Effect of post-nephrectomy acute kidney injury on renal outcome: a retrospective long-term study
| Autor: | Paola Cianfrone, Giuseppe Conte, Domenico Russo, Giorgio Fuiano, Luigi Russo, Carlo Garofalo, Maria Elena Liberti, Silvio Borrelli, Luca De Nicola, Roberto Minutolo |
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| Přispěvatelé: | Garofalo, Carlo, Liberti, Maria Elena, Russo, Domenico, Russo, Luigi, Fuiano, Giorgio, Cianfrone, Paola, Conte, Giuseppe, De Nicola, Luca, Minutolo, Roberto, Borrelli, Silvio |
| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
Male
Nephrology medicine.medical_specialty Time Factors Chronic kidney failure medicine.medical_treatment Urology Population 030232 urology & nephrology Renal function 030204 cardiovascular system & hematology Nephrectomy 03 medical and health sciences chemistry.chemical_compound Postoperative Complications 0302 clinical medicine Internal medicine Humans Medicine Renal Insufficiency Chronic education Retrospective Studies Creatinine education.field_of_study Proteinuria business.industry Acute kidney injury Middle Aged medicine.disease Treatment Outcome chemistry Disease Progression Female medicine.symptom business Kidney disease |
| Popis: | Purpose: The effects on renal prognosis of acute kidney injury after elective unilateral nephrectomy are ill-defined. We evaluated as whether post-operative acute kidney injury modifies renal outcome over the long term. Methods: This is a retrospective study examining all consecutive adult patients referred to three Nephrology Units and that had previously undergone elective unilateral nephrectomy. We evaluated the association of post-nephrectomy acute kidney injury with the combined renal outcome of chronic dialysis requirement, â¥Â 40% decline in glomerular filtration rate or new-onset severe proteinuria (> 500 mg/24 h). Clinical correlates of acute kidney injury and renal outcome were also examined. Results: 106 patients were enrolled. 52 patients had post-operative acute kidney injury with a median increment of serum creatinine of 0.67 [0.48â0.86] mg/dl; in these patients, serum creatinine and urea increased from the first day post-nephrectomy while contraction of urinary output was found in 7 patients. Older age [OR: 1.72; 95% CI 1.05â2.82; P = 0.030] associated with post-operative acute kidney injury. Over a median follow-up of 8.9 [95% CI 3.1â24.2] years, the combined renal outcome occurred, respectively, in 28 (53.8%) and 14 (25.9%) patients with and without acute kidney injury (P = 0.003). Logistic regression analysis showed that acute kidney injury (OR: 3.22; 95% CI 1.35â7.66; P = 0.008) and male gender (OR: 2.72; 95% CI 1.08â6.85; P = 0.034) were associated with poor renal outcome after adjustment for main comorbidities. Conclusions: In our population of referred patients, acute kidney injury after unilateral nephrectomy was common and associated with progressive chronic kidney disease, especially in older males. |
| Databáze: | OpenAIRE |
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