Lee Yoon Sook, Choi Yoon Ji, Park Kyu Hee, Park Byeong Seon, Son Jung-Min, Park Ju Yeon, Ri Hyun-Su, Ryu Je Ho
Department of Anaesthesiology and Pain Medicine, Ansan Hospital, Korea University, College of Medicine, Ansan 15355, Korea.
Department of Pediatrics, Korea University Hospital, Ansan 15355, Korea.
J Clin Med. 2020 May 28;9(6):1629. doi: 10.3390/jcm9061629.
Acute kidney injury (AKI) is one of the most frequent postoperative complications after liver transplantation (LT). Increased serum ammonia levels due to the liver disease itself may affect postoperative renal function. This study aimed to compare the incidence of postoperative AKI according to preoperative serum ammonia levels in patients after LT. Medical records from 436 patients who underwent LT from January 2010 to February 2020 in a single university hospital were retrospectively reviewed. The patients were then categorized according to changes in plasma creatinine concentrations within 48 h of LT using the Acute Kidney Injury Network criteria. A preoperative serum ammonia level above 45 mg/dL was associated with postoperative AKI ( < 0.0001). Even in patients with a normal preoperative creatinine level, when the ammonia level was greater than 45 μg/dL, the incidence of postoperative AKI was significantly higher ( < 0.0001); the AKI stage was also higher in this group than in the group with preoperative ammonia levels less than or equal to 45 μg/dL ( < 0.0001). Based on the results of our research, an elevation in preoperative serum ammonia levels above 45 μg/dL is related to postoperative AKI after LT.
急性肾损伤（AKI）是肝移植（LT）后最常见的术后并发症之一。肝脏疾病本身导致的血清氨水平升高可能会影响术后肾功能。本研究旨在比较肝移植术后患者术前血清氨水平与术后AKI的发生率。回顾性分析了2010年1月至2020年2月在一家大学医院接受肝移植的436例患者的病历。然后根据急性肾损伤网络标准，根据肝移植术后48小时内血浆肌酐浓度的变化对患者进行分类。术前血清氨水平高于45mg/dL与术后AKI相关（<0.0001）。即使术前肌酐水平正常的患者，当氨水平大于45μg/dL时，术后AKI的发生率也显著更高（<0.0001）；该组的AKI分期也高于术前氨水平小于或等于45μg/dL的组（<0.0001）。根据我们的研究结果，术前血清氨水平升高至45μg/dL以上与肝移植术后AKI有关。
