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Effect of Diabetes Mellitus on Acute Kidney Injury after Minimally Invasive Partial Nephrectomy: A Case-Matched Retrospective Analysis

Authors
 Na Young Kim  ;  Jung Hwa Hong  ;  Dong Hoon Koh  ;  Jongsoo Lee  ;  Hoon Jae Nam  ;  So Yeon Kim 
Citation
 JOURNAL OF CLINICAL MEDICINE, Vol.8(4) : E468, 2019 
Journal Title
 JOURNAL OF CLINICAL MEDICINE 
Issue Date
2019
Keywords
acute kidney injury ; diabetes mellitus ; minimally invasive surgical procedures ; nephrectomy ; risk factors
Abstract
Postoperative acute kidney injury (AKI) is still a concern in partial nephrectomy (PN), even with the development of minimally invasive technique. We aimed to compare AKI incidence between patients with and without diabetes mellitus (DM) and to determine the predictive factors for postoperative AKI. This case-matched retrospective study included 884 patients with preoperative creatinine levels ≤1.4 mg/dL who underwent laparoscopic or robot-assisted laparoscopic PN between December 2005 and May 2018. Propensity score matching was employed to match patients with and without DM in a 1:3 ratio (101 and 303 patients, respectively). Of 884 patients, 20.4% had postoperative AKI. After propensity score matching, the incidence of postoperative AKI in DM and non-DM patients was 30.7% and 14.9%, respectively (P < 0.001). In multivariate analysis, male sex and warm ischemia time (WIT) >25 min were significantly associated with postoperative AKI in patients with and without DM. In patients with DM, hemoglobin A1c (HbA1c) >7% was a predictive factor for AKI, odds ratio (OR) = 4.59 (95% CI, 1.47⁻14.36). In conclusion, DM increased the risk of AKI after minimally invasive PN; male sex, longer WIT, and elevated HbA1c were independent risk factors for AKI in patients with DM.
Files in This Item:
T201901008.pdf Download
DOI
10.3390/jcm8040468
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Urology (비뇨의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Na Young(김나영) ORCID logo https://orcid.org/0000-0003-3685-2005
Kim, So Yeon(김소연) ORCID logo https://orcid.org/0000-0001-5352-157X
Nam, Hoon Jae(남훈재) ORCID logo https://orcid.org/0000-0001-7112-9221
Lee, Jong Soo(이종수) ORCID logo https://orcid.org/0000-0002-9984-1138
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/169821
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