Effects of acute kidney injury after liver resection on long-term outcomes
BackgroundTo investigate the effects of acute kidney injury (AKI) after liver resection on the long-term outcome, including mortality and renal dysfunction after hospital discharge.MethodsWe conducted a historical cohort study of patients who underwent liver resection for hepatocellular carcinoma wi...
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| Format: | Article |
| Language: | English |
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Korean Society of Anesthesiologists
2017-10-01
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| Series: | Korean Journal of Anesthesiology |
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| Online Access: | http://ekja.org/upload/pdf/kjae-70-527.pdf |
| _version_ | 1831648038030934016 |
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| author | Seiji Ishikawa Manami Tanaka Fumi Maruyama Arisa Fukagawa Nobuhiro Shiota Satoshi Matsumura Koshi Makita |
| author_facet | Seiji Ishikawa Manami Tanaka Fumi Maruyama Arisa Fukagawa Nobuhiro Shiota Satoshi Matsumura Koshi Makita |
| author_sort | Seiji Ishikawa |
| collection | DOAJ |
| description | BackgroundTo investigate the effects of acute kidney injury (AKI) after liver resection on the long-term outcome, including mortality and renal dysfunction after hospital discharge.MethodsWe 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.ResultsAKI 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).ConclusionsAfter 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. |
| first_indexed | 2024-12-19T14:24:12Z |
| format | Article |
| id | doaj.art-c343c5f1665b4b229286a92bdc1e88c5 |
| institution | Directory Open Access Journal |
| issn | 2005-6419 2005-7563 |
| language | English |
| last_indexed | 2024-12-19T14:24:12Z |
| publishDate | 2017-10-01 |
| publisher | Korean Society of Anesthesiologists |
| record_format | Article |
| series | Korean Journal of Anesthesiology |
| spelling | doaj.art-c343c5f1665b4b229286a92bdc1e88c52022-12-21T20:17:40ZengKorean Society of AnesthesiologistsKorean Journal of Anesthesiology2005-64192005-75632017-10-0170552753410.4097/kjae.2017.70.5.5278342Effects of acute kidney injury after liver resection on long-term outcomesSeiji Ishikawa0Manami Tanaka1Fumi Maruyama2Arisa Fukagawa3Nobuhiro Shiota4Satoshi Matsumura5Koshi Makita6Department of Anesthesiology, Tokyo Medical and Dental University, Graduate School of Medical and Dental Sciences, Tokyo, Japan.Department of Anesthesiology, Tokyo Medical and Dental University, Graduate School of Medical and Dental Sciences, Tokyo, Japan.Department of Critical Care Medicine, Tokyo Medical and Dental University, Graduate School of Medical and Dental Sciences, Tokyo, Japan.Department of Anesthesiology, Tokyo Medical and Dental University, Graduate School of Medical and Dental Sciences, Tokyo, Japan.Department of Anesthesiology, Tokyo Medical and Dental University, Graduate School of Medical and Dental Sciences, Tokyo, Japan.Department of Hepatobiliary and Pancreatic Surgery, Tokyo Medical and Dental University, Graduate School of Medical and Dental Sciences, Tokyo, Japan.Department of Anesthesiology, Tokyo Medical and Dental University, Graduate School of Medical and Dental Sciences, Tokyo, Japan.BackgroundTo investigate the effects of acute kidney injury (AKI) after liver resection on the long-term outcome, including mortality and renal dysfunction after hospital discharge.MethodsWe 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.ResultsAKI 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).ConclusionsAfter 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.http://ekja.org/upload/pdf/kjae-70-527.pdfacute kidney injuryhepatectomylong term adverse effectsperioperative management |
| spellingShingle | Seiji Ishikawa Manami Tanaka Fumi Maruyama Arisa Fukagawa Nobuhiro Shiota Satoshi Matsumura Koshi Makita Effects of acute kidney injury after liver resection on long-term outcomes Korean Journal of Anesthesiology acute kidney injury hepatectomy long term adverse effects perioperative management |
| title | Effects of acute kidney injury after liver resection on long-term outcomes |
| title_full | Effects of acute kidney injury after liver resection on long-term outcomes |
| title_fullStr | Effects of acute kidney injury after liver resection on long-term outcomes |
| title_full_unstemmed | Effects of acute kidney injury after liver resection on long-term outcomes |
| title_short | Effects of acute kidney injury after liver resection on long-term outcomes |
| title_sort | effects of acute kidney injury after liver resection on long term outcomes |
| topic | acute kidney injury hepatectomy long term adverse effects perioperative management |
| url | http://ekja.org/upload/pdf/kjae-70-527.pdf |
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