Acute Kidney Injury After Pediatric Liver Transplantation
| Autor: | Akın Akbulut, Zafer Gökkaya, Özlem Yenidünya, Oya Ferah, Yaman Tokat, Umut Acar, Ercument Yentur, Mehmet Eren Açık |
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| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Renal function Liver transplantation urologic and male genital diseases Gastroenterology Risk Factors Internal medicine Ascites medicine Humans Hypoalbuminemia Child Blood urea nitrogen Retrospective Studies Transplantation Kidney urogenital system business.industry Incidence Acute kidney injury Furosemide Acute Kidney Injury medicine.disease female genital diseases and pregnancy complications Liver Transplantation medicine.anatomical_structure Child Preschool Surgery Female medicine.symptom business medicine.drug |
| Zdroj: | Transplantation proceedings. 51(7) |
| ISSN: | 1873-2623 |
| Popis: | Background The aim of the present study is to assess acute kidney injury (AKI) incidence according to the pRIFLE and AKIN criteria and to evaluate the risk factors for early developing AKI in postoperative intensive care unit after pediatric liver transplantation (LT). Materials After exclusion of retransplantations, 7 cadaveric and 44 living donors, totaling 51 pediatric LT patients that were performed between 2005 and 2017, were reviewed retrospectively. AKI was defined according to both pediatric RIFLE (Risk for renal dysfunction, Injury to the kidney, Failure of kidney function, Loss of kidney function, and End-stage renal disease) and Acute Kidney Injury Network (AKIN) criteria. Documented data were compared between AKI and non-AKI patients. Results AKI incidences were 17.6% by AKIN and 37.8% by pRIFLE criteria. AKIN-defined AKI group had statistically lower serum albumin level, higher serum sodium level, higher furosemide dose, and higher rate of red blood cell (RBC) transfusion than the non-AKI group (P = .02, P = .02, P = .01 and P = .04, respectively). AKI patients had significantly prolonged mechanical ventilation (P = .01) and hospital LOS (P = .02). The pRIFLE-defined AKI group had significantly lower serum albumin level, higher blood urea nitrogen (BUN) level, and higher ascites drained and also showed higher requirement for RBC and 20% human albumin transfusions than the non-AKI group (P = .02, P = .04, P: =.007, P = .02 and P = .05, respectively). Conclusion We evaluated that hypoalbuminemia, high requirement for RBC and 20% human albumin transfusions, high serum sodium, high furosemide use, and high flow of ascites are risk factors for AKI and high BUN levels can be predictive for AKI in pediatric LT patients. The effect of AKI on outcome variables were prolonged mechanical ventilation and hospital LOS. |
| Databáze: | OpenAIRE |
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