New Ileostomy Formation and Subsequent Community-onset Acute and Chronic Kidney Disease
| Autor: | Elijah Dixon, Neesh Pannu, Matthew T. James, Paul E. Ronksley, W. Donald Buie, Zhi Tan, Brenda R. Hemmelgarn, Stephen A. Smith |
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| Rok vydání: | 2019 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Population Gastroenterology Ileostomy Postoperative Complications Risk Factors Internal medicine medicine Humans Renal Insufficiency Chronic education education.field_of_study business.industry Case-control study Acute kidney injury Bowel resection Odds ratio Acute Kidney Injury Middle Aged medicine.disease Case-Control Studies Female Surgery business Cohort study Kidney disease |
| Zdroj: | Annals of Surgery. 274:352-358 |
| ISSN: | 1528-1140 0003-4932 |
| Popis: | Objective The aim of this study was to examine relationships between ileostomy formation and subsequent kidney disease. Summary and background data Colonic absorptive capacity loss from ileostomy formation can cause volume depletion and could result in kidney disease. Methods We conducted a population-based cohort study comparing patients who underwent ileostomy formation with or without bowel resection (ileostomy group) to patients who underwent bowel resection without ileostomy formation (reference group). Adjusted odds ratios (aORs) for community-onset acute kidney injury (AKI) within 3 months and new-onset chronic kidney disease (CKD) within 1 year following hospital discharge were determined. Results Among 19,889 patients, 4136 comprised the ileostomy group and 15,753 comprised the reference group; 1350 patients experienced community-onset AKI and 464 developed new-onset CKD. The aOR for community-onset AKI with ileostomy formation was 4.08 [95% confidence interval (CI) = 3.62-4.61] for any stage AKI, 7.08 (95% CI = 5.66-8.85) for stage ≥2 injury, and 7.67 (95% CI = 5.06-11.63) for stage 3 injuries. Community-onset AKI modified associations between ileostomy formation and new-onset CKD (P = 0.002). Odds of new-onset CKD were increased in the ileostomy group relative to the reference group for patients both with (aOR = 4.99; 95% CI = 3.42-7.28) and without (aOR = 2.45; 95% CI = 1.85-2.23) previous community-onset AKI episodes. In analyses comparing patients that underwent ileostomy formation and subsequent reversal within 1 year to the reference group without ileostomy, the relationship with new-onset CKD was attenuated for patients both with (aOR = 2.49; 95% CI = 1.50-4.12) and without (aOR = 0.97; 95% CI = 0.67-1.40) previous community-onset AKI episodes. Conclusions Ileostomy formation is strongly associated with subsequent kidney disease. Vigilance for this complication and new strategies for prevention and treatment are necessary. |
| Databáze: | OpenAIRE |
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