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Related Concept Videos

Acute Kidney Injury I: Introduction01:22

Acute Kidney Injury I: Introduction

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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...
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Acute Kidney Injury IV: Diagnostic Studies and Prevention01:30

Acute Kidney Injury IV: Diagnostic Studies and Prevention

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Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...
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Acute Kidney Injury II: Pathophysiology01:29

Acute Kidney Injury II: Pathophysiology

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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...
350
Acute Kidney Injury V: Interprofessional Care01:20

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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...
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Acute Kidney Injury III: Clinical Manifestations01:29

Acute Kidney Injury III: Clinical Manifestations

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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...
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Acute Kidney Injury VI: Nursing Management01:22

Acute Kidney Injury VI: Nursing Management

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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...
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HIPEC-Induced Acute Kidney Injury: A Retrospective Clinical Study and Preclinical Model.

Lukas F Liesenfeld1, Benedikt Wagner1, H Christian Hillebrecht1

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Acute kidney injury (AKI) is common after hyperthermic intraperitoneal chemotherapy (HIPEC). Cisplatin-based HIPEC significantly increases AKI risk, while hyperthermia alone does not appear to cause kidney damage.

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Area of Science:

  • Oncology
  • Nephrology
  • Surgical Oncology

Background:

  • Hyperthermic intraperitoneal chemotherapy (HIPEC) with cytoreductive surgery (CRS) is a standard treatment for peritoneal malignancies.
  • Acute kidney injury (AKI) is a significant morbidity associated with HIPEC.
  • The distinct roles of cisplatin and hyperthermia in HIPEC-induced nephrotoxicity require clarification.

Purpose of the Study:

  • To identify risk factors for AKI following HIPEC.
  • To determine the independent contributions of cisplatin and hyperthermia to HIPEC-induced nephrotoxicity.
  • To evaluate the nephroprotective potential of amifostine.

Main Methods:

  • Analysis of 153 patients undergoing HIPEC, categorized by AKI presence (AKI+ vs. AKI-).
  • Collection of clinical, surgical, and HIPEC-related data to assess risk factors.
  • Utilized a preclinical mouse model to isolate the effects of cisplatin and hyperthermia on renal injury.

Main Results:

  • AKI occurred in 31.8% of HIPEC patients.
  • Cisplatin-containing HIPEC regimens were a primary risk factor for AKI (p < 0.001).
  • Independent risk factors included angiotensin receptor blockers and elevated preoperative creatinine/urea levels. Cisplatin induced AKI in mice; hyperthermia alone or combined with cisplatin did not worsen renal injury. Amifostine showed no protective effect.

Conclusions:

  • AKI is a frequent complication post-HIPEC.
  • Cisplatin administration significantly elevates the risk of renal injury.
  • Hyperthermia in HIPEC does not appear to induce or exacerbate kidney damage.