follow-up, doctors', nurses', and physiotherapists' notes from the 4 days following exposure to the study drugs were reviewed for words indicating adequate or pathologic cognitive and psychological recovery. For long-term follow-up, all 6-month survivors received questionnaires including the ICU Memory Tool (ICU-MT), Hospital Anxiety and Depression Scale (HADS), Impact of Event Scale (IES), and Well-Being Index. Additionally, several screening questions for previous posttraumatic stress symptoms were included. In the short term follow-up, no significant differences were found between groups. In the long-term follow-up, a trend toward fewer hallucinations/delusions after isoflurane sedation than after midazolam (two of ten isoflurane patients vs. five of seven midazolam patients) was found (p = .06). None of the five solely isoflurane-sedated patients reported hallucinations/delusions from the ICU. There was no difference in groups in long-term psychological morbidity as measured with HADS and IES. Memories of negative feelings in the ICU (ICU-MT) were associated with high HADS and IES scores (Fisher's exact test, p = .02 and p = .01, respectively). CONCLUSIONS: Sedation of ICU patients with isoflurane may result in fewer delusional memories or hallucinations from the ICU compared with more commonly used intravenous sedation. Memories of negative feelings from the ICU we, VR-Surgery

Published
2008
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35. The Outcome of Neutrophil Gelatinase-Associated Lipocalin-Positive Subclinical Acute Kidney Injury

Author

Haase, Michael, primary, Devarajan, Prasad, additional, Haase-Fielitz, Anja, additional, Bellomo, Rinaldo, additional, Cruz, Dinna N., additional, Wagener, Gebhard, additional, Krawczeski, Catherine D., additional, Koyner, Jay L., additional, Murray, Patrick, additional, Zappitelli, Michael, additional, Goldstein, Stuart L., additional, Makris, Konstantinos, additional, Ronco, Claudio, additional, Martensson, Johan, additional, Martling, Claes-Roland, additional, Venge, Per, additional, Siew, Edward, additional, Ware, Lorraine B., additional, Ikizler, T. Alp, additional, and Mertens, Peter R., additional

Published
2011
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