Acute renal injury after partial hepatectomy

Currently, partial hepatectomy is the treatment of choice for a wide variety of liver and biliary conditions. Among the possible complications of partial hepatectomy, acute kidney injury(AKI) should be considered as an important cause of increased morbidity and postoperative mortality. Difficulties...

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Published inWorld journal of hepatology Vol. 8; no. 21; pp. 891 - 901
Main Authors Peres, Luis Alberto Batista, Bredt, Luis Cesar, Cipriani, Raphael Flavio Fachini
Format Journal Article
LanguageEnglish
Published United States Baishideng Publishing Group Inc 28.07.2016
Subjects
Hepatectomy;Liver
injury;Hepatorenal
renal
resection;Acute
Review
syndrome;Kidney
Liver resection
Acute renal injury
Hepatorenal syndrome
Kidney
Hepatectomy
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ISSN1948-5182
1948-5182
DOI10.4254/wjh.v8.i21.891

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Summary:Currently, partial hepatectomy is the treatment of choice for a wide variety of liver and biliary conditions. Among the possible complications of partial hepatectomy, acute kidney injury(AKI) should be considered as an important cause of increased morbidity and postoperative mortality. Difficulties in the data analysis related to postoperative AKI after liver resections are mainly due to the multiplicity of factors to be considered in the surgical patients, moreover, there is no consensus of the exact definition of AKI after liver resection in the literature, which hampers comparison and analysis of the scarce data published on the subject. Despite this multiplicity of risk factors for postoperative AKI after partial hepatectomy, there are main factors that clearly contribute to its occurrence. First factor relates to large blood losses with renal hypoperfusion during the operation, second factor relates to the occurrence of post-hepatectomy liver failure with consequent distributive circulatory changes and hepatorenal syndrome. Eventually, patients can have more than one factor contributing to post-operative AKI, and frequently these combinations of acute insults can be aggravated by sepsis or exposure to nephrotoxic drugs.
Bibliography:Luis Alberto Batista Peres;Luis Cesar Bredt;Raphael Flavio Fachini Cipriani;Department of Nephrology,University Hospital of Western Paraná,State University of Western Paraná;Department of Surgical Oncology and Hepatobiliary Surgery,University Hospital of Western Paraná,State University of Western Paraná;Department of General Surgery,University Hospital of Western Paraná,State University of Western Paraná
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Author contributions: Peres LAB, Bredt LC and Cipriani RFF contributed equally to this review article; all authors equally contributed to this paper with conception and design of the study, literature review and analysis, drafting and critical revision and editing, and final approval of the final version.
Correspondence to: Luis Cesar Bredt, Professor, Department of Surgical Oncology and Hepatobiliary Surgery, University Hospital of Western Paraná, State University of Western Paraná, Dom Pedro II Street, 2099, apto 701, Cascavel, Paraná 85819-110, Brazil. lcbredt@gmail.com
Telephone: +55-45-99369943 Fax: +55-45-33215151
ISSN:1948-5182
1948-5182
DOI:10.4254/wjh.v8.i21.891