Acute kidney injury after pediatric liver transplantation: incidence, risk factors, and association with outcome
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- Hamada, Miho
- Department of AnesthesiaKyoto University Hospital
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- Matsukawa, Shino
- Department of AnesthesiaKyoto University Hospital
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- Shimizu, Satoshi
- Department of AnesthesiaKyoto University Hospital
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- Kai, Shinichi
- Department of AnesthesiaKyoto University Hospital
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- Mizota, Toshiyuki
- Department of AnesthesiaKyoto University Hospital
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Abstract
[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.
Journal
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- Journal of Anesthesia
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Journal of Anesthesia 31 (5), 758-763, 2017-10
Springer Nature
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Details 詳細情報について
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- CRID
- 1050001338207643264
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- NII Article ID
- 120006510279
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- NII Book ID
- AA10852931
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- ISSN
- 09138668
- 14388359
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- HANDLE
- 2433/234193
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- NDL BIB ID
- 028582578
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- Text Lang
- en
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- Article Type
- journal article
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- Data Source
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- IRDB
- NDL
- Crossref
- CiNii Articles
- KAKEN