Incidence of acute kidney injury after teicoplanin– or vancomycin– and piperacillin/tazobactam combination therapy: A comparative study using propensity score matching analysis

Abstract Background Angiography has been conducted as a hemostatic procedure for trauma patients. While several complications, such as tissue necrosis after embolization, have been reported, little is known regarding subsequent acute kidney injury (AKI) due to contrast media. To elucidate whether emergency angiography would introduce kidney dysfunction in trauma victims, we compared the incidence of AKI between patients who underwent emergency angiography and those who did not. Methods A retrospective cohort study was conducted using a nationwide trauma database (2004–2019), and adult trauma patients were included. The indication of emergency angiography was determined by both trauma surgeons and radiologists, and AKI was diagnosed by treating physicians based on a rise in serum creatinine and/or fall in urine output according to any published standard criteria. Incidence of AKI was compared between patients who underwent emergency angiography and those who did not. Propensity score matching was conducted to adjust baseline characteristics including age, comorbidities, mechanism of injury, vital signs on admission, Injury Severity Scale (ISS), degree of traumatic kidney injury, surgical procedures, and surgery on the kidney, such as nephrectomy and nephrorrhaphy. Results Among 230,776 patients eligible for the study, 14,180 underwent emergency angiography. The abdomen/pelvis was major site for angiography (10,624 [83.5%]). Embolization was performed in 5,541 (43.5%). Propensity score matching selected 12,724 pairs of severely injured patients (median age, 59; median ISS, 25). While the incidence of AKI was rare, it was higher among patients who underwent emergency angiography than in those who did not (140 [1.1%] vs. 67 [0.5%]; odds ratio = 2.10 [1.57–2.82]; p < 0.01). The association between emergency angiography and subsequent AKI was observed regardless of vasopressor usage or injury severity in subgroup analyses. Conclusions Emergency angiography in trauma patients was probably associated with increased incidence of AKI. The results should be validated in future studies.

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Effect of Diabetes Mellitus on Acute Kidney Injury after Minimally Invasive Partial Nephrectomy: A Case-Matched Retrospective Analysis

Journal of Clinical Medicine ◽

10.3390/jcm8040468 ◽

2019 ◽

Vol 8 (4) ◽

pp. 468 ◽

Cited By ~ 6

Author(s):

Na Young Kim ◽

Jung Hwa Hong ◽

Dong Hoon Koh ◽

Jongsoo Lee ◽

Hoon Jae Nam ◽

...

Keyword(s):

Diabetes Mellitus ◽

Acute Kidney Injury ◽

Propensity Score ◽

Minimally Invasive ◽

Propensity Score Matching ◽

Partial Nephrectomy ◽

Kidney Injury ◽

Invasive Technique ◽

Male Sex ◽

Postoperative Aki

Postoperative acute kidney injury (AKI) is still a concern in partial nephrectomy (PN), even with the development of minimally invasive technique. We aimed to compare AKI incidence between patients with and without diabetes mellitus (DM) and to determine the predictive factors for postoperative AKI. This case-matched retrospective study included 884 patients with preoperative creatinine levels ≤1.4 mg/dL who underwent laparoscopic or robot-assisted laparoscopic PN between December 2005 and May 2018. Propensity score matching was employed to match patients with and without DM in a 1:3 ratio (101 and 303 patients, respectively). Of 884 patients, 20.4% had postoperative AKI. After propensity score matching, the incidence of postoperative AKI in DM and non-DM patients was 30.7% and 14.9%, respectively (P < 0.001). In multivariate analysis, male sex and warm ischemia time (WIT) >25 min were significantly associated with postoperative AKI in patients with and without DM. In patients with DM, hemoglobin A1c (HbA1c) >7% was a predictive factor for AKI, odds ratio (OR) = 4.59 (95% CI, 1.47–14.36). In conclusion, DM increased the risk of AKI after minimally invasive PN; male sex, longer WIT, and elevated HbA1c were independent risk factors for AKI in patients with DM.

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