Impact of acute kidney injury after extended liver resections
| Autor: | Richard Drexler, Martin Schneider, York von Rittberg, Tim Reese, Georgios Makridis, Karl J. Oldhafer, Fabian Kröger, Maximilian Stanley Jusufi, Kim C Wagner, Roland Brüning |
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| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Urology 030230 surgery Liver resections urologic and male genital diseases 03 medical and health sciences Postoperative Complications 0302 clinical medicine Risk Factors Clinical endpoint medicine Hepatectomy Humans Risk factor Retrospective Studies Hepatology urogenital system business.industry Incidence Incidence (epidemiology) Liver Neoplasms Gastroenterology Acute kidney injury Perioperative Acute Kidney Injury medicine.disease female genital diseases and pregnancy complications 030220 oncology & carcinogenesis Hepatocellular carcinoma business Kidney disease |
| Zdroj: | HPB. 23:1000-1007 |
| ISSN: | 1365-182X |
| DOI: | 10.1016/j.hpb.2020.10.015 |
| Popis: | Background Complex liver resection is a risk factor for the development of AKI, which is associated with increased morbidity and mortality. Aim of this study was to assess risk factors for acute kidney injury (AKI) and its impact on outcome for patients undergoing complex liver surgery. Methods AKI was defined according to the KDIGO criteria. Primary endpoint was the occurrence of AKI after liver resection. Secondary endpoints were complications and mortality. Results Overall, 146 patients undergoing extended liver resection were included in the study. The incidence of AKI was 21%. The incidence of chronic kidney disease (CKD) and hepatocellular carcinoma were significantly higher in patients with AKI. In the AKI group, the proportion of extended right hepatectomies was the highest (53%), followed by ALPPS (43%). Increased intraoperative blood loss, increased postoperative complications and perioperative mortality was associated with AKI. Besides age and CKD, ALPPS was an independent risk factor for postoperative AKI. A small future liver remnant seemed to increase the risk of AKI in patients undergoing ALPPS. Conclusion Following extended liver resection, AKI is associated with an increased morbidity and mortality. ALPPS is a major independent risk factor for the development of AKI and a sufficient future liver remnant could avoid postoperative AKI. |
| Databáze: | OpenAIRE |
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