Intraoperative Hypertension is Associated With Postoperative Acute Kidney Injury After Laparoscopic Surgery

2021 ◽  
Author(s):  
Yongzhong Tang ◽  
Wen Ouyang ◽  
Guiping Jiang ◽  
Hongjia Tang ◽  
Jianbin Tong ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Laparoscopic Surgery ◽  
Kidney Injury ◽  
Intraoperative Hypertension

scholarly journals Comparison of the Effects of Laparoscopic and Open Surgery on Postoperative Acute Kidney Injury in Patients with Colorectal Cancer: Propensity Score Analysis

2021 ◽  
Vol 10 (7) ◽  
pp. 1438
Author(s):  
Ji Hoon Sim ◽  
Sa-Jin Kang ◽  
Ji-Yeon Bang ◽  
Jun-Gol Song
Keyword(s):  
Colorectal Cancer ◽  
Risk Factors ◽  
Acute Kidney Injury ◽  
Laparoscopic Surgery ◽  
Propensity Score ◽  
Hospital Stay ◽  
Open Surgery ◽  
Kidney Injury ◽  
Icu Admission ◽  
Postoperative Aki

Postoperative acute kidney injury (AKI) is a serious complication that increases patient morbidity and mortality. However, few studies have evaluated the effect of laparoscopic surgery on postoperative AKI. This study compared the incidence of postoperative AKI between laparoscopic and open surgery in patients with colorectal cancer. This study retrospectively analyzed 3637 patients who underwent colorectal cancer surgery between June 2008 and February 2012. The patients were classified into laparoscopic (n = 987) and open (n = 2650) surgery groups. We performed multivariable regression analysis to assess the risk factors for AKI and propensity score matching analysis to compare the incidence of AKI between the two groups. We also assessed postoperative intensive care unit (ICU) admission, complications, hospital stay, and 1-year mortality. We observed no significant differences in the incidence of postoperative AKI between the two groups before (8.8% vs. 9.1%, p = 0.406) and after (8.8% vs. 7.7%, p = 0.406) matching. Laparoscopic surgery was not associated with AKI even after adjusting for intraoperative variables (adjusted odds ratio (OR): 1.17, 95% confidence interval (CI): 0.84–1.62, p = 0.355). Body mass index, diabetes mellitus, hypertension, and albumin were risk factors for AKI. ICU admission (0.6% vs. 2.5%, p = 0.001), complications (0.2% vs. 1.5%, p = 0.002), hospital stay (6.89 days vs. 8.61 days, p < 0.001), and 1-year mortality (0.1% vs. 0.9%, p = 0.021) were significantly better in the laparoscopic than in the open group. The incidence of postoperative AKI did not differ significantly between laparoscopic and open surgery. However, considering its better surgical outcomes, laparoscopic surgery may be recommended for patients with colorectal cancer.

Acute Kidney Injury Induced by Various Pneumoperitoneum Pressures in a Rabbit Model of Mild and Severe Hydronephrosis

2014 ◽  
Vol 94 (2) ◽  
pp. 225-233 ◽  
Author(s):  
Wei Li ◽  
Zhixiu Cao ◽  
Zhongyuan Xia ◽  
Qingtao Meng ◽  
Wei-min Yu ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Laparoscopic Surgery ◽  
Serum Creatinine ◽  
Cell Apoptosis ◽  
Rabbit Model ◽  
Kidney Injury ◽  
Acute Injury ◽  
Intraabdominal Pressure ◽  
Pressure Tolerance ◽  
Kidney Injury Molecule 1

Objective: Increased pneumoperitoneum pressure during laparoscopic surgery can result in acute kidney injury. We aimed to clarify whether intraabdominal pressure tolerance is modified in various degrees of unilateral kidney hydronephrosis in rabbits. Methods: A total 90 rabbits were randomly allocated to three groups (group PN, PM and PS, i.e. rabbits with no, mild and severe hydronephrosis, respectively, subjected to intraabdominal pressures). Rabbits in group PM (n = 30) and group PS (n = 30) underwent a surgical procedure inducing a mild or severe left hydronephrosis. Rabbits in all groups were then allocated to 5 subgroups. Then, they were subjected to intraabdominal pressures of 0, 6, 9, 12, and 15 mm Hg, respectively. Acute kidney injury was assessed by measuring serum creatinine (Scr), blood urea nitrogen (BUN), tubular cell apoptosis, kidney injury molecule-1 (KIM-1) and cysteine-rich 61 (Cyr-61/CCN1) expression. Results: Acute kidney injury with increased tubular apoptosis and KIM-1 and Cyr-61 expression occurred when intraabdominal pressure reached 15, 15 and 9 mm Hg in PN, PM and PS groups, respectively. The Scr and BUN levels were similar in all groups. Conclusions: In rabbits, kidneys with severe hydronephrosis were more likely to suffer acute injury when they were exposed to pneumoperitoneal pressure.

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