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Incidence of and risk factors for delayed acute kidney injury in patients undergoing colorectal surgery - 17/10/19

Doi : 10.1016/j.amjsurg.2019.03.027 
Youn Kyung Kee a, Hyoungnae Kim b, Jong Hyun Jhee c, Seung Hyeok Han d, Tae-Hyun Yoo d, Shin-Wook Kang d, Jung Tak Park d,
a Department of Internal Medicine, College of Medicine, Hallym University Medical Center, Hankang Sacred Heart Hospital, Seoul, South Korea 
b Department of Internal Medicine, College of Medicine, Soonchunhyang University, Seoul, South Korea 
c Department of Internal Medicine, College of Medicine, Inha University, Incheon, South Korea 
d Department of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei University, Seoul, South Korea 

Corresponding author. Department of Internal Medicine, Yonsei University College of Medicine, 134 Shinchon-Dong, Seodaemoon-Gu, Seoul, 120-752, South Korea.Department of Internal MedicineYonsei University College of Medicine134 Shinchon-DongSeodaemoon-GuSeoul120-752South Korea

Abstract

Background

The risk of delayed AKI (AKI development beyond the perioperative period) in patients undergoing colorectal surgery is greater than that in patients undergoing other major operations. However, the characteristics of and risk factors for delayed AKI are unclear.

Methods

We investigated 683 patients who underwent colorectal surgery with intestinal resection at a single tertiary hospital. All patients were followed-up for a year postoperatively. The primary outcome was the development of AKI during follow-up.

Results

AKI occurred in 177 (25.9%) during the first postoperative year. Patients who developed AKI were significantly older, showed a lower body mass index, and significantly lower preoperative hemoglobin and serum albumin levels. AKI occurred most commonly during the first 3 months postoperatively. However, AKI occurred persistently even after this initial period. Older age, lower preoperative serum albumin levels, and late ostomy closure were independently associated with a higher risk of delayed AKI.

Conclusion

AKI commonly occurs beyond the perioperative period. Careful risk stratification and modification of risk factors may prevent delayed AKI in patients undergoing colorectal cancer surgery.

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Highlights

Patients undergoing colorectal surgery are vulnerable to occurrence of post-operative acute kidney injury (AKI).
The characteristics of and risk factors for delayed AKI (AKI development beyond the perioperative period) are unclear.
Analysis of the incidence of and risk factors for delayed AKI in patients undergoing colorectal surgery.
AKI occurred most commonly during the first 3 months after surgery, however AKI occurred persistently even after this period.
Older age, lower albumin levels, and late ostomy closure were independently associated with a higher risk of delayed AKI.

Le texte complet de cet article est disponible en PDF.

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Vol 218 - N° 5

P. 907-912 - novembre 2019 Retour au numéro
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