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タイトル: | Acute kidney injury after pediatric liver transplantation: incidence, risk factors, and association with outcome |
著者: | Hamada, Miho Matsukawa, Shino Shimizu, Satoshi Kai, Shinichi Mizota, Toshiyuki https://orcid.org/0000-0003-2770-4262 (unconfirmed) |
著者名の別形: | 松川, 志乃 清水, 覚司 甲斐, 慎一 溝田, 敏幸 |
キーワード: | Acute kidney injury Adolescent Child Infant Liver transplantation |
発行日: | Oct-2017 |
出版者: | Springer Nature |
誌名: | Journal of Anesthesia |
巻: | 31 |
号: | 5 |
開始ページ: | 758 |
終了ページ: | 763 |
抄録: | [Purpose]: Data on the incidence of, risk factors for, and association with outcomes of acute kidney injury (AKI) after pediatric liver transplantation are scarce. We conducted a retrospective cohort study to determine the incidence of AKI after pediatric liver transplantation. In addition, we examined risk factors for AKI and association of AKI with outcomes. [Methods]: This study included 156 children aged between 3 months and 18 years undergoing liver transplantation at Kyoto University Hospital. AKI was defined according to the Kidney Disease: Improving Global Outcomes guidelines based on serum creatinine and urine output. We used multivariable logistic regression with stepwise variable selection to identify independent risk factors for AKI. [Results]: AKI occurred in 72 patients (46.2%); 34 (21.8%) had stage 1, 32 (20.5%) had stage 2, and 6 (3.8%) had stage 3 AKI. Factors independently associated with the development of AKI were increased preoperative total bilirubin level (adjusted odds ratio, 1.04 per 1 mg/dl; 95% confidence interval, 1.01–1.09; P = 0.026) and increased intraoperative blood loss (adjusted odds ratio, 1.03 per 10 ml/kg; 95% confidence interval, 1.00–1.06; P = 0.022). AKI was significantly associated with prolonged hospitalization (median, 61 vs. 46 days; P = 0.028). In-hospital mortality rate was 4.2% in patients with AKI and 3.6% in those without AKI (P = 1.000). [Conclusion]: The incidence of AKI after pediatric liver transplantation was 46.2%. Increased preoperative total bilirubin level and increased intraoperative blood loss were independently associated with the development of AKI. AKI was associated with prolonged hospitalization. |
著作権等: | This is a post-peer-review, pre-copyedit version of an article published in Journal of Anesthesia. The final authenticated version is available online at: http://dx.doi.org/10.1007/s00540-017-2395-2. The full-text file will be made open to the public on 01 August 2018 in accordance with publisher's 'Terms and Conditions for Self-Archiving'. この論文は出版社版でありません。引用の際には出版社版をご確認ご利用ください。 This is not the published version. Please cite only the published version. |
URI: | http://hdl.handle.net/2433/234193 |
DOI(出版社版): | 10.1007/s00540-017-2395-2 |
PubMed ID: | 28766021 |
出現コレクション: | 学術雑誌掲載論文等 |
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