Acute kidney injury after liver surgery: does postoperative urine output correlate with postoperative serum creatinine?
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Version: Final published version
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State: Public
Version: Final published version
License: Not specified
Serval ID
serval:BIB_CDDF6500DEF6
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Acute kidney injury after liver surgery: does postoperative urine output correlate with postoperative serum creatinine?
Journal
HPB
ISSN
1477-2574 (Electronic)
ISSN-L
1365-182X
Publication state
Published
Issued date
01/2020
Peer-reviewed
Oui
Volume
22
Number
1
Pages
144-150
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Publication Status: ppublish
Abstract
Acute kidney injury (AKI) after hepatectomy occurs in around 10% of cases. AKI is often defined based only on postoperative serum creatinine increase. This study aimed to assess if postoperative urine output (UO) correlated with serum creatinine after hepatectomy.
All consecutive hepatectomy patients (2010-2016) were assessed. AKI was defined according to KDIGO criteria: serum creatinine increase ≥26.5 μmol/l, creatinine increase ≥1.5x baseline creatinine, or postoperative oliguria. Oliguria was defined as daily mean UO <0.5 mL/kg/h. AKI was subdivided into creatinine-based or oliguria-based AKI according to the defining criterion.
Out of 285 patients, AKI was observed in 79 cases (28%). Creatinine-based AKI occurred in 25 patients (9%) and oliguria-based only AKI in 54 patients (19%). Ten patients fulfilled both criteria (4%). Postoperative UO correlated poorly with postoperative serum creatinine level in both whole cohort (rho = -0.34, p <0.001) and AKI subgroup (rho = -0.189, p = 0.124). No association was found between postoperative oliguria and postoperative serum creatinine increase (HR = 0.5, 95%CI: 0.2-1.9, p = 0.341). On multivariable analysis, operation duration >360 minutes was the only predictor of creatinine increase (HR = 3.6, 95%CI: 1.1-11.4, p = 0.032).
Postoperative UO showed poor correlation with postoperative serum creatinine both in all patients and AKI patients. Surgery duration >360 minutes appeared as the only independent predictor of postoperative serum creatinine increase.
All consecutive hepatectomy patients (2010-2016) were assessed. AKI was defined according to KDIGO criteria: serum creatinine increase ≥26.5 μmol/l, creatinine increase ≥1.5x baseline creatinine, or postoperative oliguria. Oliguria was defined as daily mean UO <0.5 mL/kg/h. AKI was subdivided into creatinine-based or oliguria-based AKI according to the defining criterion.
Out of 285 patients, AKI was observed in 79 cases (28%). Creatinine-based AKI occurred in 25 patients (9%) and oliguria-based only AKI in 54 patients (19%). Ten patients fulfilled both criteria (4%). Postoperative UO correlated poorly with postoperative serum creatinine level in both whole cohort (rho = -0.34, p <0.001) and AKI subgroup (rho = -0.189, p = 0.124). No association was found between postoperative oliguria and postoperative serum creatinine increase (HR = 0.5, 95%CI: 0.2-1.9, p = 0.341). On multivariable analysis, operation duration >360 minutes was the only predictor of creatinine increase (HR = 3.6, 95%CI: 1.1-11.4, p = 0.032).
Postoperative UO showed poor correlation with postoperative serum creatinine both in all patients and AKI patients. Surgery duration >360 minutes appeared as the only independent predictor of postoperative serum creatinine increase.
Keywords
Acute Kidney Injury/blood, Acute Kidney Injury/diagnosis, Acute Kidney Injury/epidemiology, Aged, Creatinine/blood, Female, Hepatectomy/adverse effects, Humans, Length of Stay, Liver Diseases/blood, Liver Diseases/pathology, Liver Diseases/surgery, Male, Middle Aged, Oliguria/blood, Oliguria/diagnosis, Oliguria/etiology, Operative Time, Postoperative Complications/blood, Postoperative Complications/diagnosis, Postoperative Complications/epidemiology, Retrospective Studies, Risk Factors
Pubmed
Web of science
Open Access
Yes
Create date
11/02/2021 1:55
Last modification date
10/02/2024 8:14