Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Incidence, Risk Factors and Consequences of Acute Kidney Injury in Patients Undergoing Esophageal Cancer Surgery: A Historical Cohort

Ilaria GODI
* ORCID logo ,
Paolo Feltracco
,
Giulia Lorenzoni
,
Alessio Antonelli
,
Renato Salvador
,
Dario Gregori
,
Ivo Tiberio
,
Michele Valmasoni
Version 1 : Received: 22 February 2024 / Approved: 22 February 2024 / Online: 23 February 2024 (10:32:51 CET)

A peer-reviewed article of this Preprint also exists.

Godi, I.; Feltracco, P.; Lorenzoni, G.; Antonelli, A.; Salvador, R.; Gregori, D.; Tiberio, I.; Valmasoni, M. Incidence, Risk Factors, and Consequences of Acute Kidney Injury in Patients Undergoing Esophageal Cancer Surgery: A Historical Cohort. Kidney Dial. 2024, 4, 93-104. Godi, I.; Feltracco, P.; Lorenzoni, G.; Antonelli, A.; Salvador, R.; Gregori, D.; Tiberio, I.; Valmasoni, M. Incidence, Risk Factors, and Consequences of Acute Kidney Injury in Patients Undergoing Esophageal Cancer Surgery: A Historical Cohort. Kidney Dial. 2024, 4, 93-104.

Abstract

Background: Limited data exist on postoperative acute kidney injury (AKI) in patients underwent esophageal cancer surgery. The purpose of the study was to evaluate the incidence, risk factors and consequences of postoperative acute kidney after esophagectomy. Methods: This was a retrospective cohort study. The study was conducted in a tertiary specialized cancer center in Italy. All patients undergoing elective esophageal cancer surgery between 2016 and 2021 were included in the study. AKI was defined according to Kidney Disease: Improving Global Outcomes criteria (both serum creatinine and urine output), within 48 hours after surgery. Preoperative and intraoperative data were registered. We also collected data concerning progression of AKI, need for kidney replacement therapy, mortality, medical (pulmonary, cardiovascular, septic) and surgical complications within 30 days from surgery, as well as length of hospital stay. Results: Incidence of postoperative AKI was 32%. The independent risk factors were body mass index and the invasive surgical approach. Persistent AKI accounted for 15% of the cases and it was associated with increased risk of major cardiovascular events (odds ratio 4.14, 95% CI 1.05-15.8, p-value 0.036), pulmonary complications (OR 3.67, 95% CI 1.04-14.9, p-value 0.050) and increased length of hospital stay (AME 7.2, 0.5-13.9, p-value 0.035). Conclusions: Postoperative AKI is common after esophageal cancer surgery. BMI and totally invasive surgical approach are independent risk factors. Persistent AKI lasting more than 48 hours increased the risk for cardiovascular and pulmonary complications, with prolonged length of hospital stay.

Keywords

postoperative acute kidney injury; esophageal cancer surgery; outcome

Subject

Medicine and Pharmacology, Urology and Nephrology

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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