Impact of acute kidney injury after extended liver resections
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Impact of acute kidney injury after extended liver resections. / Reese, Tim; Kröger, Fabian; Makridis, Georgios; Drexler, Richard; Jusufi, Maximilian; Schneider, Martin; Brüning, Roland; von Rittberg, York; Wagner, Kim C; Oldhafer, Karl J.
In: HPB, Vol. 23, No. 7, 07.2021, p. 1000-1007.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Impact of acute kidney injury after extended liver resections
AU - Reese, Tim
AU - Kröger, Fabian
AU - Makridis, Georgios
AU - Drexler, Richard
AU - Jusufi, Maximilian
AU - Schneider, Martin
AU - Brüning, Roland
AU - von Rittberg, York
AU - Wagner, Kim C
AU - Oldhafer, Karl J
N1 - Copyright © 2020 International Hepato-Pancreato-Biliary Association Inc. Published by Elsevier Ltd. All rights reserved.
PY - 2021/7
Y1 - 2021/7
N2 - BACKGROUND: Complex liver resection is a risk factor for the development of AKI, which is associated with increased morbidity and mortality. Aim of this study was to assess risk factors for acute kidney injury (AKI) and its impact on outcome for patients undergoing complex liver surgery.METHODS: AKI was defined according to the KDIGO criteria. Primary endpoint was the occurrence of AKI after liver resection. Secondary endpoints were complications and mortality.RESULTS: Overall, 146 patients undergoing extended liver resection were included in the study. The incidence of AKI was 21%. The incidence of chronic kidney disease (CKD) and hepatocellular carcinoma were significantly higher in patients with AKI. In the AKI group, the proportion of extended right hepatectomies was the highest (53%), followed by ALPPS (43%). Increased intraoperative blood loss, increased postoperative complications and perioperative mortality was associated with AKI. Besides age and CKD, ALPPS was an independent risk factor for postoperative AKI. A small future liver remnant seemed to increase the risk of AKI in patients undergoing ALPPS.CONCLUSION: Following extended liver resection, AKI is associated with an increased morbidity and mortality. ALPPS is a major independent risk factor for the development of AKI and a sufficient future liver remnant could avoid postoperative AKI.
AB - BACKGROUND: Complex liver resection is a risk factor for the development of AKI, which is associated with increased morbidity and mortality. Aim of this study was to assess risk factors for acute kidney injury (AKI) and its impact on outcome for patients undergoing complex liver surgery.METHODS: AKI was defined according to the KDIGO criteria. Primary endpoint was the occurrence of AKI after liver resection. Secondary endpoints were complications and mortality.RESULTS: Overall, 146 patients undergoing extended liver resection were included in the study. The incidence of AKI was 21%. The incidence of chronic kidney disease (CKD) and hepatocellular carcinoma were significantly higher in patients with AKI. In the AKI group, the proportion of extended right hepatectomies was the highest (53%), followed by ALPPS (43%). Increased intraoperative blood loss, increased postoperative complications and perioperative mortality was associated with AKI. Besides age and CKD, ALPPS was an independent risk factor for postoperative AKI. A small future liver remnant seemed to increase the risk of AKI in patients undergoing ALPPS.CONCLUSION: Following extended liver resection, AKI is associated with an increased morbidity and mortality. ALPPS is a major independent risk factor for the development of AKI and a sufficient future liver remnant could avoid postoperative AKI.
KW - Acute Kidney Injury/diagnosis
KW - Hepatectomy/adverse effects
KW - Humans
KW - Incidence
KW - Liver Neoplasms/surgery
KW - Postoperative Complications/etiology
KW - Retrospective Studies
KW - Risk Factors
U2 - 10.1016/j.hpb.2020.10.015
DO - 10.1016/j.hpb.2020.10.015
M3 - SCORING: Journal article
C2 - 33191106
VL - 23
SP - 1000
EP - 1007
JO - HPB
JF - HPB
SN - 1365-182X
IS - 7
ER -
