Effects of acute kidney injury after liver resection on long-term outcomes

Seiji Ishikawa; Manami Tanaka; Fumi Maruyama; Arisa Fukagawa; Nobuhiro Shiota; Satoshi Matsumura; Koshi Makita

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자료유형: 학술저널

저자정보: Seiji Ishikawa (Tokyo Medical and Dental University) Manami Tanaka (Tokyo Medical and Dental University) Fumi Maruyama (Tokyo Medical and Dental University) Arisa Fukagawa (Tokyo Medical and Dental University) Nobuhiro Shiota (Tokyo Medical and Dental University) Satoshi Matsumura (Tokyo Medical and Dental University) Koshi Makita (Tokyo Medical and Dental University)

저널정보: 대한마취통증의학회(구 대한마취과학회) Korean Journal of Anesthesiology Korean Journal of Anesthesiology Vol.70 No.5

발행연도: 2017.1

수록면: 527 - 534 (8page)

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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.

참고문헌 (27)

참고문헌 신청

Carmichael P / 2003 / Acute renal failure in the surgical setting / ANZ J Surg 73:144~153

Tang IY / 2004 / Prevention of perioperative acute renal failure: what works? / Best Pract Res Clin Anaesthesiol 18:91~111

Bellomo R / 2004 / Acute renal failure - definition, outcome measures, animal models, fluid therapy and information technology needs: the Second International Consensus Conference of the Acute Dialysis Quality Initiative (ADQI) Group / Crit Care 8:R204~R212

Mehta RL / 2007 / Acute Kidney Injury Network: report of an initiative to improve outcomes in acute kidney injury / Crit Care 11:R31

Moore EM / 2010 / Preoperative estimated glomerular filtration rate and RIFLE-classified postoperative acute kidney injury predict length of stay post-coronary bypass surgery in an Australian setting / Anaesth Intensive Care 38:113~121

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