Bredt LC, Peres LAB. Risk factors for acute kidney injury after partial hepatectomy. World J Hepatol 2017; 9(18): 815-822 [PMID: 28706580 DOI: 10.4254/wjh.v9.i18.815]
Corresponding Author of This Article
Luis Cesar Bredt, Full Professor, Department of Surgical Oncology and Hepatobiliary Surgery, University Hospital of Western Paraná, State University of Western Paraná, Dom Pedro II Street, 2099, apto 701, Cascavel, Paraná 85819-110, Brazil. lcbredt@gmail.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Cohort Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Hepatol. Jun 28, 2017; 9(18): 815-822 Published online Jun 28, 2017. doi: 10.4254/wjh.v9.i18.815
Risk factors for acute kidney injury after partial hepatectomy
Luis Cesar Bredt, Luis Alberto Batista Peres
Luis Cesar Bredt, Department of Surgical Oncology and Hepatobiliary Surgery, University Hospital of Western Paraná, State University of Western Paraná, Cascavel, Paraná 85819-110, Brazil
Luis Alberto Batista Peres, Department of Nephrology, University Hospital of Western Paraná, State University of Western Paraná, Cascavel, Paraná 85819-110, Brazil
Author contributions: Bredt LC and Peres LAB contributed equally to this review article; all authors equally contributed to this paper with conception and design of the study, literature review and analysis, drafting and critical revision and editing, and final approval of the final version.
Institutional review board statement: The study was approved by the Research Ethics Board at West Parana University (number. 1.665.135; July 2016). The study was conformed to the ethical guidelines of the 1975 Declaration of Helsinki.
Informed consent statement: All authors (Bredt LC, Peres LAB) declare that all involved persons (subjects or legally authorized representative) gave their informed verbal consent (in person or by phone, as appropriate) prior to study inclusion.
Conflict-of-interest statement: No potential conflicts of interest. No financial support.
Data sharing statement: All authors (Bredt LC, Peres LAB) declare that the original anonymous dataset is available on request from the corresponding author (lcbredt@gmail.com).
Correspondence to: Luis Cesar Bredt, Full Professor, Department of Surgical Oncology and Hepatobiliary Surgery, University Hospital of Western Paraná, State University of Western Paraná, Dom Pedro II Street, 2099, apto 701, Cascavel, Paraná 85819-110, Brazil. lcbredt@gmail.com
Telephone: +55-45-999369943 Fax: +55-45-33215151
Received: February 16, 2017 Peer-review started: February 17, 2017 First decision: April 14, 2017 Revised: May 14, 2017 Accepted: May 22, 2017 Article in press: May 24, 2017 Published online: June 28, 2017 Processing time: 123 Days and 16.9 Hours
Abstract
AIM
To identify risk factors for the occurrence of acute kidney injury (AKI) in the postoperative period of partial hepatectomies.
METHODS
Retrospective analysis of 446 consecutive resections in 405 patients, analyzing clinical characteristics, preoperative laboratory data, intraoperative data, and postoperative laboratory data and clinical evolution. Adopting the International Club of Ascites criteria for the definition of AKI, potential predictors of AKI by logistic regression were identified.
RESULTS
Of the total 446 partial liver resections, postoperative AKI occurred in 80 cases (17.9%). Identified predictors of AKI were: Non-dialytic chronic kidney injury (CKI), biliary obstruction, the Model for End-Stage Liver Disease (MELD) score, the extent of hepatic resection, the occurrence of intraoperative hemodynamic instability, post-hepatectomy haemorrhage, and postoperative sepsis.
CONCLUSION
The MELD score, the presence of non-dialytic CKI and biliary obstruction in the preoperative period, and perioperative hemodynamics instability, bleeding, and sepsis are risk factors for the occurrence of AKI in patients that underwent partial hepatectomy.
Core tip: Acute kidney injury (AKI) is a serious complication after partial hepatectomy. This research aims to identify risk factors for the occurrence of AKI in the postoperative period of partial hepatectomies. The Model for End-Stage Liver Disease score, the presence of non-dialytic chronic kidney injury and biliary obstruction in the preoperative period, and perioperative hemodynamics instability, bleeding, and sepsis are risk factors for the occurrence of AKI in patients that underwent partial hepatectomy.
