Department of Gastroenterology, University Hospital, School of Medicine, University of São Paulo - USP, São Paulo, SP, Brazil.
Arq Bras Cir Dig. 2022 Jan 5;34(3):e1622. doi: 10.1590/0102-672020210002e1622. eCollection 2022.
The incidence of abdominal hernia in cirrhotic patients is as higher as 20%; in cases of major ascites the incidence may increase up to 40%. One of the main and most serious complications in cirrhotic postoperative period (PO) is acute kidney injury (AKI).
To analyze the renal function of cirrhotic patients undergoing to hernia surgery and evaluate the factors related to AKI.
Follow-up of 174 cirrhotic patients who underwent hernia surgery. Laboratory tests including the renal function were collected in the PO.AKI was defined based on the consensus of the ascite´s club. They were divided into two groups: with (AKI PO) and without AKI .
All 174 patients were enrolled and AKI occurred in 58 (34.9%). In the AKI PO group, 74.1% had emergency surgery, whereas in the group without AKI PO it was only 34.6%.In the group with AKI PO, 90.4% presented complications, whereas in the group without AKI PO they occurred only in 29.9%. Variables age, baseline MELD, baseline creatinine, creatinine in immediate postoperative (POI), AKI and the presence of ascites were statistically significant for survival.
There is association between AKI PO and emergency surgery and, also, between AKI PO and complications after surgery. The factors related to higher occurrence were initial MELD, basal Cr, Cr POI. The patients with postoperative AKI had a higher rate of complications and higher mortality.
肝硬化患者的腹疝发生率高达 20%；大量腹水时，发生率可上升至 40%。肝硬化术后（PO）的主要且最严重的并发症之一是急性肾损伤（AKI）。
分析行疝修补术的肝硬化患者的肾功能，并评估与 AKI 相关的因素。
对 174 例行疝修补术的肝硬化患者进行随访。PO 期收集包括肾功能在内的实验室检查。AKI 根据腹水俱乐部的共识定义。他们分为两组：AKI PO 组和无 AKI PO 组。
所有 174 例患者均纳入研究，其中 58 例（34.9%）发生 AKI PO。在 AKI PO 组中，74.1%为急诊手术，而在无 AKI PO 组中仅为 34.6%。在 AKI PO 组中，90.4%出现并发症，而在无 AKI PO 组中仅发生 29.9%。变量年龄、基线 MELD、基线肌酐、POI 肌酐、AKI 和腹水的存在对生存率有统计学意义。
PO 期 AKI 与急诊手术之间存在关联，与术后并发症之间也存在关联。与 AKI PO 发生相关的因素是初始 MELD、基础 Cr、Cr POI。术后发生 AKI 的患者并发症发生率更高，死亡率更高。
