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VOLUME 25 , ISSUE 4 ( April, 2021 ) > List of Articles

ORIGINAL RESEARCH

Incidence and Predictors of Acute Kidney Injury in Patients Undergoing Elective Hepatic Resection for Malignant Tumors: A 3-year Prospective Observational Study

Malini Joshi, Ranjeet Milmile, Pravin Dhakane

Keywords : Acute kidney injury, Hepatic resection, Obesity, Postoperative mechanical ventilation, Postoperative morbidity, Postoperative mortality, Predictors of outcome

Citation Information : Joshi M, Milmile R, Dhakane P. Incidence and Predictors of Acute Kidney Injury in Patients Undergoing Elective Hepatic Resection for Malignant Tumors: A 3-year Prospective Observational Study. Indian J Crit Care Med 2021; 25 (4):398-404.

DOI: 10.5005/jp-journals-10071-23776

License: CC BY-NC 4.0

Published Online: 01-04-2021

Copyright Statement:  Copyright © 2021; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Background: Acute kidney injury (AKI) is common in patients undergoing major surgeries, and leads to the need for renal replacement therapy and increased morbidity, intensive care unit (ICU) and hospital length of stay (LOS), cost, and mortality. We evaluated the incidence and predictors of postoperative AKI in patients undergoing hepatic resections and their short-term outcomes. Materials and methods: This prospective observational study was conducted over a 3-year period in 180 patients undergoing elective hepatic resections for a variety of indications. We used the Acute Kidney Injury Network criteria to determine the incidence of AKI at 72 hours. Perioperative variables contributing to the development of AKI and the short-term postoperative outcomes of patients were evaluated. Results: Postoperative AKI occurred in 29.4% of patients. Persistent renal dysfunction was seen in five patients. Development of AKI was associated with hepatic failure (18.5 vs 5.5%, p < 0.005), prolonged ICU (2 vs 1 days, p < 0.001) and hospital LOS (11 vs 8 days, p < 0.004), and increased ICU and hospital mortality (9.6 vs 1.4%, p < 0.02). Age [OR (odds ratio) 1.033, 95% CI (confidence interval) 1.003–1.065, p = 0.03], BMI (body mass index) (OR 1.131, 95% CI 1.043–1.227, p = 0.003), and need for postoperative ventilation (OR 3.456, 95% CI 1.593–7.495, p = 0.002) were independent predictors of AKI. Conclusion: AKI after elective hepatic resection occurred in nearly one-third of our patients. Persistent renal dysfunction was seen in five patients. Age, BMI, and need for postoperative ventilation were independent predictors of postoperative AKI. (CTRI reg. No.: CTRI/2016/06/007044).


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