scholarly journals Acute kidney injury following resection of hepatocellular carcinoma: prognostic value of the acute kidney injury network criteria

2018 ◽  
pp. E11-E16
Author(s):  
Alexsander K. Bressan ◽  
Matthew T. James ◽  
Elijah Dixon ◽  
Oliver F. Bathe ◽  
Francis R. Sutherland ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Acute Kidney Injury ◽  
Liver Resection ◽  
Hospital Stay ◽  
Urine Output ◽  
Prognostic Value ◽  
Postoperative Mortality ◽  
Kidney Injury ◽  
Acute Kidney Injury Network ◽  
Urine Output Criterion

Background: Acute kidney injury (AKI) is associated with increased morbidity and mortality after liver resection. Patients with hepatocellular carcinoma (HCC) have a higher risk of AKI owing to the underlying association between hepatic and renal dysfunction. Use of the Acute Kidney Injury Network (AKIN) diagnostic criteria is recommended for patients with cirrhosis, but remains poorly studied following liver resection. We compared the prognostic value of the AKIN creatinine and urine output criteria in terms of postoperative outcomes following liver resection for HCC. Methods: All patients who underwent a liver resection for HCC from January 2010 to June 2016 were included. We used AKIN urine output and creatinine criteria to assess for AKI within 48 hours of surgery. Results: Eighty liver resections were performed during the study period. Cirrhosis was confirmed in 80%. Median hospital stay was 9 (interquartile range 7–12) days, and 30-day mortality was 2.5%. The incidence of AKI was higher based on the urine output than on the creatinine criterion (53.8% v. 20%), and was associated with prolonged hospitalization and 30-day postoperative mortality when defined by serum creatinine (hospital stay: 11.2 v. 20.1 d, p = 0.01; mortality: 12.5% v. 0%, p < 0.01), but not urine output (hospital stay: 15.6 v. 10 d, p = 0.05; mortality: 2.3% v. 2.7%, p > 0.99). Conclusion: The urine output criterion resulted in an overestimation of AKI and compromised the prognostic value of AKIN criteria. Revision may be required to account for the exacerbated physiologic postoperative reduction in urine output in patients with HCC.

Definition and Diagnosis of Acute Kidney Injury in Cirrhosis

2015 ◽  
Vol 33 (4) ◽  
pp. 539-547 ◽  
Author(s):  
Florence Wong
Keyword(s):  
Acute Kidney Injury ◽  
Serum Creatinine ◽  
Urine Output ◽  
Negative Impact ◽  
Kidney Injury ◽  
Acute Kidney Injury Network ◽  
Severe Form ◽  
Loss Of Function ◽  
Baseline Serum ◽  
Advanced Cirrhosis

Background: Acute kidney injury (AKI) is a common complication of advanced cirrhosis. Type 1 hepatorenal syndrome is the best-known and most severe form of AKI, and it has a precise definition and a set of specific diagnostic criteria. More recently, it has become recognized that milder degrees of renal dysfunction also have a negative impact on patient outcome in various patient populations. Key Messages: Several definitions and criteria for staging the severity of AKI have been proposed, including the RIFLE (Risk, Injury, Failure, Loss of Function and End-Stage Renal Disease) group, the Acute Kidney Injury Network (AKIN), and the Kidney Disease: Improving Global Outcome (KDIGO) group. All of them incorporate some changes of serum creatinine and urine output in the definition and staging of AKI. The hepatology community has mostly embraced the AKIN diagnostic and staging criteria and has applied them in the prognostication of patients with advanced cirrhosis. However, the AKIN criteria have not been strictly applied in all studies on cirrhosis. This is partly related to the fact that changes in urine output are difficult to assess in advanced cirrhosis, and partly related to the difficulty in defining the baseline serum creatinine from which the change in serum creatinine is calculated. This has led to some confusion in the interpretation of results of the various studies on AKI in cirrhosis. More recently, some investigators have suggested incorporating the AKIN criteria with setting a lower limit of serum creatinine of 1.5 mg/dl in determining the diagnosis and prognosis of AKI in cirrhosis. Conclusions: This is an ongoing debate as to how best to define AKI in cirrhosis. In the near future there should be prospective clinical trials that will clarify which diagnostic and staging criteria of AKI will best serve the cirrhotic population.

scholarly journals Defining urine output criterion for acute kidney injury in critically ill patients

2010 ◽  
Vol 26 (2) ◽  
pp. 509-515 ◽  
Author(s):  
E. Macedo ◽  
R. Malhotra ◽  
R. Claure-Del Granado ◽  
P. Fedullo ◽  
R. L. Mehta
Keyword(s):  
Acute Kidney Injury ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Urine Output ◽  
Kidney Injury ◽  
Urine Output Criterion ◽  
Output Criterion

STUDY OF CLINICAL PROFILE OF COMMUNITY-ACOUIRED ACUTE KIDNEY INJURY DEFINED USING RIFLE CRITERIA IN IGIMS PATNA

2021 ◽  
pp. 34-36
Author(s):  
Farogh Haidry ◽  
Arshad Ahmad ◽  
Debarshi Jana
Keyword(s):  
Acute Kidney Injury ◽  
Hospital Mortality ◽  
Hospital Stay ◽  
Urine Output ◽  
Kidney Injury ◽  
Mortality Rates ◽  
Class I ◽  
Rifle Criteria ◽  
Classi Cation ◽  
Class F

Aim: To examine the progression between stages of the classication, and to relate this classication to the length of stay and mortality in a large cohort of critically ill patients. Material and methods:A total of 5,383 patients was evaluated. We classied patients according to the maximum RIFLE class (class R, class I or class F) reached during their hospital stay. The RIFLE class was determined based on the worst of either glomerular ltration rate criteria or urine output criteria. We used the change in serum creatinine level and urine output to classify patients according to the RIFLE criteria. Result:Increasing severity of acute kidney injury was associated with an increasing length of ICU stay and hospital stay, and higher mortality. Patients with maximum RIFLE class R, class I and class F had hospital mortality rates of 8.6%, 11.7% and 26.8%, respectively, compared with 5.5% for patients without acute kidney injury. Conclusion:ICU population, newly developed RIFLE classication was associated with increased hospital mortality.

scholarly journals Acute kidney injury following hepatectomy for hepatocellular carcinoma: incidence, risk factors and prognostic value

HPB ◽  
2016 ◽  
Vol 18 (6) ◽  
pp. 540-548 ◽  
Author(s):  
Chetana Lim ◽  
Etienne Audureau ◽  
Chady Salloum ◽  
Eric Levesque ◽  
Eylon Lahat ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hepatocellular Carcinoma ◽  
Acute Kidney Injury ◽  
Prognostic Value ◽  
Kidney Injury ◽  
Incidence Risk
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