Factors Associated with Development of Acute Kidney Injury After Liver Transplantation

Abstract

Background: Early post-liver transplant (LT) acute kidney injury (AKI) has been associated with worse short-term and long-term outcomes, but the incidence and risk factors in our population are unknown. Methods: We designed a prospective, singlecenter, longitudinal cohort study to determine the incidence of AKI during the immediate postoperative period of LT, and to identify the risk factors associated with AKI after LT. Pre-operative and intraoperative variables were analyzed to determine if there was any correlation with the development of post-operative AKI. Results: Eighty-six patients were included in the final analysis; from them, 45 (52%) developed AKI in the following 30 days after LT. The presence of hepatic encephalopathy prior to LT was the factor most strongly associated with the development of AKI (Relative Risk 3.67, 95% Confidence Interval 1.08-8.95). Other factors associated with AKI development were male gender and a higher serum lactate during surgery. Conclusion: AKI was a frequent complication that significantly worsened the prognosis of LT recipients and was associated with an increased 30-day mortality rate. The presence of hepatic encephalopathy strongly predicted the development of severe AKI. (REV INVEST CLIN. [AHEAD OF PRINT]

Low preoperative serum uric acid is associated with early acute kidney injury after living donor liver transplantation

“…Preexisting conditions, such as nonalcoholic liver disease, liver cirrhosis, diabetes mellitus (DM), diuretic use (furosemide/ spironolactone), and the presence of hepatic encephalopathy in addition to perioperative risk factors, including ABO incompatibility, intraoperative blood loss or hypotension requiring red blood cell (RBC) transfusion, and prolonged cold ischemia time (CIT) or warm ischemia time (WIT), are all considered significant risk factors. 4,6,[8][9][10] Early allograft dysfunction (EAD) within 1 week after transplantation has also been identified as associated with postoperative AKI and a higher mortality rate. 11,12 The association of serum uric acid (SUA) levels with AKI is controversial.…”