(Press-News.org) Physicians treating hospitalized patients for conditions unrelated to the kidneys should pay close attention to common blood and urine tests for kidney function in order to prevent incidental injury to the organs that help cleanse the body of toxins, new Johns Hopkins Bloomberg School of Public Health-led research suggests.
The findings, published this month in two studies in the American Journal of Kidney Diseases, suggest that while being older, male, African-American or having diabetes are risk factors for developing acute kidney injury, the strongest risk factor is even mildly abnormal results on tests of kidney function.
Acute kidney injury - a sudden loss of kidney function, which can develop as quickly as a few hours or over the span of a few days - occurs in up to 10 percent of hospitalized patients and up to 22 percent of intensive care unit patients worldwide. And its incidence has increased over the past two decades. Researchers say that this type of injury, which can lead to irreversible kidney damage, is often caused inadvertently during a patient's medical care, either through the prescription of certain medications, the use of medical tests requiring iodine contrast or the effects of dehydration.
"Once a patient suffers an acute kidney injury, we have no effective treatment, so it is important to focus on prevention whenever possible," says Morgan E. Grams, MD, PhD, an assistant professor of epidemiology at the Bloomberg School and a co-author on both of the studies. "Our research tells us that regardless of why someone is in a doctor's care, that doctor needs to pay very close attention to these basic markers of kidney function."
Researchers analyzed data from more than 1.3 million patient records, including 18,567 patients who developed acute kidney injury. They explored a number of factors including results from tests measuring eGFR (estimated glomerular filtration rate), or how well the kidneys are cleaning the blood, and one measuring albuminuria, or the amount of protein found leaking from the kidneys into the urine. The researchers with the Chronic Kidney Disease Prognosis Consortium based at the Bloomberg School found that reduced eGFR rates and elevated albuminuria levels were the strongest risk factors for kidney injury.
It makes biological sense, Grams says, that abnormally functioning kidneys would be more susceptible to kidney injury. But, she adds, physicians treating patients for other conditions may not be as attuned to kidney function when their focus is elsewhere and they may not think about kidney risk in younger patients, for example. She says she hopes this new research reminds doctors to consider the kidneys, especially since this potentially devastating injury is often preventable.
For example, doctors could steer clear of certain medications for patients with abnormal eGFR and albuminuria, regularly test for albuminuria before surgery or, when possible, avoid giving medical tests requiring iodine contrast.
Acute kidney injury is associated with adverse outcomes such as prolonged hospital stays, the beginnings of chronic kidney disease, end-stage kidney disease and mortality.
"Reducing acute kidney injury worldwide can be accomplished simply by paying close attention to the kidney levels of patients in hospitals and ICUs," says Grams, who is also an assistant professor of nephrology at the Johns Hopkins University School of Medicine. "It may really be that simple."
INFORMATION:
"A Meta-analysis of the Association of Estimated GFR, Albuminuria, Age, Race, and Sex with Acute Kidney Injury" was written by Morgan E. Grams; Yingying Sang; Shoshana H. Ballew; Ron T. Gansevoort; Heejin Kimm; Csaba P. Kovesdy; David Naimark; Cecilia Oien; David H. Smith; Josef Coresh; Mark J. Sarnak; Benedicte Stengel and Marcello Tonelli.
"A Meta-analysis of the Association of Estimated GFR, Albuminuria, Diabetes Mellitus and Hypertension with Acute Kidney Injury" was written by Matthew T. James; Morgan E. Grams; Mark Woodward; C. Raina Elley; Jamie A. Green; David C. Wheeler; Paul de Jong; Ron T. Gansevoort; Andrew S. Levey; David G. Warnock and Mark J. Sarnak.
This research was supported by the US National Kidney Foundation (NKF sources include AbbVie and Amgen) and the National Institutes of Health's National Institute of Diabetes and Digestive and Kidney Diseases (R01DK100446-01).
An international group of scientists has proposed that fallout from hundreds of nuclear weapons tests in the late 1940s to early 1960s could be used to mark the dawn of a new geological age in Earth history - the Anthropocene.
The study, led by Dr Colin Waters of the British Geological Survey, published new research in the Bulletin of the Atomic Scientists. The research involved 10 members of the Anthropocene Working Group that is chaired by Professor Jan Zalasiewicz of the Department of Geology at the University of Leicester and Gary Hancock, a world expert on plutonium ...
May 11, 2015 - What are the most influential studies on surgery of the lower (lumbar) spine? The "top 100" research papers in lumbar spine are counted down in a special review in the May 15 issue of Spine, published by Wolters Kluwer.
Dr. Samuel K. Cho and colleagues of Icahn School of Medicine at Mount Sinai, New York City, performed a literature review to analyze and quantify the most important research papers on lumbar spine surgery. Their results raise some interesting "questions, trends and observations"--including the finding that the two most-cited studies ...
The water flea has genetically adapted to climate change. Biologists from KU Leuven, Belgium, compared 'resurrected' water fleas -- hatched from 40-year-old eggs -- with more recent specimens. The project was coordinated by Professor Luc De Meester from the Laboratory of Aquatic Ecology, Evolution and Conservation.
The water flea has genetically adapted to climate change. Biologists from KU Leuven, Belgium, compared 'resurrected' water fleas - hatched from forty-year-old eggs - with more recent specimens. The project was coordinated by Professor Luc De Meester from the ...
What does space experimentation have in common with liquid cocktails? Both help in understanding what happens when multiple fluids are mixed together and subjected to temperature change - a phenomenon ubiquitous in nature and industrial applications such as oil fluids contained in natural reservoirs. The latest experimental data performed in zero gravity on the International Space Station is now available in the newly published Topical Issue of EPJ E. The results constitute the first set of highly accurate and broadly validated data on the thermodiffusion effects that occur ...
MADISON -- Mike Graham knows that fluid dynamics can reveal much about how the flow of blood helps and hinders individual blood cells as they go about their work.
Graham, the Vilas Distinguished Achievement Professor and Harvey D. Spangler Professor of Chemical and Biological Engineering at UW-Madison, established a theoretical basis for these ideas by creating complex computer stimulations that show how relatively stiff white blood cells and platelets interact with more flexible red blood cells. As the different cells collide during blood flow, white cells tend to be ...
Volcanoes are considered chaotic systems. They are difficult to model because the geophysical and chemical parameters in volcanic eruptions exhibit high levels of uncertainty. Now, Dmitri V. Alexandrov and colleagues from the Ural Federal University in Ekaterinburg, in the Russian Federation, have further extended an eruption model -- previously developed by other scientists -- to the friction force at work between the volcanic plug and volcanic conduit surface. The results, published in EPJ B, provide evidence that volcanic activity can be induced by external noises that ...
Chinese scientists have reared beef rich in the beneficial fatty acids associated with fish oils. The study in Springer's journal Biotechnology Letters also highlights the scientific challenges that remain.
The team from Northwest A&F University and the National Beef Cattle Improvement Centre, both in Yangling (Shaanxi), successfully introduced a gene into foetal cells from Luxi Yellow cattle, a Chinese breed with a high beef yield. The fat1 gene, isolated from a nematode worm, codes for desaturase enzymes that are involved in the conversion of n-6 to n-3 polyunsaturated ...
How much food your dining companion eats can have a big influence on how much you consume, a UNSW Australia-led study concludes.
This psychological effect, known as social modelling, leads people to eat less than they normally would if alone when their companion consumes a small amount of food.
Study lead author, Associate Professor Lenny Vartanian of the UNSW School of Psychology, says that in social situations the appropriate amount of food to eat can be unclear.
"Internal signals like hunger and feeling full can often be unreliable guides. In these situations people ...
An international consortium of scientists led by a group from the University of Leicester has announced a new advance in understanding the mechanisms of cancer and how to target it more effectively with new treatments.
Two papers published in the same issue of the world-leading Journal of Cell Biology have arisen from research work led by Professor Andrew Fry at the University of Leicester. Both papers suggest that new understanding of the mechanics of cell division can reveal new targets for cancer therapy.
Professor Fry, who is Director of Research in the College ...
Geoscientists have, for the first time, discovered the origins of Australia's two largest basins: Lake Eyre and the Murray-Darling Basin. The research also implies that in 30 million years' time both basins will cease to exist.
Monash University geoscientist Associate Professor Wouter Schellart, and his colleague Professor Wim Spakman from Utrecht University, have discovered how the floor of an entire ocean basin that was destroyed 70 to 50 million years ago off the North coast of New Guinea is currently located at 800-1200km depth below Central and South-eastern Australia.
Using ...
