Risk factors for acute kidney injury and 30-day mortality after liver transplantation



Título del documento: Risk factors for acute kidney injury and 30-day mortality after liver transplantation
Revista: Annals of hepatology
Base de datos: PERIÓDICA
Número de sistema: 000390994
ISSN: 1665-2681
Autors: 1
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2
3
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1
3
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Institucions: 1Universidade Federal do Ceara, Faculdade de Medicina, Fortaleza, Ceara. Brasil
2Universidade de Fortaleza, Faculdade de Medicina, Fortaleza, Ceara. Brasil
3Universidade Federal do Ceara, Hospital Universitario Walter Cantidio, Fortaleza, Ceara. Brasil
Any:
Període: Sep-Oct
Volum: 14
Número: 5
Paginació: 688-694
País: México
Idioma: Inglés
Tipo de documento: Estadística o encuesta
Enfoque: Analítico
Resumen en inglés The aim of this study is to evaluate the risk factors for acute kidney injury (AKI) and 30-day mortality after liver transplantation. Material and methods. This is a retrospective cohort of consecutive adults undergoing orthotopic liver transplantation (OLT) at a referral hospital in Brazil, from January 2013 to January 2014. Risk factors for AKI and death were investigated. Results. A total 134 patients were included, with median age of 56 years. AKI was found in 46.7% of patients in the first 72 h after OLT. Risk factors for AKI were: viral hepatitis (OR 2.9, 95% CI = 1.2-7), warm ischemia time (OR 1.1, 95% CI = 1.01-1.2) and serum lactate (OR 1.3, 95%CI = 1.02-1.89). The length of intensive care unit (ICU) stay was longer in AKI group: 4 (3-7) days vs. 3 (2-4) days (p = 0.001), as well as overall hospitalization stay: 16 (9-26) days vs. 10 (8- 14) days (p = 0.001). The 30-day mortality was 15%. AKI was an independent risk factor for mortality (OR 4.3, 95% CI = 1.3-14.6). MELD-Na ≥ 22 was a predictor for hemodialysis need (OR 8.4, 95%CI = 1.5-46.5). Chronic kidney disease (CKD) was found in 36 patients (56.2% of AKI patients). Conclusions. Viral hepatitis, longer warm ischemia time and high levels of serum lactate are risk factors for AKI after OLT. AKI is a risk factor for death and can lead to CKD in a high percentage of patients after OLT. A high MELD-Na score is a predictor for hemodialysis need
Disciplines Medicina
Paraules clau: Gastroenterología,
Nefrología,
Salud pública,
Insuficiencia renal aguda (IRA),
Trasplantes,
Hígado,
Factores de riesgo,
Mortalidad,
Donación de órganos
Keyword: Medicine,
Gastroenterology,
Nephrology,
Public health,
Acute renal failure (ARF),
Transplantation,
Liver,
Mortality,
Risk factors,
Organ donation
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