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Acute Kidney Injury after Endoscopic Retrograde Cholangiopancreatography—A Hospital-Based Prospective Observational Study

Background: Endoscopic retrograde cholangiopancreatography (ERCP) represents a major pivotal point in gastrointestinal endoscopy. Little is known about acute kidney injury (AKI) post-ERCP. This study analyses the incidence, risk factors, and prognosis of post-ERCP AKI. Methods: A total of 396 patien...

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Autores principales: Gadalean, Florica, Parv, Florina, Milas, Oana, Petrica, Ligia, Ratiu, Iulia, Miutescu, Bogdan, Goldis, Adrian, Gluhovschi, Cristina, Bob, Flaviu, Simulescu, Anca, Patruica, Mihaela, Apostol, Adrian, Ivan, Viviana, Schiller, Adalbert, Radu, Daniela
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9775076/
https://www.ncbi.nlm.nih.gov/pubmed/36551921
http://dx.doi.org/10.3390/biomedicines10123166
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author Gadalean, Florica
Parv, Florina
Milas, Oana
Petrica, Ligia
Ratiu, Iulia
Miutescu, Bogdan
Goldis, Adrian
Gluhovschi, Cristina
Bob, Flaviu
Simulescu, Anca
Patruica, Mihaela
Apostol, Adrian
Ivan, Viviana
Schiller, Adalbert
Radu, Daniela
author_facet Gadalean, Florica
Parv, Florina
Milas, Oana
Petrica, Ligia
Ratiu, Iulia
Miutescu, Bogdan
Goldis, Adrian
Gluhovschi, Cristina
Bob, Flaviu
Simulescu, Anca
Patruica, Mihaela
Apostol, Adrian
Ivan, Viviana
Schiller, Adalbert
Radu, Daniela
author_sort Gadalean, Florica
collection PubMed
description Background: Endoscopic retrograde cholangiopancreatography (ERCP) represents a major pivotal point in gastrointestinal endoscopy. Little is known about acute kidney injury (AKI) post-ERCP. This study analyses the incidence, risk factors, and prognosis of post-ERCP AKI. Methods: A total of 396 patients were prospectively studied. AKI was defined by an increase in serum creatinine (SCr) ≥ 0.3 mg/dL or by an increase in SCr ≥ 50% in the first 48 h post-ERCP. Logistic regression analysis was used to identify the predictors of AKI and in-hospital mortality. A two-tailed p value < 0.05 was considered significant. Results: One hundred and three patients (26%) developed post-ERCP AKI. Estimated glomerular filtration rate (adjusted odds ratio (aOR) = 0.95, 95% confidence interval (CI): 0.94–0.96, p < 0.001), nonrenal Charlson Comorbidity Index (Aor = 1.19, 95% CI: 1.05–1.35, p = 0.006), choledocholithiasis (aOR = 4.05, 95% CI: 1.98–8.29, p < 0.001), and bilirubin (aOR = 1.1, 95% CI: 1.05–1.15, p < 0.001) were associated with post-ERCP AKI. Post-ERCP AKI was associated with longer hospital stay (p < 0.001) and with increased in-hospital mortality (7.76% versus 0.36%, p < 0.001). Moderate-to-severe (stage 2 and 3) AKI was independently associated with in-hospital mortality (aOR = 6.43, 95% CI: 1.48–27.88, p < 0.013). Conclusions: Post-ERCP AKI represented an important complication associated with longer hospital stay. Moderate-to-severe post-ERCP AKI was an independent risk factor for in-hospital mortality.
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spelling pubmed-97750762022-12-23 Acute Kidney Injury after Endoscopic Retrograde Cholangiopancreatography—A Hospital-Based Prospective Observational Study Gadalean, Florica Parv, Florina Milas, Oana Petrica, Ligia Ratiu, Iulia Miutescu, Bogdan Goldis, Adrian Gluhovschi, Cristina Bob, Flaviu Simulescu, Anca Patruica, Mihaela Apostol, Adrian Ivan, Viviana Schiller, Adalbert Radu, Daniela Biomedicines Article Background: Endoscopic retrograde cholangiopancreatography (ERCP) represents a major pivotal point in gastrointestinal endoscopy. Little is known about acute kidney injury (AKI) post-ERCP. This study analyses the incidence, risk factors, and prognosis of post-ERCP AKI. Methods: A total of 396 patients were prospectively studied. AKI was defined by an increase in serum creatinine (SCr) ≥ 0.3 mg/dL or by an increase in SCr ≥ 50% in the first 48 h post-ERCP. Logistic regression analysis was used to identify the predictors of AKI and in-hospital mortality. A two-tailed p value < 0.05 was considered significant. Results: One hundred and three patients (26%) developed post-ERCP AKI. Estimated glomerular filtration rate (adjusted odds ratio (aOR) = 0.95, 95% confidence interval (CI): 0.94–0.96, p < 0.001), nonrenal Charlson Comorbidity Index (Aor = 1.19, 95% CI: 1.05–1.35, p = 0.006), choledocholithiasis (aOR = 4.05, 95% CI: 1.98–8.29, p < 0.001), and bilirubin (aOR = 1.1, 95% CI: 1.05–1.15, p < 0.001) were associated with post-ERCP AKI. Post-ERCP AKI was associated with longer hospital stay (p < 0.001) and with increased in-hospital mortality (7.76% versus 0.36%, p < 0.001). Moderate-to-severe (stage 2 and 3) AKI was independently associated with in-hospital mortality (aOR = 6.43, 95% CI: 1.48–27.88, p < 0.013). Conclusions: Post-ERCP AKI represented an important complication associated with longer hospital stay. Moderate-to-severe post-ERCP AKI was an independent risk factor for in-hospital mortality. MDPI 2022-12-07 /pmc/articles/PMC9775076/ /pubmed/36551921 http://dx.doi.org/10.3390/biomedicines10123166 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Gadalean, Florica
Parv, Florina
Milas, Oana
Petrica, Ligia
Ratiu, Iulia
Miutescu, Bogdan
Goldis, Adrian
Gluhovschi, Cristina
Bob, Flaviu
Simulescu, Anca
Patruica, Mihaela
Apostol, Adrian
Ivan, Viviana
Schiller, Adalbert
Radu, Daniela
Acute Kidney Injury after Endoscopic Retrograde Cholangiopancreatography—A Hospital-Based Prospective Observational Study
title Acute Kidney Injury after Endoscopic Retrograde Cholangiopancreatography—A Hospital-Based Prospective Observational Study
title_full Acute Kidney Injury after Endoscopic Retrograde Cholangiopancreatography—A Hospital-Based Prospective Observational Study
title_fullStr Acute Kidney Injury after Endoscopic Retrograde Cholangiopancreatography—A Hospital-Based Prospective Observational Study
title_full_unstemmed Acute Kidney Injury after Endoscopic Retrograde Cholangiopancreatography—A Hospital-Based Prospective Observational Study
title_short Acute Kidney Injury after Endoscopic Retrograde Cholangiopancreatography—A Hospital-Based Prospective Observational Study
title_sort acute kidney injury after endoscopic retrograde cholangiopancreatography—a hospital-based prospective observational study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9775076/
https://www.ncbi.nlm.nih.gov/pubmed/36551921
http://dx.doi.org/10.3390/biomedicines10123166
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