Related Experiment Video
Updated: Feb 9, 2026
07:30
Robot-Assisted Kidney Transplantation
Published on: July 19, 2021
4.4K
Acute Kidney Injury After Cardiac Transplantation: Foe or Common Innocent Bystander?
F J Romeo1, C F Varela2, N Vulcano1
1Cardiology Department, Hospital Italiano de Buenos Aires, Argentina.
Transplantation Proceedings
|June 9, 2018
Summary
Severe acute kidney injury (AKI) is common after heart transplantation (HT), significantly increasing mortality. Early identification of high-risk patients is crucial for better outcomes in heart failure management.
Area of Science:
- Cardiology
- Nephrology
- Transplantation Medicine
Background:
- Heart transplantation (HT) is the primary treatment for end-stage heart failure (ESHF).
- Severe acute kidney injury (AKI) is a frequent and serious complication post-HT.
Purpose of the Study:
- To investigate the incidence and impact of AKI on mortality after HT.
- To identify predictors for severe AKI in ESHF patients undergoing HT.
Main Methods:
- Retrospective review of 112 ESHF patients undergoing HT from 2010-2015.
- AKI staging and mortality assessed using Kidney Disease Improving Global Outcomes (KDIGO) criteria.
- Primary endpoint: AKI stage III; secondary outcomes: in-hospital and 1-year mortality.
Main Results:
- 72.3% of patients developed AKI, with 26.7% experiencing AKI stage III.
- Hospital mortality rose from 0% (no AKI) to 46% (AKI stage III).
- 1-year mortality increased from 6% to 53% for patients without AKI versus AKI stage III, respectively. Renal replacement therapy (RRT) was associated with 59.2% 1-year mortality.
Conclusions:
- AKI stage III is prevalent after HT and significantly worsens both early and long-term survival.
- Predictive models incorporating clinical and hemodynamic factors may improve pre-HT risk assessment for AKI.
- Optimizing heart-kidney recipient evaluation is essential to mitigate post-transplant AKI complications.
Related Concept Videos
02:09Bystander Effect
10.3K
The discussion of bullying highlights the problem of witnesses not intervening to help a victim. This is a common occurrence, as the following well-publicized event demonstrates. In 1964, in Queens, New York, a 19-year-old woman named Kitty Genovese was attacked by a person with a knife near the back entrance to her apartment building and again in the hallway inside her apartment building. When the attack occurred, she screamed for help numerous times and eventually died from her stab wounds.
10.3K
01:22Acute Kidney Injury I: Introduction
782
Introduction:Acute Kidney Injury (AKI) describes a swift decrease in kidney function occurring over hours to days, characterized by the kidneys' failure to remove waste products from the bloodstream. This leads to dangerous complications like metabolic acidosis, fluid overload, and electrolyte imbalances, such as hyperkalemia, which can cause life-threatening arrhythmias. AKI is common in both hospital and outpatient settings, often triggered by dehydration, sepsis, or exposure to nephrotoxic...
782
01:29Acute Kidney Injury II: Pathophysiology
1.1K
Acute kidney injury (AKI) causes are categorized into three primary categories based on the location of the injury: prerenal, intrarenal (or intrinsic), and postrenal causes. This classification guides clinical management and illustrates how different pathways can impair kidney function.Etiology and Pathophysiology of Acute Kidney Injury1. Prerenal causesEtiology: Prerenal Acute Kidney Injury, the most common type, occurs when reduced blood flow to the kidneys decreases filtration capacity...
1.1K
01:22Acute Kidney Injury VI: Nursing Management
482
Acute Kidney Injury (AKI) results in an inability to maintain fluid, electrolyte, and acid-base balance. Effective nursing management is critical in improving patient outcomes and includes comprehensive patient assessment and targeted interventions.Comprehensive Patient AssessmentA detailed history collection is essential, focusing on any recent infections, nephrotoxic medication use, or chronic conditions such as hypertension and diabetes that may contribute to AKI. During the physical...
482
01:20Acute Kidney Injury V: Interprofessional Care
364
Acute Kidney Injury (AKI) requires a collaborative healthcare approach to restore renal function and prevent complications. Essential management strategies involve monitoring fluid and electrolyte balance, adjusting medications, initiating dialysis when necessary, and providing nutritional support.Fluid and Electrolyte ManagementFluid Monitoring: Regularly monitoring body weight, central venous pressure, and urine output helps detect fluid imbalances early. Patient intake and output are...
364
01:29Acute Kidney Injury III: Clinical Manifestations
966
Acute Kidney Injury (AKI) progresses through distinct clinical phases: the oliguric, diuretic, and recovery phases, each marked by unique manifestations and challenges.Oliguric Phase:The oliguric phase is the initial stage of AKI, typically lasting 10 to 14 days. This phase is marked by a significant reduction in urine output, usually less than 400 mL per day, indicating decreased kidney function. Fluid retention is a prominent feature, leading to symptoms such as edema, hypertension, and...
966