Acute kidney injury after liver resection in elderly patients
Abstract Background Acute kidney injury (AKI) affects approximately 13% of patients undergoing major abdominal surgery, and is a common and important clinical sign of perioperative injury. The aim of our analysis was to identify risk factors for AKI in elderly patients with no known kidney disease a...
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| Format: | Article |
| Language: | English |
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BMC
2019-07-01
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| Series: | BMC Nephrology |
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| Online Access: | http://link.springer.com/article/10.1186/s12882-019-1449-0 |
| _version_ | 1818940960169525248 |
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| author | Ivana Dedinská Peter Mikolajčík Patra Skálová Marián Mokáň Ľudovít Laca |
| author_facet | Ivana Dedinská Peter Mikolajčík Patra Skálová Marián Mokáň Ľudovít Laca |
| author_sort | Ivana Dedinská |
| collection | DOAJ |
| description | Abstract Background Acute kidney injury (AKI) affects approximately 13% of patients undergoing major abdominal surgery, and is a common and important clinical sign of perioperative injury. The aim of our analysis was to identify risk factors for AKI in elderly patients with no known kidney disease at the time of surgery, and to evaluate their 30-day, 12-month and 5-year survival. Methods We performed a retrospective analysis on a group of 785 patients after liver resection to determine the incidence of complications (AKI – according to KDIGO classification, sepsis, cardiovascular and surgical complications). All patients had normal kidney function prior to surgery. We determined risk factors for the development of AKI for two groups of patients, stratified for age: patients younger than 65 years, and patients older than 65 years. Results The incidence of complications was significantly higher in the group of patients older than 65 years (n = 76) than in younger patients (n = 119) (P = 0.0496). In the group of younger patients, significantly worse 30-day survival was observed for patients who developed AKI (P = 0.0004). We identified the following independent risk factors for AKI: male gender (HR 10,3834; P = 0,0238), histological identification of colorectal carcinoma metastases (HR 2,8651; P = 0,0499), surgery duration longer than 300 min (HR 6,0096; P < 0,0001), blood loss of more than 500 ml (HR 10,5857; P = 0,0012), and the need for more than 500 ml of fresh frozen plasma during surgery ml (HR 2,4878; P < 0,0317). Age was not confirmed to be an independent risk factor for AKI in our study. Conclusion Approaches to treatment should be highly individualized, with assessment of several variables. According to our findings, age should not present a contraindication for the indication of a patient for surgery. |
| first_indexed | 2024-12-20T06:47:56Z |
| format | Article |
| id | doaj.art-14a2c3683ff046ec8ca90b656c45ec1a |
| institution | Directory Open Access Journal |
| issn | 1471-2369 |
| language | English |
| last_indexed | 2024-12-20T06:47:56Z |
| publishDate | 2019-07-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Nephrology |
| spelling | doaj.art-14a2c3683ff046ec8ca90b656c45ec1a2022-12-21T19:49:39ZengBMCBMC Nephrology1471-23692019-07-0120111010.1186/s12882-019-1449-0Acute kidney injury after liver resection in elderly patientsIvana Dedinská0Peter Mikolajčík1Patra Skálová2Marián Mokáň3Ľudovít Laca4Department of Surgery and Transplant Center, University Hospital Martin and Jessenius Medical Faculty, Comenius UniversityDepartment of Surgery and Transplant Center, University Hospital Martin and Jessenius Medical Faculty, Comenius UniversityDepartment of Surgery and Transplant Center, University Hospital Martin and Jessenius Medical Faculty, Comenius UniversityIst Department of Internal Diseases, University Hospital Martin and Jessenius Medical Faculty, Comenius University Kollárova 2Department of Surgery and Transplant Center, University Hospital Martin and Jessenius Medical Faculty, Comenius UniversityAbstract Background Acute kidney injury (AKI) affects approximately 13% of patients undergoing major abdominal surgery, and is a common and important clinical sign of perioperative injury. The aim of our analysis was to identify risk factors for AKI in elderly patients with no known kidney disease at the time of surgery, and to evaluate their 30-day, 12-month and 5-year survival. Methods We performed a retrospective analysis on a group of 785 patients after liver resection to determine the incidence of complications (AKI – according to KDIGO classification, sepsis, cardiovascular and surgical complications). All patients had normal kidney function prior to surgery. We determined risk factors for the development of AKI for two groups of patients, stratified for age: patients younger than 65 years, and patients older than 65 years. Results The incidence of complications was significantly higher in the group of patients older than 65 years (n = 76) than in younger patients (n = 119) (P = 0.0496). In the group of younger patients, significantly worse 30-day survival was observed for patients who developed AKI (P = 0.0004). We identified the following independent risk factors for AKI: male gender (HR 10,3834; P = 0,0238), histological identification of colorectal carcinoma metastases (HR 2,8651; P = 0,0499), surgery duration longer than 300 min (HR 6,0096; P < 0,0001), blood loss of more than 500 ml (HR 10,5857; P = 0,0012), and the need for more than 500 ml of fresh frozen plasma during surgery ml (HR 2,4878; P < 0,0317). Age was not confirmed to be an independent risk factor for AKI in our study. Conclusion Approaches to treatment should be highly individualized, with assessment of several variables. According to our findings, age should not present a contraindication for the indication of a patient for surgery.http://link.springer.com/article/10.1186/s12882-019-1449-0Acute kidney injuryLiver resectionGeriatric patients |
| spellingShingle | Ivana Dedinská Peter Mikolajčík Patra Skálová Marián Mokáň Ľudovít Laca Acute kidney injury after liver resection in elderly patients BMC Nephrology Acute kidney injury Liver resection Geriatric patients |
| title | Acute kidney injury after liver resection in elderly patients |
| title_full | Acute kidney injury after liver resection in elderly patients |
| title_fullStr | Acute kidney injury after liver resection in elderly patients |
| title_full_unstemmed | Acute kidney injury after liver resection in elderly patients |
| title_short | Acute kidney injury after liver resection in elderly patients |
| title_sort | acute kidney injury after liver resection in elderly patients |
| topic | Acute kidney injury Liver resection Geriatric patients |
| url | http://link.springer.com/article/10.1186/s12882-019-1449-0 |
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