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Incidence and Risk Factors of Acute Kidney Injury After Kasai Operation for Biliary Atresia: A Retrospective Study

Authors
 Jin Ha Park  ;  Kyong Ihn  ;  Seok Joo Han  ;  Sijin Kim  ;  Sung Yeon Ham  ;  Sangmin Ko  ;  Min-Soo Kim 
Citation
 INTERNATIONAL JOURNAL OF MEDICAL SCIENCES, Vol.17(8) : 1023-1029, 2020-04 
Journal Title
 INTERNATIONAL JOURNAL OF MEDICAL SCIENCES 
Issue Date
2020-04
Keywords
Kasai operation ; acute kidney injury ; biliary atresia ; epidemiology ; risk factors
Abstract
Background: Biliary atresia is a progressive, inflammatory, and destructive pathology of the bile ducts. Patients who undergo surgery for correction of biliary atresia (Kasai operation) are at risk of acute kidney injury (AKI) because of their young age at the time of surgery, long operation time, and liver fibrosis or failure as complication of biliary atresia. Conversely, AKI is associated with poor outcomes after surgery. This study therefore aimed to evaluate the incidence, risk factors, and outcomes of AKI after Kasai operation. Methods: All consecutive patients who underwent Kasai operation between March 2006 and December 2015 in a single tertiary-care university hospital were enrolled. AKI was defined based on the Acute Kidney Injury Network criteria. Multivariate logistic regression models were used to assess risk factors for AKI. Results: One hundred sixty-six patients received Kasai operation during study period. Of these, AKI occurred in 37 of 166 patients (22.3%). In multivariate logistic regression analysis, age older than 30 days, higher preoperative estimated glomerular filtration rate, and preoperative contrast use within 7 days were associated with the development of AKI. Perioperative packed red blood cells transfusion was related to reduced occurrence of AKI. AKI was associated with longer ICU stay (OR = 1.015, p = 0.016). More patients with AKI were also found to receive additional surgery except liver transplantation within 1 year compared to those without AKI (10.8 % vs. 2.3 %, p = 0.045). Conclusions: Increased age is strongly associated with the development of AKI after Kasai operation. These findings indicate a rational basis for early corrective surgery for biliary atresia, early screening for AKI, and intervention to improve the results of Kasai operation.
Files in This Item:
T202001286.pdf Download
DOI
10.7150/ijms.44163
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 Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Min Soo(김민수) ORCID logo https://orcid.org/0000-0001-8760-4568
Kim, Sijin(김시진) ORCID logo https://orcid.org/0000-0002-8906-9391
Park, Jin Ha(박진하) ORCID logo https://orcid.org/0000-0002-1398-3304
Ihn, Kyong(인경) ORCID logo https://orcid.org/0000-0002-6161-0078
Han, Seok Joo(한석주) ORCID logo https://orcid.org/0000-0001-5224-1437
Ham, Sung Yeon(함성연) ORCID logo https://orcid.org/0000-0001-8619-4595
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/176073
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