Effects of acute kidney injury after liver resection on long-term outcomes
| Autor: | Satoshi Matsumura, Nobuhiro Shiota, Manami Tanaka, Arisa Fukagawa, Koshi Makita, Seiji Ishikawa, Fumi Maruyama |
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| Rok vydání: | 2017 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment Urology Renal function 030204 cardiovascular system & hematology urologic and male genital diseases lcsh:RD78.3-87.3 03 medical and health sciences chemistry.chemical_compound hepatectomy 0302 clinical medicine long term adverse effects medicine Risk of mortality Clinical Research Article Creatinine business.industry General surgery Hazard ratio Acute kidney injury perioperative management 030208 emergency & critical care medicine medicine.disease female genital diseases and pregnancy complications Anesthesiology and Pain Medicine acute kidney injury chemistry lcsh:Anesthesiology Hepatocellular carcinoma Long Term Adverse Effects Hepatectomy business |
| Zdroj: | Korean Journal of Anesthesiology, Vol 70, Iss 5, Pp 527-534 (2017) Korean Journal of Anesthesiology |
| ISSN: | 2005-7563 2005-6419 |
| DOI: | 10.4097/kjae.2017.70.5.527 |
| Popis: | Background To investigate the effects of acute kidney injury (AKI) after liver resection on the long-term outcome, including mortality and renal dysfunction after hospital discharge. Methods We conducted a historical cohort study of patients who underwent liver resection for hepatocellular carcinoma with sevoflurane anesthesia between January 2004 and October 2011, survived the hospital stay, and were followed for at least 3 years or died within 3 years after hospital discharge. AKI was diagnosed based on the Acute Kidney Injury Network classification within 72 hours postoperatively. In addition to the data obtained during hospitalization, serum creatinine concentration data were collected and the glomerular filtration rate (GFR) was estimated after hospital discharge. Results AKI patients (63%, P = 0.002) were more likely to reach the threshold of an estimated GFR (eGFR) of 45 ml/min/1.73 m2 within 3 years than non-AKI patients (31%) although there was no significant difference in mortality (33% vs. 29%). Cox proportional hazard regression analysis showed that postoperative AKI was significantly associated with the composite outcome of mortality or an eGFR of 45 ml/min/1.73 m2 (95% CI of hazard ratio, 1.05-2.96, P = 0.033), but not with mortality (P = 0.699), the composite outcome of mortality or an eGFR of 60 ml/min/1.73 m2 (P =0.347). Conclusions After liver resection, AKI patients may be at higher risk of mortality or moderate renal dysfunction within 3 years. These findings suggest that even after discharge from the hospital, patients who suffered AKI after liver resection may need to be followed-up regarding renal function in the long term. |
| Databáze: | OpenAIRE |
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