Predictive indicators of early acute renal injury following liver transplantation

Abstract

Objective To investigate the predictive indicators of early acute kiney injury (AKI) following liver transplantation. Methods A total of 64 patients with end-stage liver diseases undergoing orthotopic liver transplantation (OLT) in the Third Affiliated Hospital of Sun Yat-sen University from April 2007 to December 2012 were enrolled in this prospective study. The informed consents of all patients were obtained and the ethical committee approval was received. There were 59 males and 5 females with a mean age of (44±11) years old. According to whether the patients suffered AKI 3 d after OLT, they were divided into AKI group (n=30) and non-AKI group (n=34). Cystatin C in the peripheral venous blood and urine β2-microglobulin (β2-MG), urine N-acetyl-β-D-glucosidase (NAG) were detected before operation. And serum creatinine (Scr) was detected during the perioperative period. Normally distributed data were compared between two groups using t test. Skew distributed data were compared using rank sum test. Results The Scr was (80±26) μmol/L in AKI group before operation and was (76±19) μmol/L in non-AKI group, where no significant difference was observed between two groups (t=0.596, P>0.05). The blood Cystatin C, urine β2-MG, urine NAG were (1.06±0.24) mg/L, 1.49 (0.19~22.63) mg/L, 43(11~188) U/L respectively in AKI group before operation, which were significantly higher compared with those in non-AKI group [(0.95±0.20) mg/L, 0.21(0.19~14.10) mg/L, 21(2~101) U/L)] (t=2.129, Z=1.963, Z=3.840; P<0.05). Conclusion Preoperative blood Cystatin C, urine β2-MG and urine NAG can be the sensitive indicators for predicting early AKI following OLT. Key words: Liver transplantation; Acute kidney injury; Perioperative care