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논문분류	춘계학술대회 초록집
제목	Postoperative acute kidney injury in patients with advanced chronic kidney disease; Incidence, risk factors
저자	Hyun Seop Cho, Ha Nee Jang, Tae Won Lee, Eunjin Bae, Hyun-Jung KimSe-Ho Chang
출판정보	2019; 2019(1):
키워드	postoperative AKI \| acute kidney injury \| advanced CKD
초록	Acute kidney injury (AKI) after surgery is a common complication. The incidence and risk factors of postoperative acute kidney injury in patients with advanced chronic kidney disease are not well known. We retrospectively analyzed patients older than 18 years who underwent surgery from 2013 to 2018 at Gyeongsang National University Hospital. The exclusion criteria were as follows: (1) eGFR >30 ml/min per 1.73 m2, (2) patients receiving renal replacement therapy, or preoperative acute kidney injury, (3) cardiac surgery, urologic surgery, and minor procedural operations. Postoperative AKI was defined as dialysis within 30 days. Of the 47430 patients who underwent surgery at Gyeongsang National University Hospital from 2013 to 2018, we retrospectively analyzed 146 patients who met inclusion criteria. Postoperative AKI occurred in 33 patients(22.6%). The mean age was 71.3±13.6 years. 13 patients (39.4%) had diabetes mellitus. Preoperative estimated glomerular filtration rate was 16.53±6.6 ml/min/1.73m2. In logistic regression analysis, independent risk factors for AKI were vasopressor use (95% CI, 0.142-0.773, p=0.011), emergency operation (95% CI, 0.051-0.297, p=0.00), hypoalbuminemia (95% CI, 0.114-0.707, p=0.007), preoperative creatinine level (95% CI, 0.123-0.673, p=0.004). In advanced CKD, acute kidney injury requiring postoperative renal replacement therapy were not uncommon. Especially emergency surgery, hypoalbuminemia, high neutrophil to lymphocyte ratio is an independent predictor of AKI.
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