Acute critical illness raises risk of kidney complications

People with acute critical illness have an increased risk of kidney complications and death, finds a study.

BS | “Patients with acute critical illness without apparent underlying renal disease — a group traditionally considered to be at low risk of renal diseases — have clinically relevant long-term renal risks,” wrote Dr. Shih-Ting Huang and Dr. Chia-Hung Kao of Taichung Veterans General Hospital and China Medical University, Taiwan, respectively.

Most studies have looked at patients with pre-existing kidney disease, while this study looked at data on 33, 613 Taiwanese patients with critical acute illness and no pre-existing kidney disease compared with 63, 148 controls for a medium-term renal outcome.

More than half of the patients (53 per cent) were above 65 years of age and two-thirds (67 per cent) had high blood pressure. Patients who had experienced acute kidney illness were at an increased risk of renal complications, developing chronic kidney disease and end-stage renal disease, with septicemia and septic shock being the strongest risk factors.

Of the critically ill patients in the study, 335 developed an end-stage renal disease, with a rate of 21 per 10 000 person-years compared with 4.9 per 10 000 person-years in the control group.

Patients who developed chronic kidney disease and end-stage renal disease were at a higher risk of death.

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New genes linked to childhood nephrotic syndrome identified

Childhood nephrotic syndrome is one of the most common chronic kidney diseases among children.

A Japanese research team led by Professor Kazumoto Iijima, Associate Professor Kandai Nozu and Tomoko Horinouchi, identified a group of genes which are strongly related to the development of childhood nephrotic syndrome.

Also known as nephrosis, childhood nephrotic syndrome is an incurable disease with an unknown cause, characterised by large amounts of protein leaving the body in the patient’s urine, and protein levels in the bloodstream becoming extremely low.

The majority of patients develop a steroid-sensitive nephrotic syndrome that responds to steroids and immune-suppressing drugs and go into remission, but at least 20% of cases are resistant strains that recur repeatedly during adulthood.

It is found that people who are genetically predisposed develop the syndrome when exposed to an immunological stimulus such as infection.

The research team is currently carrying out a genome-wide association study using the Japonica Array that targets 1,152 samples from infant nephrotic syndrome sufferers and a control group of 2,807 healthy Japanese individuals….READ MORE