Bredt Luis Cesar, Peres Luis Alberto Batista
Luis Cesar Bredt, Department of Surgical Oncology and Hepatobiliary Surgery, University Hospital of Western Paraná, State University of Western Paraná, Cascavel, Paraná 85819-110, Brazil.
World J Hepatol. 2017 Jun 28;9(18):815-822. doi: 10.4254/wjh.v9.i18.815.
To identify risk factors for the occurrence of acute kidney injury (AKI) in the postoperative period of partial hepatectomies.
Retrospective analysis of 446 consecutive resections in 405 patients, analyzing clinical characteristics, preoperative laboratory data, intraoperative data, and postoperative laboratory data and clinical evolution. Adopting the International Club of Ascites criteria for the definition of AKI, potential predictors of AKI by logistic regression were identified.
Of the total 446 partial liver resections, postoperative AKI occurred in 80 cases (17.9%). Identified predictors of AKI were: Non-dialytic chronic kidney injury (CKI), biliary obstruction, the Model for End-Stage Liver Disease (MELD) score, the extent of hepatic resection, the occurrence of intraoperative hemodynamic instability, post-hepatectomy haemorrhage, and postoperative sepsis.
The MELD score, the presence of non-dialytic CKI and biliary obstruction in the preoperative period, and perioperative hemodynamics instability, bleeding, and sepsis are risk factors for the occurrence of AKI in patients that underwent partial hepatectomy.
确定部分肝切除术后急性肾损伤（AKI）发生的危险因素。
对405例患者连续进行的446例肝切除术进行回顾性分析，分析临床特征、术前实验室数据、术中数据、术后实验室数据及临床病程。采用国际腹水俱乐部标准定义AKI，通过逻辑回归确定AKI的潜在预测因素。
在446例肝部分切除术中，术后发生AKI 80例（17.9%）。确定的AKI预测因素为：非透析性慢性肾损伤（CKI）、胆道梗阻、终末期肝病模型（MELD）评分、肝切除范围、术中血流动力学不稳定的发生、肝切除术后出血及术后脓毒症。
MELD评分、术前存在非透析性CKI和胆道梗阻，以及围手术期血流动力学不稳定、出血和脓毒症是接受部分肝切除术患者发生AKI的危险因素。
