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Title: Acute kidney injury after pediatric liver transplantation: incidence, risk factors, and association with outcome
Authors: Hamada, Miho
Matsukawa, Shino
Shimizu, Satoshi  kyouindb  KAKEN_id
Kai, Shinichi
Mizota, Toshiyuki  kyouindb  KAKEN_id
Author's alias: 松川, 志乃
清水, 覚司
甲斐, 慎一
溝田, 敏幸
Keywords: Acute kidney injury
Adolescent
Child
Infant
Liver transplantation
Issue Date: Oct-2017
Publisher: Springer Nature
Journal title: Journal of Anesthesia
Volume: 31
Issue: 5
Start page: 758
End page: 763
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.
Rights: 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'.
This is not the published version. Please cite only the published version. 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。
URI: http://hdl.handle.net/2433/234193
DOI(Published Version): 10.1007/s00540-017-2395-2
PubMed ID: 28766021
Appears in Collections:Journal Articles

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