AIM: To determine renal dysfunction post liver transplantation, its incidence and risk factors in patients from a Belgian University Hospital.METHODS: Orthotopic liver transplantations performed from January 2006 unti...AIM: To determine renal dysfunction post liver transplantation, its incidence and risk factors in patients from a Belgian University Hospital.METHODS: Orthotopic liver transplantations performed from January 2006 until September 2012 were retrospectively reviewed(n = 187). Patients with no renal replacement therapy(RRT) before transplantation were classified into four groups according to their highest creatinine plasma level during the first postoperative week. The first group had a peak creatinine level below 12 mg/L, the second group between 12 and 20 mg/L, the third group between 20 and 35 mg/L, and the fourth above 35 mg/L. In addition, patients who needed RRT during the first week after transplantation were also classified into the fourth group. Perioperative parameters were recorded as risk factors, namely age, sex, bodymass index(BMI), length of preoperative hospital stay, prior bacterial infection within one month, preoperative ascites, preoperative treatment with β-blocker, angiotensin-converting enzyme inhibitor or non steroidal anti-inflammatory drugs, preoperative creatinine and bilirubin levels, donor status(cardiac death or brain death), postoperative lactate level, need for intraoperative vasopressive drugs, surgical revision, mechanical ventilation for more than 24 h, postoperative bilirubin and transaminase peak levels, postoperative hemoglobin level, amount of perioperative blood transfusions and type of immunosuppression. Univariate and multivariate analysis were performed using logistic ordinal regression method. Post hoc analysis of the hemostatic agent used was also done.RESULTS: There were 78 patients in group 1(41.7%), 46 in group 2(24.6%), 38 in group 3(20.3%) and 25 in group 4(13.4%). Twenty patients required RRT: 13(7%) during the first week after transplantation. Using univariate analysis, the severity of renal dysfunction was correlated with presence of ascites and prior bacterial infection, preoperative bilirubin, urea and creatinine level, need for surgical revision, use of vasopre展开更多
目的探讨颈内静脉置管在急危重症肾功能衰竭患者血液净化中的应用价值。方法抽取在我院接受血液净化治疗的98例危重症肾功能衰竭患者参与本次临床研究,根据患者穿刺置管方法的不同将98例患者分为观察组(50例;颈内静脉置管)和一般组(48例...目的探讨颈内静脉置管在急危重症肾功能衰竭患者血液净化中的应用价值。方法抽取在我院接受血液净化治疗的98例危重症肾功能衰竭患者参与本次临床研究,根据患者穿刺置管方法的不同将98例患者分为观察组(50例;颈内静脉置管)和一般组(48例;股静脉置管),对比两组患者的穿刺置管相关指标及血液净化治疗效果。结果经对比发现观察组患者的一次性穿刺成功率高于一般组患者(96.0% vs 83.3%),导管留置时间长于一般组患者(45.9±5.2 d vs 38.2±4.9 d),导管相关并发症发生和血液净化治疗过程中的血流量不足发生率均低于一般组患者(4.0% vs 16.8%;4.0% vs 16.8%)。两组上述指标比较均存在明显差异(P<0.05)。结论颈内静脉置管在急危重症肾功能衰竭患者血液净化中的应用,能够有效提高患者穿刺置管安全性,延长患者导管使用时间,降低患者血液净化治疗过程中的血流量不足发生率,有利于减轻患者机体痛苦,改善患者血液净化治疗效果。展开更多
文摘AIM: To determine renal dysfunction post liver transplantation, its incidence and risk factors in patients from a Belgian University Hospital.METHODS: Orthotopic liver transplantations performed from January 2006 until September 2012 were retrospectively reviewed(n = 187). Patients with no renal replacement therapy(RRT) before transplantation were classified into four groups according to their highest creatinine plasma level during the first postoperative week. The first group had a peak creatinine level below 12 mg/L, the second group between 12 and 20 mg/L, the third group between 20 and 35 mg/L, and the fourth above 35 mg/L. In addition, patients who needed RRT during the first week after transplantation were also classified into the fourth group. Perioperative parameters were recorded as risk factors, namely age, sex, bodymass index(BMI), length of preoperative hospital stay, prior bacterial infection within one month, preoperative ascites, preoperative treatment with β-blocker, angiotensin-converting enzyme inhibitor or non steroidal anti-inflammatory drugs, preoperative creatinine and bilirubin levels, donor status(cardiac death or brain death), postoperative lactate level, need for intraoperative vasopressive drugs, surgical revision, mechanical ventilation for more than 24 h, postoperative bilirubin and transaminase peak levels, postoperative hemoglobin level, amount of perioperative blood transfusions and type of immunosuppression. Univariate and multivariate analysis were performed using logistic ordinal regression method. Post hoc analysis of the hemostatic agent used was also done.RESULTS: There were 78 patients in group 1(41.7%), 46 in group 2(24.6%), 38 in group 3(20.3%) and 25 in group 4(13.4%). Twenty patients required RRT: 13(7%) during the first week after transplantation. Using univariate analysis, the severity of renal dysfunction was correlated with presence of ascites and prior bacterial infection, preoperative bilirubin, urea and creatinine level, need for surgical revision, use of vasopre
文摘目的探讨颈内静脉置管在急危重症肾功能衰竭患者血液净化中的应用价值。方法抽取在我院接受血液净化治疗的98例危重症肾功能衰竭患者参与本次临床研究,根据患者穿刺置管方法的不同将98例患者分为观察组(50例;颈内静脉置管)和一般组(48例;股静脉置管),对比两组患者的穿刺置管相关指标及血液净化治疗效果。结果经对比发现观察组患者的一次性穿刺成功率高于一般组患者(96.0% vs 83.3%),导管留置时间长于一般组患者(45.9±5.2 d vs 38.2±4.9 d),导管相关并发症发生和血液净化治疗过程中的血流量不足发生率均低于一般组患者(4.0% vs 16.8%;4.0% vs 16.8%)。两组上述指标比较均存在明显差异(P<0.05)。结论颈内静脉置管在急危重症肾功能衰竭患者血液净化中的应用,能够有效提高患者穿刺置管安全性,延长患者导管使用时间,降低患者血液净化治疗过程中的血流量不足发生率,有利于减轻患者机体痛苦,改善患者血液净化治疗效果。
