Acute kidney injury following orthotopic liver transplantation: incidence, risk factors, and effects on patient and graft outcomes
Acute kidney injury following orthotopic liver transplantation: incidence, risk factors, and effects on patient and graft outcomes
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DOI：
10.1093/bja/aeu556
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发表时间：
2015-06-01
影响因子：
9.8
通讯作者：
Kellum, J. A.
中科院分区：
文献类型：
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作者：
Hilmi, I. A.;Damian, D.;Kellum, J. A.
背景肝移植受者经常发生急性肾损伤（阿基），但阿基的诱发因素和长期后果尚不清楚。本研究的目的是确定早期移植后阿基的诱发因素和阿基对患者和移植物存活的影响，并构建一个模型，使用临床变量预测阿基。在这项为期5年的回顾性研究中，我们分析了来自本中心的424例肝移植受者的临床和实验室数据。到移植后72小时，221例患者（52%）发生了阿基[根据肾脏疾病改善全球结局（KDIGO）标准]。发生阿基的易感因素为女性、体重（>100 kg）、肝病严重程度（Child-Pugh评分）、既存糖尿病、术中输注的血液或新鲜冷冻血浆单位数以及作为终末期肝病病因的非酒精性脂肪性肝炎（P <100 kg，Child-Pugh评分高糖尿病与72 h内阿基的发生显著相关（P
Background. Liver transplant recipients frequently develop acute kidney injury (AKI), but the predisposing factors and long-term consequences of AKI are not well understood. The aims of this study were to identify predisposing factors for early post-transplant AKI and the impact of AKI on patient and graft survival and to construct a model to predict AKI using clinical variables.Methods. In this 5-year retrospective study, we analysed clinical and laboratory data from 424 liver transplant recipients from our centre.Results. By 72 h post-transplant, 221 patients (52%) had developed AKI [according to the Kidney Disease Improving Global Outcomes (KDIGO) criteria]. Predisposing factors for development of AKI were female sex, weight (>100 kg), severity of liver disease (Child-Pugh score), pre-existing diabetes mellitus, number of units of blood or fresh frozen plasma transfused during surgery, and non-alcoholic steatohepatitis as the aetiology of end-stage liver disease (P 100 kg, high Child-Pugh score, and diabetes remained significantly associated with the development of AKI within 72 h (P