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Dergiler / Journal of Medicine and Palliative Care / 2026 / Volume: 5 Issue: 3

Majör abdominal cerrahilerde akut böbrek hasarında perioperatif risk faktörleri

Perioperative risk factors for acute kidney injury in major abdominal surgeries: a retrospective observatioal study

Emine Nilgün Zengin(Ministry of Health, Ankara Bilkent City Hospital, Department of Anesthesiology and Reanimation)0000-0002-7653-6405
Nevriye Salman(University of Health Sciences, Ankara Bilkent City Hospital, Department of Anesthesiology and Reanimation)0000-0001-9416-4177
Zeliha Aslı Demir(University of Health Sciences, Ankara Bilkent City Hospital, Department of Anesthesiology and Reanimation)0000-0003-3053-0443
Behiç Girgin(Ministry of Health, Ankara Bilkent City Hospital, Department of Anesthesiology and Reanimation)0000-0003-3838-9886
Hülya Yiğit Özay(Ministry of Health Ankara Bilkent City Hospital, Department of Anesthesiology and Reanimation)0000-0002-4104-6924
Umut Cahit Ersoy(Ministry of Health Ankara Bilkent City Hospital, Department of Anesthesiology and Reanimation)0000-0002-5878-8027
Ali Alagöz(University of Health Sciences, Ankara Atatürk Sanatorium Training and Research Hospital, Department of Anesthesiology and Reanimation)0000-0002-7538-2213
Sayfa
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Yayın Tarihi
2024-06-28
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⚡ TL;DR(1 Cümlede Hızlı Çıkarım)

Bulgular: Verileri tam olan toplam 64 hasta çalışmaya dahil edildi.

📌 3 Maddede Bu Makale

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Amaç & Hipotez:Amaç: Akut böbrek hasarı (ABH), özellikle cerrahiye bağlı postoperatif bir komplikasyon olarak, bağımsız olarak morbidite ve mortalite ile ilişkilendirilmiştir.
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Temel Bulgular & Veri:ABH ayrıca majör abdominal cerrahiden sonra da önemli oranda gelişir.
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Sonuç & Katkı:Bulgular: Verileri tam olan toplam 64 hasta çalışmaya dahil edildi.
🔬Tür:Laboratuvar & Saha Deneyi
📍Kapsam:64 hasta
⚙️Değişkenler:Abdominal surgery · acute kidney injury · perioperative

Özet

Amaç: Akut böbrek hasarı (ABH), özellikle cerrahiye bağlı postoperatif bir komplikasyon olarak, bağımsız olarak morbidite ve mortalite ile ilişkilendirilmiştir. ABH ayrıca majör abdominal cerrahiden sonra da önemli oranda gelişir. Bu çalışmada, majör abdominal cerrahi sonrası ABH gelişimine sebep olan risk faktörlerinin belirlenmesi amaçlandı. Gereç ve Yöntem: Çalışma retrospektif olarak planlandı. Çalışmaya majör abdominal cerrahi geçiren hastalar dahil edildi. Hasta dosyalarından hastaların demografik verileri, ameliyat öncesi laboratuvar verileri, ameliyat sırasındaki verileri ve ameliyat sonrası verileri kaydedildi. Postoperatif akut böbrek hasarının (PO-ABH) tanısı ve derecesi, KDIGO kılavuzlarına uygun olarak serum kreatinin ve/veya idrar çıkışı kriterleri ile değerlendirildi. Hastalar ABH olan ve ABH olmayan olmak üzere iki gruba ayrıldı. Bulgular: Verileri tam olan toplam 64 hasta çalışmaya dahil edildi. Bu hastaların 6'sında (%9.3) ABH gelişti. ABH grubunda yaş ortalaması istatistiksel olarak anlamlı derecede yüksek bulundu (p:0.043). Kırılganlık indeksi ABH grubunda anlamlı derecede yüksekti (p:0.020). Ayrıca ABH grubunda aspirin ve anjiyotensin dönüştürücü enzim inhibitörü (ACEI)/anjiyotensin reseptör blokeri (ARB) kullanımının istatistiksel olarak anlamlı düzeyde daha yüksek olduğu görüldü (sırasıyla p:0.022, p:0.044). Hastalar intraoperatif parametreler açısından değerlendirildiğinde ABH grubunda, kullanılan kolloid miktarı, kullanılan ES miktarı ve vazopressör kullanımı istatistiksel olarak anlamlı derecede yüksek bulundu (p:<0.001, p:0.036, p:0.022), sırasıyla). Son olarak ABH grubunda postoperatif dönemde vazopressör kullanımı ve diüretik kullanımı istatistiksel olarak anlamlı düzeyde yüksek bulundu (sırasıyla p:0.002, p:0.044). Sonuç: Perioperatif dönemi kapsayan birçok parametre PO-ABH'na neden olabilir. Özellikle yaşlı hastalarda kırılganlık ve yaş akılda tutulması gereken önemli faktörlerdir.

Abstract

Aims: Acute kidney injury (AKI), particularly as a postoperative complication related to surgery, has been independently associated with morbidity and mortality. AKI also develops at a significant rate after major abdominal surgery. In this study, it was aimed to identify the risk factors contributing to the development of AKI following major abdominal surgery. Methods: The study was retrospectively planned. Patients who underwent major abdominal surgery were included in the study. Patients’ demographic data, preoperative laboratory data, intraoperative data, and postoperative data were recorded from patient files. The diagnosis and severity of postoperative acute kidney injury (PO-AKI) were assessed using serum creatinine and/or urine output criteria in accordance with the Kidney Disease: Improving Global Outcomes (KDIGO) guidelines. The patients were divided into two groups: AKI and non-AKI. Results: A total of 64 patients with complete data were included in the study. Among these patients, 6 developed AKI (9.3%). The mean age in the AKI group was found to be statistically significantly higher (p: 0.043). The Frailty index was significantly higher in the AKI group (p: 0.020). Additionally, it was observed that the use of aspirin and angiotensin-converting enzyme inhibitor (ACEI) / angiotensin receptor blocker (ARB) was statistically significantly higher in the AKI group (p: 0.022, p: 0.044, respectively). When patients were evaluated in terms of intraoperative parameters, the amount of colloid used, the amount of ES used, and vasopressor usage were found to be statistically significantly higher in the AKI group (p<0.001, p: 0.036, p: 0.022, respectively). Lastly, vasopressor usage and diuretic usage were found to be statistically significantly higher in the AKI group for postoperative period (p: 0.002, p: 0.044, respectively) Conclusion: Many parameters covering the perioperative period can cause PO-AKI. Especially in elderly patients, frailty and age are significant factors that must be kept in mind.

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Bu Makaleye Atıf Yap

Zengin, E. N., Salman, N., Demir, Z. A., Girgin, B., Özay, H. Y., Ersoy, U. C., Alagöz, A. (2024). Majör abdominal cerrahilerde akut böbrek hasarında perioperatif risk faktörleri. Journal of Medicine and Palliative Care, Volume: 5 Issue: 3. https://doi.org/10.47582/jompac.1479651

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