A Simplified Clinical Risk Score to Predict Acute Kidney Injury After Living-Donor Liver Transplantation.

Kim, W.; Shim, Haeng Seon; Shin, Sang Won; Gwak, Mi Sook; Kim, G.

doi:10.1097/00007890-201407151-02575

Cited by 1 publication

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“…Demographic or perioperative variables previously known to be related to postoperative renal dysfunction were included in this study (Table 1). [3][4][5][9][10][11][12][13][14] Postoperative outcome variables included the length of postoperative hospital or intensive care unit (ICU) stay, and in-hospital, 1-and 5-year all-cause mortality. We defined postoperative AKI and its stages using the KDIGO and AKIN criteria 6 and divided stage 1 into 2 distinct substages of stage 1a and 1b.…”

Section: Methodsmentioning

confidence: 99%

Dividing Stage 1 Acute Kidney Injury After Cardiac or Thoracic Aortic Surgery

Bae

Shin

et al. 2021

The Annals of Thoracic Surgery

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Background. Although the Kidney Disease: Improving Global Outcomes (KDIGO) criteria are used to define acute kidney injury, the criteria have limitations for including 2 different serum creatinine criteria in stage 1. We hypothesized that there would be differences in clinical outcomes between the 2 subgroups of stage 1 acute kidney injury in patients undergoing cardiac or thoracic aortic surgery.Methods. We reviewed 2510 cases. Patients with KDIGO stage 1 were divided into 2 subgroups (stage 1a: 0.3 mg/dL or greater of absolute increase in serum creatinine, n [ 376; and stage 1b: 50% or greater relative increase, n [ 365). Propensity score analysis was performed between stage 1a and 1b groups, yielding 240 pairs. We compared the length of hospital stay, the incidence of cardiovascular complications, 5-year all-cause mortality between these subgroups. Overall survival was compared between the subgroups after propensity score matching. We performed sensitivity analysis for Acute Kidney Injury Network (AKIN) criteria.Results. Length of hospital stay and 5-year all-cause mortality were worse in patients with KDIGO stage 1b compared with stage 1a. Five-year patient survival was significantly worse in patients with stage 1b compared with stage 1a after matching (log rank test, P [ .002). We found similar results regarding AKIN criteria. Subgroup analysis showed that the significant difference in survival existed only when baseline serum creatinine was 0.8 mg/ dL or greater.Conclusions. The KDIGO or AKIN criteria for stage 1 acute kidney injury could be further divided into 2 substages with different severity of clinical outcomes. These modified criteria could give additional prognostic information in patients undergoing cardiac or thoracic aortic surgery.

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