Preoperative Albuminuria and Intraoperative Chloride Load: Predictors of Acute Kidney Injury Following Major Abdominal Surgery
Autor: | Stavroula Kolyvaki, Dimitris Georgopoulos, Nikolaos Kroustalakis, Christos V. Ioannou, G.E.O.R.G.I.O.S. Papadopoulos, Diamantina Marouli, Eleftherios Papadakis, Kostas Stylianou, Eugene Daphnis, Helen Askitopoulou, Alexandra Papaioannou |
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Jazyk: | angličtina |
Rok vydání: | 2018 |
Předmět: |
medicine.medical_specialty
chloride lcsh:Medicine 030204 cardiovascular system & hematology urologic and male genital diseases Article albuminuria 03 medical and health sciences 0302 clinical medicine medicine 030212 general & internal medicine business.industry urogenital system lcsh:R Acute kidney injury General Medicine Perioperative medicine.disease female genital diseases and pregnancy complications Cardiac surgery Anesthesia Albuminuria postoperative acute kidney injury Fresh frozen plasma medicine.symptom business Complication Abdominal surgery Kidney disease |
Zdroj: | Journal of Clinical Medicine, Vol 7, Iss 11, p 431 (2018) Journal of Clinical Medicine Volume 7 Issue 11 |
ISSN: | 2077-0383 |
Popis: | Background: Postoperative Acute Kidney Injury (AKI) is a common and serious complication associated with significant morbidity and mortality. While several pre- and intra-operative risk factors for AKI have been recognized in cardiac surgery patients, relatively few data are available regarding the incidence and risk factors for perioperative AKI in other surgical operations. The aim of the present study was to determine the risk factors for perioperative AKI in patients undergoing major abdominal surgery. Methods: This was a prospective, observational study of patients undergoing major abdominal surgery in a tertiary care center. Postoperative AKI was diagnosed according to the Acute Kidney Injury Network criteria within 48 h after surgery. Patients with chronic kidney disease stage IV or V were excluded. Logistic regression analysis was used to evaluate the association between perioperative factors and the risk of developing postoperative AKI. Results: Eleven out of 61 patients developed postoperative AKI. Four intra-operative variables were identified as predictors of AKI: intra-operative blood loss (p = 0.002), transfusion of fresh frozen plasma (p = 0.004) and red blood cells (p = 0.038), as well as high chloride load (p = 0.033, cut-off value > 500 mEq). Multivariate analysis demonstrated an independent association between AKI development and preoperative albuminuria, defined as a urinary Albumin to Creatinine ratio &ge 30 mg· g&minus 1 (OR = 6.88, 95% CI: 1.43&ndash 33.04, p = 0.016) as well as perioperative chloride load > 500 mEq (OR = 6.87, 95% CI: 1.46&ndash 32.4, p = 0.015). Conclusion: Preoperative albuminuria, as well as a high intraoperative chloride load, were identified as predictors of postoperative AKI in patients undergoing major abdominal surgery. |
Databáze: | OpenAIRE |
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