Transient acute kidney injury observed immediately after robot‑assisted radical prostatectomy but not after open radical prostatectomy

Naito, Akira; Taguchi, Satoru; Suzuki, Motofumi; Kawai, Taketo; Uchida, Kanji; Fujimura, Tetsuya; Fukuhara, Hiroshi; Kume, Haruki

doi:10.3892/mco.2020.2087

Cited by 11 publications

(21 citation statements)

References 10 publications

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“…The evaluation of patients on POD 1 and not POD 0 would result in a lower incidence of postoperative AKI after RARP, as observed by us and other researchers. [27,30] In our study, RARP was associated with a significantly higher incidence of postoperative AKI, compared with both RRP and exLRP. The specific characteristics of RARP include high intra-abdominal pressure caused by pneumoperitoneum and the Trendelenburg position.…”

Section: Discussionsupporting

confidence: 45%

Comparison of incidence of acute kidney injury after robot-assisted radical prostatectomy with that after open retropubic and extraperitoneal laparoscopic radical prostatectomies in patients with prostate cancer

et al. 2023

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Background: We retrospectively evaluated the postoperative renal function in patients who had undergone radical prostatectomy to compare the incidences of postoperative acute kidney injury (AKI) among the patients who had undergone robot-assisted radical prostatectomy (RARP), retropubic radical prostatectomy (RRP), and extraperitoneal laparoscopic radical prostatectomy (exLRP). Materials and methods: Patients with prostate cancer who had undergone radical prostatectomy at our institution between 2008 and 2014 were included. Robot-assisted radical prostatectomy was performed using an intraperitoneal approach in a 25-degree Trendelenburg position, whereas other procedures were performed with the patient in the supine position. We evaluated the serum creatinine levels and estimated glomerular filtration rates immediately after surgery and on postoperative day 1. We evaluated the incidence of AKI after prostatectomy using the Acute Kidney Injury Network criteria of the Kidney Disease: Improving Global Outcomes guidelines. Results: A total of 150 consecutive patients were included, with each of the 3 groups (RARP, RRP, and exLRP) comprising 50 patients. Postoperative AKI was observed in 15 (30.0%), 1 (2.0%), and 3 (6.0%) patients in the RARP, RRP, and exLRP groups, respectively. Stage 1 AKI was observed in all the patients except one. The incidence of AKI in RARP group was significantly higher than that in the other groups ( p < 0.001). In the RARP group, the serum creatinine level was significantly elevated immediately after the surgery; however, it returned to baseline on postoperative day 1. Surgical procedures were the only independent factor associated with AKI incidence. Conclusions: This study suggest that compared with RRP and exLRP, RARP is associated with a higher incidence of postoperative AKI, although most patients recover rapidly. Intra-abdominal pneumoperitoneum may contribute to AKI onset.

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Section: Discussionsupporting

confidence: 45%

Comparison of incidence of acute kidney injury after robot-assisted radical prostatectomy with that after open retropubic and extraperitoneal laparoscopic radical prostatectomies in patients with prostate cancer

et al. 2023

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“…A study reported that compared with open radical prostatectomy, RALP involves a significantly lower incidence of AKI 5 . However, in another study, 25 (13.4%) out of 187 patients who underwent RALP showed an acute increase in SCr levels on the operation day, which met the Kidney Disease Improving Global Outcomes (KDIGO) criteria for AKI; however, none of the patients who underwent open radical prostatectomy met this criteria 7 . Therefore, AKI after RALP remains a concern; accordingly, there have been clinical trials for mitigating AKI in patients undergoing RALP.…”

Section: Discussionmentioning

confidence: 93%

“…The incidence of acute kidney injury (AKI) after RALP has been reported to be significantly lower than that after open radical prostatectomy 5 ; however, AKI still occurs in approximately 5% of patients undergoing RALP 5 , 6 . Moreover, an acute increase in serum creatinine (SCr) levels after RALP usually occurs on the operation day 7 , 8 . Patients who develop AKI on the operation day have been reported to present reduced renal function at 12 months after RALP 8 .…”

Section: Introductionmentioning

confidence: 99%

Intraoperative mean arterial pressure and acute kidney injury after robot-assisted laparoscopic prostatectomy: a retrospective study

Kim

Shin

et al. 2023

Sci Rep

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Intraoperative hemodynamics can affect postoperative kidney function. We aimed to investigate the effect of intraoperative mean arterial pressure (MAP) as well as other risk factors on the occurrence of acute kidney injury (AKI) after robot-assisted laparoscopic prostatectomy (RALP). We retrospectively evaluated the medical records of 750 patients who underwent RALP. The average real variability (ARV)-MAP, standard deviation (SD)-MAP, time-weighted average (TWA)-MAP, area under threshold (AUT)-65 mmHg, and area above threshold (AAT)-120 mmHg were calculated using MAPs collected within a 10-s interval. Eighteen (2.4%) patients developed postoperative AKI. There were some univariable associations between TWA-MAP, AUT-65 mmHg, and AKI occurrence; however, multivariable analysis found no association. Alternatively, American Society of Anesthesiologists physical status ≥ III and the low intraoperative urine output were independently associated with AKI occurrence. Moreover, none of the five MAP parameters could predict postoperative AKI, with the area under the receiver operating characteristic curve values for ARV-MAP, SD-MAP, TWA-MAP, AUT-65 mmHg, and AAT-120 mmHg being 0.561 (95% confidence interval [CI], 0.424–0.697), 0.561 (95% CI, 0.417–0.704), 0.584 (95% CI, 0.458–0.709), 0.590 (95% CI, 0.462–0.718), and 0.626 (95% CI, 0.499–0.753), respectively. Therefore, intraoperative MAP changes may not be a determining factor for AKI after RALP.

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“…A study reported that compared with open radical prostatectomy, RALP involves a signi cantly lower incidence of AKI 5 . However, in another study, 25 (13.4%) out of 187 patients who underwent RALP showed an acute increase in SCr levels on the operation day, which met the Kidney Disease Improving Global Outcomes (KDIGO) criteria for AKI; however, none of the patients who underwent open radical prostatectomy met this criteria 7 . Therefore, AKI after RALP remains a concern; accordingly, there have been clinical trials for mitigating AKI in patients undergoing RALP.…”

Section: Discussionmentioning

confidence: 93%

“…The incidence of acute kidney injury (AKI) after RALP has been reported to be signi cantly lower than that after open radical prostatectomy 5 ; however, AKI still occurs in approximately 5% of patients undergoing RALP 5,6 . Moreover, an acute increase in serum creatinine (SCr) levels after RALP usually occurs on the operation day 7,8 . Patients who develop AKI on the operation day have been reported to present reduced renal function at 12 months after RALP 8 .…”

Section: Introductionmentioning

confidence: 99%

Relationship between intraoperative mean arterial pressure and acute kidney injury after robot-assisted laparoscopic prostatectomy

Kim

Shin

et al. 2022

Preprint

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We aimed to investigate the relationship between intraoperative mean arterial pressure (MAP) and acute kidney injury (AKI) occurrence after robot-assisted laparoscopic prostatectomy (RALP), as well as the relationship between MAP and the maximal increase in serum creatinine (SCr) levels. We retrospectively evaluated the medical records of 750 patients who underwent RALP. The average real variability (ARV)-MAP, standard deviation (SD)-MAP, time-weighted average (TWA)-MAP, area under threshold (AUT)-65 mmHg, and area above threshold (AAT)-120 mmHg were calculated using MAPs collected within a 10-s interval. Eighteen (2.4%) patients developed postoperative AKI. None of the five MAP parameters could predict postoperative AKI, with the area under the receiver operating characteristic curve values for ARV-MAP, SD-MAP, TWA-MAP, AUT-65 mmHg, and AAT-120 mmHg being 0.561 (95% confidence interval [CI], 0.424–0.697), 0.561 (95% CI, 0.417–0.704), 0.584 (95% CI, 0.458–0.709), 0.590 (95% CI, 0.462–0.718), and 0.626 (95% CI, 0.499–0.753), respectively. ARV-MAP (per 15-mmHg/min increase) and TWA-MAP (per 30-mmHg increase) were positively correlated with delta-SCr levels (β = 0.21, P = 0.010 and β = 0.14, P = 0.002; respectively). However, the resulting increases did not cause AKI. Therefore, intraoperative MAP changes may not be a determining factor for AKI after RALP.

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Transient acute kidney injury observed immediately after robot‑assisted radical prostatectomy but not after open radical prostatectomy

Cited by 11 publications

References 10 publications

Comparison of incidence of acute kidney injury after robot-assisted radical prostatectomy with that after open retropubic and extraperitoneal laparoscopic radical prostatectomies in patients with prostate cancer

Comparison of incidence of acute kidney injury after robot-assisted radical prostatectomy with that after open retropubic and extraperitoneal laparoscopic radical prostatectomies in patients with prostate cancer

Intraoperative mean arterial pressure and acute kidney injury after robot-assisted laparoscopic prostatectomy: a retrospective study

Relationship between intraoperative mean arterial pressure and acute kidney injury after robot-assisted laparoscopic prostatectomy

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