scholarly journals The impact of comorbidities, sex and age on the occurrence of acute kidney injury among patients undergoing nephron-sparing surgery

2018 ◽  
Vol 10 (3) ◽  
pp. 103-108 ◽  
Author(s):  
Elias Hellou ◽  
Zaher Bahouth ◽  
Edmond Sabo ◽  
Zaid Abassi ◽  
Ofer Nativ
Keyword(s):  
Acute Kidney Injury ◽  
Kidney Cancer ◽  
Univariate Analysis ◽  
Kidney Injury ◽  
Nephron Sparing Surgery ◽  
Average Decrease ◽  
Nephron Sparing ◽  
Data Definition ◽  
The Impact ◽  
Postoperative Aki

Background: The aim of this study was to report the impact of patients’ baseline characteristics on the incidence of acute kidney injury (AKI) after nephron-sparing surgery (NSS) for localized kidney cancer. Patients and methods: Data from our kidney cancer database were retrospectively extracted to include 402 patients who underwent NSS between March 2000 and June 2016, and had sufficient data. Definition of AKI was based on the postoperative serum creatinine levels and estimated glomerular filtration rate (eGFR) magnitude, which were measured during the 72 h after surgery. Results: Based on RIFLE and AKIN criteria, the overall rate of postoperative AKI was 35%. The average decrease in eGFR among patients who developed AKI was 20% as compared with the non-AKI subgroup (2%). In univariate analysis, variables that were associated with AKI included right-sided tumors ( p = 0.014), male sex ( p = 0.01), hypertension ( p = 0.003), baseline eGFR ( p = 0.009) and history of nephrolithiasis ( p = 0.039). However, multivariate analysis revealed that the only independent predictors of postoperative AKI were hypertension ( p = 0.009) and cigarette smoking ( p = 0.024). Conclusion: AKI is a common complication of NSS affecting about one-third of the patients. The most important risk factors are hypertension and smoking.

scholarly journals Renin–angiotensin system blocker use and the risk of acute kidney injury after colorectal cancer surgery: a population-based cohort study

BMJ Open ◽  
2019 ◽  
Vol 9 (11) ◽  
pp. e032964
Author(s):  
Charlotte Slagelse ◽  
H Gammelager ◽  
Lene Hjerrild Iversen ◽  
Kathleen D Liu ◽  
Henrik T Toft Sørensen ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Acute Kidney Injury ◽  
Cohort Study ◽  
Angiotensin Receptor Blockers ◽  
Kidney Injury ◽  
Population Based ◽  
Adjusted Risk ◽  
Increased Risk ◽  
The Impact ◽  
Postoperative Aki

ObjectivesIt is unknown whether preoperative use of ACE inhibitors (ACE-I) or angiotensin receptor blockers (ARBs) affects the risk of acute kidney injury (AKI) after colorectal cancer (CRC) surgery. We assessed the impact of preoperative ACE-I/ARB use on risk of AKI after CRC surgery.DesignObservational cohort study. Patients were divided into three exposure groups—current, former and non-users—through reimbursed prescriptions within 365 days before the surgery. AKI within 7 days after surgery was defined according to the current Kidney Disease Improving Global Outcome consensus criteria.SettingPopulation-based Danish medical databases.ParticipantsA total of 9932 patients undergoing incident CRC surgery during 2005–2014 in northern Denmark were included through the Danish Colorectal Cancer Group Database.Outcome measureWe computed cumulative incidence proportions (risk) of AKI with 95% CIs for current, former and non-users of ACE-I/ARB, including death as a competing risk. We compared current and former users with non-users by computing adjusted risk ratios (aRRs) using log-binomial regression adjusted for demographics, comorbidities and CRC-related characteristics. We stratified the analyses of ACE-I/ARB users to address any difference in impact within relevant subgroups.ResultsTwenty-one per cent were ACE-I/ARB current users, 6.4% former users and 72.3% non-users. The 7-day postoperative AKI risk for current, former and non-users was 26.4% (95% CI 24.6% to 28.3%), 25.2% (21.9% to 28.6%) and 17.8% (17.0% to 18.7%), respectively. The aRRs of AKI were 1.20 (1.09 to 1.32) and 1.16 (1.01 to 1.34) for current and former users, compared with non-users. The relative risk of AKI in current compared with non-users was consistent in all subgroups, except for higher aRR in patients with a history of hypertension.ConclusionsBeing a current or former user of ACE-I/ARBs is associated with an increased risk of postoperative AKI compared with non-users. Although it may not be a drug effect, users of ACE-I/ARBs should be considered a risk group for postoperative AKI.

Perioperative Anaemia is a Risk Factor of Acute Kidney Injury in Patients Undergoing Partial Nephrectomy

2020 ◽  
Author(s):  
Shun Zhang ◽  
Huangqi Duan ◽  
Yu Wu ◽  
Weimin Xia ◽  
Subo Qian ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Logistic Regression ◽  
Risk Factor ◽  
Partial Nephrectomy ◽  
Pearson Correlation ◽  
Kidney Injury ◽  
Regression Analyses ◽  
Clinical Issue ◽  
The Impact ◽  
Postoperative Aki

Abstract Background Acute kidney injury (AKI) secondary to partial nephrectomy (PN) is a challenging clinical issue. During PN anaemia develops due to haemodilution and blood loss, which decreases oxygen transfer and provokes tissue hypoxia, leading to postoperative adverse outcomes. The aim of this study was to investigate the impact of perioperative anaemia on postoperative AKI after PN.Methods This retrospective cohort study included 68 adult patients undergoing PN for a single nonmetastatic renal tumor. Detailed clinical information was systematically reviewed and analyzed. Serum concentrations of neutrophil gelatinase-associated lipocalin (NGAL) and creatinine (sCr) were tested before, 2 hours and 1 day after PN surgery. Perioperative anaemia was assessed according to haematocrit (Ht) value at the same timepoint. Association between perioperative anaemia and postoperative AKI were explored by logistic regression analyses and pearson correlation analysis. Results The rate of perioperative anaemia in patients undergoing PN was 35.3% when the criteria of Ht < 30% was adopted. AKI developed in 32.4% of the patients when KDIGO criteria was applicated and in 51.5% of the patients when the criteria of serum NGAL >150 ng/mL was used. The incidence of AKI in patients with perioperative anaemia was higher than that in patients without anaemia. Univariate logistic regression analyses showed perioperative anaemia was a relevant factor of postoperative AKI in patients undergoing PN.Conclusions Perioperative anaemia might be a risk factor of postoperative AKI after PN. But the detailed interrelation still needs to be verified by large-scale prospective studies.

THE IMPACT OF NEPHRON-SPARING SURGERY ON QUALITY OF LIFE IN PATIENTS WITH LOCALIZED KIDNEY CANCER

1999 ◽  
pp. 194
Author(s):  
Nobuo Shinohara ◽  
Toru Harabayashi ◽  
Soshu Sato ◽  
Kazuya Sakamoto ◽  
Takaya Hioka ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Kidney Cancer ◽  
Nephron Sparing Surgery ◽  
Nephron Sparing ◽  
The Impact

scholarly journals Acute kidney injury following primary hip and knee arthroplasty surgery

2017 ◽  
Vol 99 (4) ◽  
pp. 307-312 ◽  
Author(s):  
KB Ferguson ◽  
A Winter ◽  
L Russo ◽  
A Khan ◽  
M Hair ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Length Of Stay ◽  
Knee Arthroplasty ◽  
Univariate Analysis ◽  
Kidney Injury ◽  
Targeted Interventions ◽  
Knee Arthroplasty Surgery ◽  
Postoperative Aki ◽  
Arthroplasty Surgery

Acute kidney injury (AKI) is a recognised postoperative complication following primary hip/knee arthroplasty surgery. The aim of this study was to determine causative and potentially modifiable risk factors associated with postoperative AKI. Standard data were collected for 413 consecutive arthroplasty patients, both retrospectively and prospectively. Univariate and multivariate analyses were performed to identify any potential causative factors. Eight percent of patients developed postoperative AKI. Univariate analysis found increasing age, history of previous chronic kidney disease and requirement for postoperative intravenous fluids to be risk factors for AKI. The multivariate regression analysis model identified age and volume of postoperative fluid prescription as predictive of postoperative AKI. Antibiotic regime and prescription of non-steroidal anti-inflammatory drugs had no significant effect on the risk of AKI. No patients required dialysis but length of stay increased by 50% in the AKI group. Postoperative AKI may result in significant postoperative morbidity and increased length of stay, and may necessitate invasive therapies such as dialysis. Episodes of AKI could also predispose to future similar episodes and are associated with a long-term decrease in baseline renal function. This study has demonstrated that the identified risk factors are generally non-modifiable. Further work is suggested to determine whether targeted interventions in high risk patients would reduce the incidence of AKI.

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