World Journal of Nephrology最新文献

{"title":"Role of imaging in the evaluation of renal dysfunction in heart failure patients.","authors":"Dario Grande,&nbsp;Paola Terlizzese,&nbsp;Massimo Iacoviello","doi":"10.5527/wjn.v6.i3.123","DOIUrl":"https://doi.org/10.5527/wjn.v6.i3.123","url":null,"abstract":"<p><p>Heart failure and kidney disease share common pathophysiological pathways which can lead to mutual dysfunction, known as cardiorenal syndrome. In heart failure patients, renal impairment is related to hemodynamic and non-hemodynamic factors. Both decreased renal blood flow and renal venous congestion due to heart failure could lead to impaired renal function. Kidney disease and worsening renal function are independently associated with poor prognosis in heart failure patients, both in acute and chronic clinical settings. The aim of this review is to assess the role of renal imaging modalities in the evaluation and management of heart failure patients. Renal imaging techniques could complete laboratory data, as estimated glomerular filtration rate, exploring different pathophysiological factors involved in kidney disease and adding valuable information about renal structure and function. In particular, Doppler examination of arterial and venous hemodynamics is a feasible and non invasive technique, which has proven to be a reliable method for prognostic stratification in patients with cardiorenal syndrome. The renal resistance index, a measure related to renal hemodynamics, can be calculated from the Doppler evaluation of arterial flow. Moreover, the analysis of Doppler venous flow patterns can integrate information from the arterial study and evaluate renal congestion. Other imaging modalities are promising, but still confined to research purposes.</p>","PeriodicalId":23745,"journal":{"name":"World Journal of Nephrology","volume":"6 3","pages":"123-131"},"PeriodicalIF":0.0,"publicationDate":"2017-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b5/f1/WJN-6-123.PMC5424434.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35023761","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinicopathological spectrum of snake bite-induced acute kidney injury from India.","authors":"Sanjay Vikrant,&nbsp;Ajay Jaryal,&nbsp;Anupam Parashar","doi":"10.5527/wjn.v6.i3.150","DOIUrl":"https://doi.org/10.5527/wjn.v6.i3.150","url":null,"abstract":"<p><strong>Aim: </strong>To study the clinico-pathological spectrum of snake bite-induced acute kidney injury (AKI).</p><p><strong>Methods: </strong>A retrospective study of patients admitted at Indira Gandhi Medical College Hospital, Shimla with snake bite-induced AKI from July 2003 to June 2016. Medical records were evaluated for patient's information on demographic, clinical characteristics, complications and outcome. Outcomes of duration of hospital stay, requirement for intensive care unit support, treatment with dialysis, survival and mortality were analyzed. The survival and non survival groups were compared to see the difference in the demographic factors, clinical characteristics, laboratory results, and complications. In patients subjected to kidney biopsy, the findings of histopathological examination of the kidney biopsies were also analyzed.</p><p><strong>Results: </strong>One hundred and twenty-one patients were diagnosed with snake bite-induced AKI. Mean age was 42.2 ± 15.1 years and majority (58%) were women. Clinical details were available in 88 patients. The mean duration of arrival at hospital was 3.4 ± 3.7 d with a range of 1 to 30 d. Eighty percent had oliguria and 55% had history of having passed red or brown colored urine. Coagulation defect was seen in 89% patients. The hematological and biochemical laboratory abnormalities were: Anemia (80.7%), leukocytosis (75%), thrombocytopenia (47.7%), hyperkalemia (25%), severe metabolic acidosis (39.8%), hepatic dysfunction (40.9%), hemolysis (85.2%) and rhabdomyolysis (68.2%). Main complications were: Gastrointestinal bleed (12.5%), seizure/encephalopathy (10.2%), hypertension, pneumonia/acute respiratory distress syndrome (ARDS) and disseminated intravascular coagulation (9.1% each), hypotension and multi organ failure (MOF) (4.5% each). Eighty-two percent patients required renal replacement therapy. One hundred and ten (90.9%) patient survived and 11 (9.1%) patients died. As compared to the survival group, the white blood cell count (<i>P</i> = 0.023) and bilirubin levels (<i>P</i> = 0.006) were significant higher and albumin levels were significantly lower (0.005) in patients who died. The proportion of patients with pneumonia/ARDS (<i>P</i> = 0.001), seizure/encephalopathy (<i>P</i> = 0.005), MOF (<i>P</i> = 0.05) and need for intensive care unit support (0.001) was significantly higher and duration of hospital stay was significantly shorter (<i>P</i> = 0.012) in patients who died. Kidney biopsy was done in total of 22 patients. Predominant lesion on kidney biopsy was acute tubular necrosis (ATN) in 20 (91%) cases. In 11 cases had severe ATN and in other nine (41%) cases kidney biopsy showed features of ATN associated with mild to moderate acute interstitial nephritis (AIN). One patient only had moderate AIN and one had patchy renal cortical necrosis (RCN).</p><p><strong>Conclusion: </strong>AKI due to snake bite is severe and a high proportion requires renal replacement therap","PeriodicalId":23745,"journal":{"name":"World Journal of Nephrology","volume":"6 3","pages":"150-161"},"PeriodicalIF":0.0,"publicationDate":"2017-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5527/wjn.v6.i3.150","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35024737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute kidney injury from different poisonous substances.","authors":"Rubina Naqvi","doi":"10.5527/wjn.v6.i3.162","DOIUrl":"https://doi.org/10.5527/wjn.v6.i3.162","url":null,"abstract":"AIM To report our experience of acute kidney injury (AKI) developed after exposure to poisonous substance. METHODS Retrospective study where data was collected from case records of patients coming to this institute during January 1990 to May 2016. This institution is a tertiary care center for renal care in the metropolitan city of Karachi, Pakistan. History of ingested substance, symptoms on presentation, basic laboratory tests on arrival, mode of treatment and outcome were recorded from all patients and are presented here. Patients developing AKI after snake envenomation or scorpion stings are not included in this study. RESULTS During studied period 184 cases of AKI developing after poisoning were seen at our institution. The largest group was from paraphenyline diamine poisoning comprising 135 patients, followed by methanol in 8, organophosphorus compounds in 5, paraquat in 5, copper sulphate in 5, tartaric acid in 4, phenobarbitone in 3 and benzodiazipines, datura, rat killer, fish gall bladder, arsenic, boiler water, ammonium dichromate, acetic acid and herbs with lesser frequency. In 8 patients multiple substances were ingested in combination. Renal replacement therapy was required in 96% of patients. Complete recovery was seen in 72.28% patients, 20% died during acute phase of illness. CONCLUSION It is important to report poisonous substances causing vital organ failure to increase awareness among general population as well as health care providers.","PeriodicalId":23745,"journal":{"name":"World Journal of Nephrology","volume":"6 3","pages":"162-167"},"PeriodicalIF":0.0,"publicationDate":"2017-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5527/wjn.v6.i3.162","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35024738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Any link of gout disease control among hypertensive patients and onset of end-stage renal disease? Results from a population-based study.","authors":"Sylvie Perreault,&nbsp;Javier Nuevo,&nbsp;Scott Baumgartner,&nbsp;Robert Morlock","doi":"10.5527/wjn.v6.i3.132","DOIUrl":"https://doi.org/10.5527/wjn.v6.i3.132","url":null,"abstract":"<p><strong>Aim: </strong>To determine the impact of allopurinol non-adherence as a proxy for uncontrolled disease on primary prevention of end-stage renal disease (ESRD).</p><p><strong>Methods: </strong>A cohort of 2752 patients with gout diagnosis was reconstructed using the Québec Régie de l'assurance maladie du Québec and MedEcho administrative databases. Eligible patients were new users of allopurinol, aged 45-85, with a diagnosis of hypertension, and treated with an antihypertensive drug between 1997 and 2007.</p><p><strong>Results: </strong>Major risk factor for ESRD onset was chronic kidney disease at stages 1 to 3 [rate ratio (RR) = 8.00; 95% confidence interval (CI): 3.16-22.3 and the severity of hypertension (≥ 3 <i>vs</i> < 3 antihypertensives)] was a trending risk factor as a crude estimate (RR = 1.94; 95%CI: 0.68-5.51). Of 341 patients, cases (<i>n</i> = 22) and controls (<i>n</i> = 319), high adherence level (≥ 80%) to allopurinol therapy, compared with lower adherence level (< 80%), was associated with a lower rate of ESRD onset (RR = 0.35; 95%CI: 0.13-0.91).</p><p><strong>Conclusion: </strong>Gout control seem to be associated with a significant decreased risk of ESRD onset in hypertensive populations, further research should be conducted confirming this potential associated risk.</p>","PeriodicalId":23745,"journal":{"name":"World Journal of Nephrology","volume":"6 3","pages":"132-142"},"PeriodicalIF":0.0,"publicationDate":"2017-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/8a/21/WJN-6-132.PMC5424435.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35024735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advanced wasting in peritoneal dialysis patients.","authors":"Zhi Xu,&nbsp;Glen H Murata,&nbsp;Robert H Glew,&nbsp;Yijuan Sun,&nbsp;Darlene Vigil,&nbsp;Karen S Servilla,&nbsp;Antonios H Tzamaloukas","doi":"10.5527/wjn.v6.i3.143","DOIUrl":"https://doi.org/10.5527/wjn.v6.i3.143","url":null,"abstract":"<p><strong>Aim: </strong>To identify patients with end-stage renal disease treated by peritoneal dialysis (PD) who had zero body fat (BF) as determined by analysis of body composition using anthropometric formulas estimating body water (V) and to compare nutritional parameters between these patients and PD patients whose BF was above zero.</p><p><strong>Methods: </strong>Body weight (W) consists of fat-free mass (FFM) and BF. Anthropometric formulas for calculating V allow the calculation of FFM as V/0.73, where 0.73 is the water fraction of FFM at normal hydration. Wasting from loss of BF has adverse survival outcomes in PD. Advanced wasting was defined as zero BF when V/0.73 is equal to or exceeds W. This study, which analyzed 439 PD patients at their first clearance study, used the Watson formulas estimating V to identify patients with V_Watson/0.73 ≥ W and compared their nutritional indices with those of PD patients with V_Watson/0.73 < W.</p><p><strong>Results: </strong>The study identified at the first clearance study two male patients with V_Watson/0.73 ≥ W among 439 patients on PD. Compared to 260 other male patients on PD, the two subjects with advanced wasting had exceptionally low body mass index and serum albumin concentration. The first of the two subjects also had very low values for serum creatinine concentration and total (in urine and spent peritoneal dialysate) creatinine excretion rate while the second subject had an elevated serum creatinine concentration and high creatinine excretion rate due, most probably, to non-compliance with the PD prescription.</p><p><strong>Conclusion: </strong>Advanced wasting (zero BF) in PD patients, identified by the anthropometric formulas that estimate V, while rare, is associated with indices of poor somatic and visceral nutrition.</p>","PeriodicalId":23745,"journal":{"name":"World Journal of Nephrology","volume":"6 3","pages":"143-149"},"PeriodicalIF":0.0,"publicationDate":"2017-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/5c/75/WJN-6-143.PMC5424436.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35024736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of different imaging modalities of vascular calcification in predicting outcomes in chronic kidney disease.","authors":"Sinee Disthabanchong,&nbsp;Sarinya Boongird","doi":"10.5527/wjn.v6.i3.100","DOIUrl":"https://doi.org/10.5527/wjn.v6.i3.100","url":null,"abstract":"<p><p>Vascular calcification (VC) is common among patients with chronic kidney disease (CKD). The severity of VC is associated with increased risk of cardiovascular events and mortality. Risk factors for VC include traditional cardiovascular risk factors as well as CKD-related risk factors such as increased calcium and phosphate load. VC is observed in arteries of all sizes from small arterioles to aorta, both in the intima and the media of arterial wall. Several imaging techniques have been utilized in the evaluation of the extent and the severity of VC. Plain radiographs are simple and readily available but with the limitation of decreased sensitivity and subjective and semi-quantitative quantification methods. Mammography, especially useful among women, offers a unique way to study breast arterial calcification, which is largely a medial-type calcification. Ultrasonography is suitable for calcification in superficial arteries. Analyses of wall thickness and lumen size are also possible. Computed tomography (CT) scan, the gold standard, is the most sensitive technique for evaluation of VC. CT scan of coronary artery calcification is not only useful for cardiovascular risk stratification but also offers an accurate and an objective analysis of the severity and progression.</p>","PeriodicalId":23745,"journal":{"name":"World Journal of Nephrology","volume":"6 3","pages":"100-110"},"PeriodicalIF":0.0,"publicationDate":"2017-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/85/8a/WJN-6-100.PMC5424431.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35023758","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cold dialysis and its impact on renal patients' health: An evidence-based mini review.","authors":"Giorgos K Sakkas,&nbsp;Argiro A Krase,&nbsp;Christoforos D Giannaki,&nbsp;Christina Karatzaferi","doi":"10.5527/wjn.v6.i3.119","DOIUrl":"https://doi.org/10.5527/wjn.v6.i3.119","url":null,"abstract":"<p><p>Chronic renal disease is associated with advanced age, diabetes, hypertension, obesity, musculoskeletal problems and cardiovascular disease, the latter being the main cause of mortality in patients receiving haemodialysis (HD). Cooled dialysate (35 °C-36 °C) is recently employed to reduce the incidence of intradialytic hypotension in patients on chronic HD. The studies to date that have evaluated cooled dialysate are limited, however, data suggest that cooled dialysate improves hemodynamic tolerability of dialysis, minimizes hypotension and exerts a protective effect over major organs including the heart and brain. The current evidence-based review is dealing with the protective effect of cold dialysis and the benefits of it in aspects affecting patients' quality of care and life. There is evidence to suggest that cold dialysis can reduce cardiovascular mortality. However, large multicentre randomized clinical trials are urgently needed to provide further supporting evidence in order to incorporate cold dialysis in routine clinical practice.</p>","PeriodicalId":23745,"journal":{"name":"World Journal of Nephrology","volume":"6 3","pages":"119-122"},"PeriodicalIF":0.0,"publicationDate":"2017-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/c3/50/WJN-6-119.PMC5424433.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35023760","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Monoclonal gammopathy of renal significance: Diagnostic workup.","authors":"Sofia O Correia,&nbsp;Sofia Santos,&nbsp;Jorge Malheiro,&nbsp;António Cabrita,&nbsp;La Salete Martins,&nbsp;Josefina Santos","doi":"10.5527/wjn.v6.i2.72","DOIUrl":"https://doi.org/10.5527/wjn.v6.i2.72","url":null,"abstract":"<p><p>The clinical spectrum of diseases associated with monoclonal gammopathies is wide and they are most commonly the consequence of renal deposition of monoclonal immunoglobulin or its components. The differential diagnosis is difficult and renal biopsy is essential. To distinguish many of these pathologies is necessary to use techniques that are not always available, even in tertiary central hospitals. This review will discuss the clinical presentation, pathologic features, treatment, prognosis and common diagnostic difficulties of these entities.</p>","PeriodicalId":23745,"journal":{"name":"World Journal of Nephrology","volume":"6 2","pages":"72-78"},"PeriodicalIF":0.0,"publicationDate":"2017-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.5527/wjn.v6.i2.72","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34833105","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Application of established pathophysiologic processes brings greater clarity to diagnosis and treatment of hyponatremia.","authors":"John K Maesaka,&nbsp;Louis J Imbriano,&nbsp;Nobuyuki Miyawaki","doi":"10.5527/wjn.v6.i2.59","DOIUrl":"https://doi.org/10.5527/wjn.v6.i2.59","url":null,"abstract":"<p><p>Hyponatremia, serum sodium < 135 mEq/L, is the most common electrolyte abnormality and is in a state of flux. Hyponatremic patients are symptomatic and should be treated but our inability to consistently determine the causes of hyponatremia has hampered the delivery of appropriate therapy. This is especially applicable to differentiating syndrome of inappropriate antidiuresis (SIAD) from cerebral salt wasting (CSW) or more appropriately, renal salt wasting (RSW), because of divergent therapeutic goals, to water-restrict in SIAD and administer salt and water in RSW. Differentiating SIAD from RSW is extremely difficult because of identical clinical parameters that define both syndromes and the mindset that CSW occurs rarely. It is thus insufficient to make the diagnosis of SIAD simply because it meets the defined characteristics. We review the pathophysiology of SIAD and RSW, the evolution of an algorithm that is based on determinations of fractional excretion of urate and distinctive responses to saline infusions to differentiate SIAD from RSW. This algorithm also simplifies the diagnosis of hyponatremic patients due to Addison's disease, reset osmostat and prerenal states. It is a common perception that we cannot accurately assess the volume status of a patient by clinical criteria. Our algorithm eliminates the need to determine the volume status with the realization that too many factors affect plasma renin, aldosterone, atrial/brain natriuretic peptide or urine sodium concentration to be useful. Reports and increasing recognition of RSW occurring in patients without evidence of cerebral disease should thus elicit the need to consider RSW in a broader group of patients and to question any diagnosis of SIAD. Based on the accumulation of supporting data, we make the clinically important proposal to change CSW to RSW, to eliminate reset osmostat as type C SIAD and stress the need for a new definition of SIAD.</p>","PeriodicalId":23745,"journal":{"name":"World Journal of Nephrology","volume":"6 2","pages":"59-71"},"PeriodicalIF":0.0,"publicationDate":"2017-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/fd/e0/WJN-6-59.PMC5339638.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34833104","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute kidney injury following spinal instrumentation surgery in children.","authors":"Jasper J Jöbsis,&nbsp;Abdullah Alabbas,&nbsp;Ruth Milner,&nbsp;Christopher Reilly,&nbsp;Kishore Mulpuri,&nbsp;Cherry Mammen","doi":"10.5527/wjn.v6.i2.79","DOIUrl":"https://doi.org/10.5527/wjn.v6.i2.79","url":null,"abstract":"<p><strong>Aim: </strong>To determine acute kidney in jury (AKI) incidence and potential risk factors of AKI in children undergoing spinal instrumentation surgery.</p><p><strong>Methods: </strong>AKI incidence in children undergoing spinal instrumentation surgery at British Columbia Children's Hospital between January 2006 and December 2008 was determined by the Acute Kidney Injury Networ classification using serum creatinine and urine output criteria. During this specific time period, all patients following spinal surgery were monitored in the pediatric intensive care unit and had an indwelling Foley catheter permitting hourly urine output recording. Cases of AKI were identified from our database. From the remaining cohort, we selected group-matched controls that did not satisfy criteria for AKI. The controls were matched for sex, age and underlying diagnosis (idiopathic <i>vs</i> non-idiopathic scoliosis).</p><p><strong>Results: </strong>Thirty five of 208 patients met criteria for AKI with an incidence of 17% (95%CI: 12%-23%). Of all children who developed AKI, 17 (49%) developed mild AKI (AKI Stage 1), 17 (49%) developed moderate AKI (Stage 2) and 1 patient (3%) met criteria for severe AKI (Stage 3). An inverse relationship was observed with AKI incidence and the amount of fluids received intra-operatively. An inverse relationship was observed with AKI incidence and the amount of fluids received intra-operatively classified by fluid tertiles: 70% incidence in those that received the least amount of fluids <i>vs</i> 29% that received the most fluids (> 7.9, <i>P</i> = 0.02). Patients who developed AKI were more frequently exposed to nephrotoxins (non steroidal anti inflammatory drugs or aminoglycosides) than control patients during their peri-operative course (60% <i>vs</i> 22%, <i>P</i> < 0.001).</p><p><strong>Conclusion: </strong>We observed a high incidence of AKI following spinal instrumentation surgery in children that is potentially related to the frequent use of nephrotoxins and the amount of fluid administered peri-operatively.</p>","PeriodicalId":23745,"journal":{"name":"World Journal of Nephrology","volume":"6 2","pages":"79-85"},"PeriodicalIF":0.0,"publicationDate":"2017-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/d4/23/WJN-6-79.PMC5339640.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34833106","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}