Document Detail


Acute kidney injury in sickle patients with painful crisis or acute chest syndrome and its relation to pulmonary hypertension.
MedLine Citation:
PMID:  20179008     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The association between chronic kidney involvement and sickle cell disease (SCD) has been well characterized, but our knowledge on acute kidney injury (AKI) in relation to SCD remains limited. METHODS: We retrospectively assessed 254 episodes of vaso-occlusive complication in 161 SCD patients who were admitted to our hospital: these included 174 episodes of painful crisis (PC), 58 episodes of moderate acute chest syndrome (ACS) and 22 episodes of severe ACS. RESULTS: The overall incidence of AKI [defined according to Acute Kidney Injury Network (AKIN) criteria] during vaso-occlusive complications was low (4.3%) but seemed to be related to its severity: 2.3% for PC vs 6.9% for moderate ACS and 13.6% for severe ACS (P = 0.03). This finding led us prospectively to look at specific risk factors for AKI occurrence in SCD patients admitted to our intensive care unit for severe ACS and, in particular, the possible link between AKI and haemodynamic status (transthoracic echocardiography). Among patients with severe ACS, those with AKI displayed significantly greater aminotransferases, bilirubin and lactate dehydrogenase levels than patients without AKI. Echocardiography identified higher systolic pulmonary artery pressure in patients with AKI than in those without, whereas the cardiac index was similar between groups. CONCLUSIONS: AKI incidence during vaso-occlusive complications of SCD is relatively low (<5%) and appears to be confined to patients with ACS and pulmonary hypertension. These findings suggest a pathophysiological process involving right ventricular dysfunction and venous congestion.
Authors:
Vincent Audard; Sébastien Homs; Anoosha Habibi; Frederic Galacteros; Pablo Bartolucci; Bertrand Godeau; Bertrand Renaud; Yves Levy; Philippe Grimbert; Philippe Lang; Christian Brun-Buisson; Laurent Brochard; Frederique Schortgen; Bernard Maitre; Armand Mekontso Dessap
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Publication Detail:
Type:  Journal Article     Date:  2010-02-22
Journal Detail:
Title:  Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association     Volume:  25     ISSN:  1460-2385     ISO Abbreviation:  Nephrol. Dial. Transplant.     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-07-19     Completed Date:  2010-10-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8706402     Medline TA:  Nephrol Dial Transplant     Country:  England    
Other Details:
Languages:  eng     Pagination:  2524-9     Citation Subset:  IM    
Affiliation:
Nephrology and Renal Transplantation Department and Institut Francilien de Recherche en Nephrologie et Transplantation (IFRNT), Henri Mondor Hospital, 51 Avenue du Marechal de Lattre de Tassigny Creteil, France. vincent.audard@hmn.aphp.fr
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MeSH Terms
Descriptor/Qualifier:
Acute Chest Syndrome / complications*
Adult
Anemia, Sickle Cell / complications*
Female
Humans
Hypertension, Pulmonary / complications*
Incidence
Intensive Care Units
Kidney Failure, Acute / epidemiology*
Male
Prospective Studies
Retrospective Studies
Risk Factors
Severity of Illness Index

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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