Acute kidney injury and the compensation of kidney function after nephrectomy in living donation

Okumura, Kenji; Grace, Holly; Sogawa, Hiroshi; Yamanaga, Shigeyoshi

doi:10.5500/wjt.v12.i8.223

Cited by 7 publications

(8 citation statements)

References 68 publications

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“…However, data from this study indicate that perioperative hypotension is not a risk factor for CKD, which may be related to the lower incidence of hypotensive shock in our data. The development of postoperative AKI after radical nephrectomy does not damage the contralateral healthy kidney and prompts compensatory hyperplasia in the remaining kidney [ 25 ]. Immediately after nephrectomy, a 40% increase in blood flow and the GFR was observed in the kidneys [ 26 ].…”

Section: Discussionmentioning

confidence: 99%

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Trends and predictors of changes in renal function after radical nephrectomy for renal tumours

Yan,

Liu,

et al. 2024

BMC Nephrol

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Background Chronic kidney disease (CKD) is a common postoperative complication in patients who undergo radical nephrectomy for renal tumours. However, the factors influencing long-term renal function require further investigation. Objective This study was designed to investigate the trends in renal function changes and risk factors for renal function deterioration in renal tumour patients after radical nephrectomy. Methods We monitored changes in renal function before and after surgery for 3 years. The progression of renal function was determined by the progression and degradation of CKD stages. Univariate and multivariate logistic regression analyses were used to analyse the causes of renal function progression. Results We analysed the data of 329 patients with renal tumours who underwent radical nephrectomies between January 2013 and December 2018. In this study, 43.7% of patients had postoperative acute kidney injury (AKI), and 48.3% had CKD at advanced stages. Further research revealed that patients’ renal function stabilized 3 months after surgery. Additionally, renal function changes during these 3 months have a substantial impact on the progression of long-term renal function changes in patients. Conclusion AKI may be an indicator of short-term postoperative changes in renal function. Renal function tests should be performed in patients with AKI after radical nephrectomy to monitor the progression of functional impairment, particularly within the first 3 months after radical nephrectomy.

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Section: Discussionmentioning

confidence: 99%

“…Immediately after nephrectomy, a 40% increase in blood flow and the GFR was observed in the kidneys [ 26 ]. This progresses to affect the glomeruli, increasing the high-pressure experienced by the nephron filters and resulting in compensatory enlargement of the glomeruli [ 25 ].…”

Section: Discussionmentioning

confidence: 99%

Trends and predictors of changes in renal function after radical nephrectomy for renal tumours

Yan,

Liu,

et al. 2024

BMC Nephrol

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“…It failed to increase CCr in a streptozotocin-induced diabetic rat model 34 , possibly because of the AVP-resistant downregulation of aquaporin receptors 35 . Increased plasma flow due to increased water intake for a pre-diseased single kidney might induce glomerular hyperfiltration, resulting in hypertrophy of the allograft and finally leading to sclerosis 36 . Furthermore, increased water intake might induce “renal tamponade” or compression of the kidney in fibrotic kidneys 37 .…”

Section: Discussionmentioning

confidence: 99%

Water intake, baseline biopsy, and graft function after living donor kidney transplantation

Yamanaga,

Hidaka,

Kawabata

et al. 2024

Sci Rep

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Increased water intake is recommended for kidney transplant recipients; however, its efficacy remains controversial. We hypothesized that pre-existing histological findings of the allograft might modulate the impact of water intake. We retrospectively analyzed 167 adults with living-donor kidney transplants (April 2011–May 2020; median observation period, 77 months) whose baseline biopsy data were available. We compared the chronic-change group (n = 38) with the control group (n = 129) to assess the impact of self-reported daily water intake on the estimated glomerular filtration rate (eGFR). The range distribution of water intake was as follows: − 1000 ml (n = 4), 1000–1500 ml (n = 23), 1500–2000 ml (n = 64), 2000–2500 ml (n = 57), 2500–3000 ml (n = 16), and 3000 − ml (n = 3). Donor age was significantly higher in the chronic-change group. In the control group, the ΔeGFR/year increase was correlated with water intake. However, the increase in the water intake of the chronic-change group significantly decreased ΔeGFR/year (1000–1500 ml: + 1.95 ml/min/1.73 m2 and > 2000 ml: − 1.92 ml/min/1.73 m2, p = 0.014). This study suggested a potential influence of increased water intake on recipients with marginal grafts in living donor kidney transplantation.

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“…Embora não tenha havido óbitos em nosso estudo, destacamos o fato de que quase 60% dos pacientes apresentaram pelo menos uma sequela de 3 a 6 meses após a alta hospitalar, com mais de 25% apresentando TFG reduzida no acompanhamento, portanto, sem recuperar completamente a função renal normal. O achado de valores medianos da TFG que aumentam na consulta de acompanhamento entre os estágios de IRA, com valores mais elevados em pacientes com IRA mais grave, parece contraintuitivo, mas pode representar um estágio inicial de hiperfiltração em pacientes com perda mais grave de néfrons durante o episódio de IRA, como relatado anteriormente na literatura [42][43][44] .…”

Section: Tabelaunclassified

Insuficiência renal aguda: experiência de um centro terciário de Nefrologia Pediátrica

Figueiredo,

Rocha,

Silva

et al. 2024

Braz. J. Nephrol.

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RESUMO Introdução: Insuficiência renal aguda (IRA) é uma deterioração abrupta da função renal. A incidência de IRA pediátrica está aumentando em todo o mundo, em ambientes críticos e não críticos. Nosso objetivo foi caracterizar apresentação, etiologia, evolução e desfechos da IRA em pacientes pediátricos internados em um centro de atendimento terciário. Métodos: Realizamos estudo retrospectivo observacional de centro único de pacientes com idade entre 29 dias a 17 anos e 365 dias internados em nossa Unidade de Nefrologia Pediátrica, de janeiro de 2012 a dezembro de 2021, com diagnóstico de IRA. A gravidade da IRA foi categorizada de acordo com os critérios do Kidney Disease Improving Global Outcomes (KDIGO). Os desfechos considerados foram óbito ou sequelas (proteinúria, hipertensão ou alterações na função renal em avaliações de acompanhamento de 3 a 6 meses). Resultados: Incluímos 46 pacientes com idade mediana de 13,0 (3,5–15,5) anos. Cerca de metade (n = 24; 52,2%) apresentou um fator de risco identificável para o desenvolvimento de IRA. Treze pacientes (28,3%) eram anúricos; todos foram classificados como IRA KDIGO 3 (p < 0,001). Quase um quarto (n = 10; 21,7%) dos pacientes necessitaram de terapia renal substitutiva. Aproximadamente 60% (n = 26) apresentou pelo menos uma sequela, sendo proteinúria a mais comum (n = 15; 38,5%; mediana (P25–75) da relação proteína/creatinina urinária 0,30 (0,27–0,44) mg/mg), seguida de taxa de filtração glomerular (TFG) reduzida (n = 11; 27,5%; mediana (P25–75) da TFG 75 (62–83) mL/min/1,73 m2). Conclusões: A IRA pediátrica está associada à morbidade substancial, com potencial para desenvolvimento de proteinúria e comprometimento da função renal e impacto relevante no prognóstico de longo prazo.

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Acute kidney injury and the compensation of kidney function after nephrectomy in living donation

Cited by 7 publications

References 68 publications

Trends and predictors of changes in renal function after radical nephrectomy for renal tumours

Trends and predictors of changes in renal function after radical nephrectomy for renal tumours

Water intake, baseline biopsy, and graft function after living donor kidney transplantation

Insuficiência renal aguda: experiência de um centro terciário de Nefrologia Pediátrica

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