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Effect of liver resection-induced increases in hepatic venous pressure gradient on development of postoperative acute kidney injury
BACKGROUND: The impact of changes in portal pressure before and after liver resection (defined as ΔHVPG) on postoperative kidney function remains unknown. Therefore, we investigated the effect of ΔHVPG on (i) the incidence of postoperative AKI and (ii) the renin-angiotensin system (RAAS) and sympath...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8742325/ https://www.ncbi.nlm.nih.gov/pubmed/34996372 http://dx.doi.org/10.1186/s12882-021-02658-7 |
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author | Reiterer, Christian Taschner, Alexander Luf, Florian Hecking, Manfred Tamandl, Dietmar Zotti, Oliver Reiberger, Thomas Starlinger, Patrick Mandorfer, Mattias Fleischmann, Edith |
author_facet | Reiterer, Christian Taschner, Alexander Luf, Florian Hecking, Manfred Tamandl, Dietmar Zotti, Oliver Reiberger, Thomas Starlinger, Patrick Mandorfer, Mattias Fleischmann, Edith |
author_sort | Reiterer, Christian |
collection | PubMed |
description | BACKGROUND: The impact of changes in portal pressure before and after liver resection (defined as ΔHVPG) on postoperative kidney function remains unknown. Therefore, we investigated the effect of ΔHVPG on (i) the incidence of postoperative AKI and (ii) the renin-angiotensin system (RAAS) and sympathetic nervous system (SNS) activity. METHODS: We included 30 patients undergoing partial liver resection. Our primary outcome was postoperative AKI according to KDIGO criteria. For our secondary outcome we assessed the plasma renin, aldosterone, noradrenaline, adrenaline, dopamine and vasopressin concentrations prior and 2 h after induction of anaesthesia, on the first and fifth postoperative day. HVPG was measured prior and immediately after liver resection. RESULTS: ΔHVPG could be measured in 21 patients with 12 patients HVPG showing increases in HVPG (∆HVPG≥1 mmHg) while 9 patients remained stable. AKI developed in 7/12 of patients with increasing HVPG, but only in 2/9 of patients with stable ΔHVPG (p = 0.302). Noradrenalin levels were significantly higher in patients with increasing ΔHVPG than in patients with stable ΔHVPG. (p = 0.009). Biomarkers reflecting RAAS and SNS activity remained similar in patients with increasing vs. stable ΔHVPG. CONCLUSIONS: Patients with increased HVPG had higher postoperative creatinine concentrations, however, the incidence of AKI was similar between patients with increased versus stable HVPG. |
format | Online Article Text |
id | pubmed-8742325 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-87423252022-01-10 Effect of liver resection-induced increases in hepatic venous pressure gradient on development of postoperative acute kidney injury Reiterer, Christian Taschner, Alexander Luf, Florian Hecking, Manfred Tamandl, Dietmar Zotti, Oliver Reiberger, Thomas Starlinger, Patrick Mandorfer, Mattias Fleischmann, Edith BMC Nephrol Research BACKGROUND: The impact of changes in portal pressure before and after liver resection (defined as ΔHVPG) on postoperative kidney function remains unknown. Therefore, we investigated the effect of ΔHVPG on (i) the incidence of postoperative AKI and (ii) the renin-angiotensin system (RAAS) and sympathetic nervous system (SNS) activity. METHODS: We included 30 patients undergoing partial liver resection. Our primary outcome was postoperative AKI according to KDIGO criteria. For our secondary outcome we assessed the plasma renin, aldosterone, noradrenaline, adrenaline, dopamine and vasopressin concentrations prior and 2 h after induction of anaesthesia, on the first and fifth postoperative day. HVPG was measured prior and immediately after liver resection. RESULTS: ΔHVPG could be measured in 21 patients with 12 patients HVPG showing increases in HVPG (∆HVPG≥1 mmHg) while 9 patients remained stable. AKI developed in 7/12 of patients with increasing HVPG, but only in 2/9 of patients with stable ΔHVPG (p = 0.302). Noradrenalin levels were significantly higher in patients with increasing ΔHVPG than in patients with stable ΔHVPG. (p = 0.009). Biomarkers reflecting RAAS and SNS activity remained similar in patients with increasing vs. stable ΔHVPG. CONCLUSIONS: Patients with increased HVPG had higher postoperative creatinine concentrations, however, the incidence of AKI was similar between patients with increased versus stable HVPG. BioMed Central 2022-01-08 /pmc/articles/PMC8742325/ /pubmed/34996372 http://dx.doi.org/10.1186/s12882-021-02658-7 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Reiterer, Christian Taschner, Alexander Luf, Florian Hecking, Manfred Tamandl, Dietmar Zotti, Oliver Reiberger, Thomas Starlinger, Patrick Mandorfer, Mattias Fleischmann, Edith Effect of liver resection-induced increases in hepatic venous pressure gradient on development of postoperative acute kidney injury |
title | Effect of liver resection-induced increases in hepatic venous pressure gradient on development of postoperative acute kidney injury |
title_full | Effect of liver resection-induced increases in hepatic venous pressure gradient on development of postoperative acute kidney injury |
title_fullStr | Effect of liver resection-induced increases in hepatic venous pressure gradient on development of postoperative acute kidney injury |
title_full_unstemmed | Effect of liver resection-induced increases in hepatic venous pressure gradient on development of postoperative acute kidney injury |
title_short | Effect of liver resection-induced increases in hepatic venous pressure gradient on development of postoperative acute kidney injury |
title_sort | effect of liver resection-induced increases in hepatic venous pressure gradient on development of postoperative acute kidney injury |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8742325/ https://www.ncbi.nlm.nih.gov/pubmed/34996372 http://dx.doi.org/10.1186/s12882-021-02658-7 |
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