Mp208serum and Urinary Markers of Acute Kidney Injury After Complex Hepatic Surgery

Abstract

5AOUP, Chirurgia Colo-Rettale, Pisa, ITALY Introduction and Aims: Acute kidney injury (AKI) is an important post operative complication with an incidence ranging from 8% to 16% after complex hepatic surgery. Serum creatinine (sCr) is the most common clinical marker of AKI. Other plasma and urinary markers have been proposed as early markers of AKI and to highlight sub-clinical AKI. Aim of the Study: To determine the effect of complex hepatic surgery on classical and sub-clinical markers of AKI. Methods: Thirty-seven patients (28 males), aged 36-84 years (mean 64.6 years), sCr 0.58-1.53 mg/dl (mean 0.90 mg/dl) underwent elective complex hepatic surgery (hepatocellular carcinoma or liver metastases from other primary cancers). The day before, during the surgery and the following 4 days of Intensive Care Unit (ICU) stay, we determined plasma and/or urinary concentrations of creatinine, cystatin C, ß2-microglobulin (ß2M) , ßtrace protein (ßTP) , Neutrophil Gelatinase Associated Lipocalin (NGAL), Heat Shock Protein 70 (HSP 70), urine albumin, urine gamma-glutamyl-transferase (GGT) and lactate dehydrogenase (LDH). Results: The surgical time ranged 135-1380 minutes (mean 610 min) and the total liver ischemia time was 33-396 minutes (mean 112 min). Five patients (13.5%) developed a