부산대학교 도서관

Aim: Acute kidney injury (AKI) is a serious complication following orthotopic liver transplantation (OLT) and it affects long‐term patient survival. The aims of this study were to identify the effects of cumulative fluid balance (FB) on early post‐OLT AKI and adverse outcomes and to construct a model to predict AKI. Methods: We retrospectively analysed 146 adult patients who underwent OLT. AKI severity was classified according to the Kidney Disease: Improving Global Outcomes (KDIGO) criteria. Univariate and multivariate logistic regression analyses were used to evaluate the association between cumulative FB and post‐OLT AKI. The Kaplan‐Meier method was used to estimate the survival rate. Results: Within the perioperative period of 72 hours, 50% (66/132) of patients developed AKI, with 36 (54%), 16 (24%) and 14 (21%) patients having AKI stages 1, 2 and 3, respectively. The cumulative FB was the risk factors for post‐OLT AKI (odds ratio [OR], 1.011; 95% confidence interval [CI], 1.156~6.001; P =.021). Preoperative albumin was a protective factor for post‐OLT AKI (OR, 0.309; 95% CI, 0.140~0.731; P =.007). The AKI group requires renal replacement therapy (RRT) more (15.2% vs 0%, P =.001) and associated with postoperative complications (56% vs 28.8%, P =.003). The complication‐free survival was lower in the AKI group ([11.90 vs 18.74] months, χ2 = 9.60, P =.002). Conclusion: Cumulative FB within 72 hours is associated with post‐OLT AKI and requires RRT. Cumulative FB impacts the long‐term complication‐free survival of the recipients. SUMMARY AT A GLANCE: This retrospective survey of 146 patients undergoing orthotopic liver transplantation observed AKI in 50% of patients. AKI was associated with increased cumulative fluid balance and lower complication‐free survival. [ABSTRACT FROM AUTHOR]