Pediatric Critical Care Center, Instituto da Criança e do Adolescente do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil.
Pediatric Surgery and Liver Transplant Team, Instituto da Criança e do Adolescente do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil.
BMC Nephrol. 2023 May 22;24(1):141. doi: 10.1186/s12882-023-03195-1.
Sodium and chloride disturbances have attracted increasing attention in recent years. Many pathophysiological effects are associated with hyperchloremia, including reduction in mean arterial pressure and acute renal disease. Pediatric patients undergoing liver transplantation are at risk of developing various electrolyte and biochemical abnormalities, with an impact on their postoperative outcomes.
To analyze the impacts of serum sodium and chloride levels on prognosis of Pediatric Liver Transplant receptors.
This was a retrospective analytical observational study performed in a single transplant reference center in Sao Paulo, Brazil. Included patients were pediatric patients who underwent liver transplantation between January 2015 and July 2019. Statistical regression analysis and General Estimating Equations analysis were performed to evaluate the impacts of sodium and chloride disturbances on the development of acute renal failure and mortality.
A total of 143 patients were included in this study. The main diagnosis was Biliary Atresia (62.9%). Twenty-seven patients died (18.9%), and graft dysfunction was the main cause of death (29.6%). The only variable individually associated with 28-days mortality was PIM-3 score (HR 1.59, CI 95% 1.165-2.177, p = 0.004). Forty-one patients (28.6%) developed moderate or severe AKI. PIM-3 score (OR 3.052, 95% CI 1.56-5.97, p = 0.001), hypernatremia (OR 3.49, 95% CI 1.32-9.23, p = 0.012), and hyponatremia (OR 4.24, 95% CI 1.52-11.85, p = 0.006) were independently associated with the development of moderate/severe AKI.
In pediatric patients after liver transplantation, PIM-3 score, and abnormal serum sodium levels were correlated with AKI development.
近年来，钠和氯的紊乱引起了越来越多的关注。许多病理生理效应与高氯血症有关，包括平均动脉压降低和急性肾疾病。接受肝移植的儿科患者有发生各种电解质和生化异常的风险，这会影响他们的术后结果。
分析血清钠和氯水平对小儿肝移植受体预后的影响。
这是一项在巴西圣保罗的一家移植参考中心进行的回顾性分析观察性研究。纳入的患者为 2015 年 1 月至 2019 年 7 月期间接受肝移植的儿科患者。进行了统计回归分析和广义估计方程分析，以评估钠和氯紊乱对急性肾衰竭和死亡率发展的影响。
本研究共纳入 143 例患者。主要诊断为胆道闭锁（62.9%）。27 例患者死亡（18.9%），移植物功能障碍是死亡的主要原因（29.6%）。唯一与 28 天死亡率个体相关的变量是 PIM-3 评分（HR 1.59，95%CI 1.165-2.177，p=0.004）。41 例（28.6%）患者发生中度或重度 AKI。PIM-3 评分（OR 3.052，95%CI 1.56-5.97，p=0.001）、高钠血症（OR 3.49，95%CI 1.32-9.23，p=0.012）和低钠血症（OR 4.24，95%CI 1.52-11.85，p=0.006）与中度/重度 AKI 的发生独立相关。
在接受肝移植后的儿科患者中，PIM-3 评分和异常血清钠水平与 AKI 的发生相关。
