The DOI matches its Crossref record; 32 of the 32 references it cites were found in a registry or an index.
Prevention of cardiac surgery-associated AKI by implementing the KDIGO guidelines in high risk patients identified by biomarkers: the PrevAKI randomized controlled trial
Open accessAbstract
PURPOSE: Care bundles are recommended in patients at high risk for acute kidney injury (AKI), although they have not been proven to improve outcomes. We sought to establish the efficacy of an implementation of the Kidney Disease Improving Global Outcomes (KDIGO) guidelines to prevent cardiac surgery-associated AKI in high risk patients defined by renal biomarkers. METHODS: In this single-center trial, we examined the effect of a "KDIGO bundle" consisting of optimization of volume status and hemodynamics, avoidance of nephrotoxic drugs, and preventing hyperglycemia in high risk patients defined as urinary [TIMP-2]·[IGFBP7] > 0.3 undergoing cardiac surgery. The primary endpoint was the rate of AKI defined by KDIGO criteria within the first 72 h after surgery. Secondary endpoints included AKI severity, need for dialysis, length of stay, and major adverse kidney events (MAKE) at days 30, 60, and 90. RESULTS: AKI was significantly reduced with the intervention compared to controls [55.1 vs. 71.7%; ARR 16.6% (95 CI 5.5-27.9%); p = 0.004]. The implementation of the bundle resulted in significantly improved hemodynamic parameters at different time points (p < 0.05), less hyperglycemia (p < 0.001) and use of ACEi/ARBs (p < 0.001) compared to controls. Rates of moderate to severe AKI were also significantly reduced by the intervention compared to controls. There were no significant effects on other secondary outcomes. CONCLUSION: An implementation of the KDIGO guidelines compared with standard care reduced the frequency and severity of AKI after cardiac surgery in high risk patients. Adequately powered multicenter trials are warranted to examine mortality and long-term renal outcomes.
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Cites
KDIGO Clinical Practice Guidelines for Acute Kidney Injury
Khwaja, A. (2012) · Nephron Clinical Practice · doi:10.1159/000339789 · Cited by 8,014
Discovery and validation of cell cycle arrest biomarkers in human acute kidney injury
Kashani, K., Al-Khafaji, A., Ardiles, T., Artigas, A., Bagshaw, S. M., Bell, M., Bihorac, A., Birkhahn, R., Cely, C. M., Chawla, L. S., et al. (2013) · Critical Care · doi:10.1186/cc12503 · Cited by 1,362
Zarbock, A., Kellum, J. A., Schmidt, C., Van Aken, H., Wempe, C., Pavenstädt, H., Boanta, A., Gerß, J., & Meersch, M. (2016) · JAMA · doi:10.1001/jama.2016.5828 · Cited by 1,143
Self-citationAcute Kidney Injury Is Associated With Increased Long-Term Mortality After Cardiothoracic Surgery
Hobson, C. E., Yavas, S., Segal, M. S., Schold, J. D., Tribble, C. G., Layon, A. J., & Bihorac, A. (2009) · Circulation · doi:10.1161/circulationaha.108.800011 · Cited by 1,013
Urine Output Assessment as a Clinical Quality Measure
Macedo, E. (2015) · Nephron · doi:10.1159/000437312 · Cited by 798
Remote Ischemic Preconditioning and Outcomes of Cardiac Surgery
Hausenloy, D. J., Candilio, L., Evans, R., Ariti, C., Jenkins, D. P., Kolvekar, S., Knight, R., Kunst, G., Laing, C., Nicholas, J., et al. (2015) · New England Journal of Medicine · doi:10.1056/nejmoa1413534 · Cited by 722
Classifying AKI by Urine Output versus Serum Creatinine Level
Kellum, J. A., Sileanu, F. E., Murugan, R., Lucko, N., Shaw, A. D., & Clermont, G. (2015) · Journal of the American Society of Nephrology · doi:10.1681/asn.2014070724 · Cited by 527
Meersch, M., Schmidt, C., Van Aken, H., Martens, S., Rossaint, J., Singbartl, K., Görlich, D., Kellum, J. A., & Zarbock, A. (2014) · PLoS ONE · doi:10.1371/journal.pone.0093460 · Cited by 444
Self-citationZarbock, A., Schmidt, C., Van Aken, H., Wempe, C., Martens, S., Zahn, P. K., Wolf, B., Goebel, U., Schwer, C. I., Rosenberger, P., et al. (2015) · JAMA · doi:10.1001/jama.2015.4189 · Cited by 422
Self-citationEndre, Z. H., Walker, R. J., Pickering, J. W., Shaw, G. M., Frampton, C. M., Henderson, S. J., Hutchison, R., Mehrtens, J. E., Robinson, J. M., Schollum, J. B. W., et al. (2010) · Kidney International · doi:10.1038/ki.2010.25 · Cited by 271
Cited by
Ronco, C., Bellomo, R., & Kellum, J. A. (2019) · The Lancet · doi:10.1016/s0140-6736(19)32563-2 · Cited by 1,910
Engelman, D. T., Ben Ali, W., Williams, J. B., Perrault, L. P., Reddy, V. S., Arora, R. C., Roselli, E. E., Khoynezhad, A., Gerdisch, M., Levy, J. H., et al. (2019) · JAMA Surgery · doi:10.1001/jamasurg.2019.1153 · Cited by 1,225
Ostermann, M., Zarbock, A., Goldstein, S., Kashani, K., Macedo, E., Murugan, R., Bell, M., Forni, L., Guzzi, L., Joannidis, M., et al. (2020) · JAMA Network Open · doi:10.1001/jamanetworkopen.2020.19209 · Cited by 677
Self-citationCalzavacca, P., Licari, E., & Bellomo, R. (2010) · Surgical Intensive Care Medicine · doi:10.1007/978-0-387-77893-8_38 · Cited by 533
Ostermann, M., Lumlertgul, N., Jeong, R., See, E., Joannidis, M., & James, M. (2025) · The Lancet · doi:10.1016/s0140-6736(24)02385-7 · Cited by 396
Metadata
- Authors
- Meersch, M., Schmidt, C., Hoffmeier, A., Van Aken, H., Wempe, C., Gerss, J., & Zarbock, A.
- Venue
- Intensive Care Medicine
- Published
- 2017-01-21
- Volume
- 43
- Issue
- 11
- Pages
- 1551-1561
- ISSN
- 0342-4642 (ISSN-L)
- 1432-1238
- OpenAlex
- W3133528108
- Cited by
- 892
- References
- 32
- FWCI
- 65.12
- Type
- journal article
- Language
- en
- Open access
- hybrid
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- Meersch, M., Schmidt, C., Hoffmeier, A., Van Aken, H., Wempe, C., Gerss, J., & Zarbock, A. (2017). Prevention of cardiac surgery-associated AKI by implementing the KDIGO guidelines in high risk patients identified by biomarkers: the PrevAKI randomized controlled trial. Intensive Care Medicine. https://doi.org/10.1007/s00134-016-4670-3
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