title: Causes and incidence of renal replacement therapy application in orthotopic liver transplantation patients: our experience.
abstract: BACKGROUND
  Renal dysfunction is commonly found in patients with end-stage liver disease, as well as after liver transplantation, and it often needs renal replacement therapy (RRT) with the application of continuous or intermittent methods. The aim of this study was the recording of the patients who underwent continuous venovenous hemodiafiltration (CVVHDF) in the early postoperative period, as well as the recording of mortality and risk factors.
  
  
  METHODS
  We retrospectively examined 71 patients who underwent orthotopic liver transplantation during a 2-year period (2011-2012). We recorded the incidence of acute kidney injury (AKI), according to the Acute Kidney Injury Network criteria, and we distinguished 2 groups of patients. Group A included those who needed RRT during the 1st 7 days after transplantation, and group B included the patients who did not require RRT. The RRT method of choice was CVVHDF.
  
  
  RESULTS
  In group A, the population of patients who presented AKI reached 52.1%, and 22.5% of the them underwent RRT. The mean Model for End-Stage Liver Disease and Acute Physiology and Chronic Health Evaluation scores were higher in group A, who also presented greater hemodynamic instability and more frequent infections and required more transfusions. The transfusion of >10 units of red blood cells was recognized as a risk factor for RRT (P = .024; odds ratio, 1.15; 95% confidence interval, 1.8-7.53).
  
  
  CONCLUSIONS
  Patients who required RRT immediately after surgery had a significantly higher rate of mortality and it seemed that the number of transfusions played an important role in this.
authors.affiliation: Intensive Care Unit, "Hippokratio" Hospital, Thessaloniki, Greece.
authors.forename: S
authors.initials: S
authors.lastname: Papadopoulos
authors.affiliation: Intensive Care Unit, "Hippokratio" Hospital, Thessaloniki, Greece. Electronic address: aretikarapan@gmail.com.
authors.forename: A
authors.initials: A
authors.lastname: Karapanagiotou
authors.affiliation: Intensive Care Unit, "Hippokratio" Hospital, Thessaloniki, Greece.
authors.forename: C
authors.initials: C
authors.lastname: Kydona
authors.affiliation: Department of Nephrology, "Hippokratio" Hospital, Thessaloniki, Greece.
authors.forename: C
authors.initials: C
authors.lastname: Dimitriadis
authors.affiliation: Intensive Care Unit, "Hippokratio" Hospital, Thessaloniki, Greece.
authors.forename: T
authors.initials: T
authors.lastname: Theodoridou
authors.affiliation: Intensive Care Unit, "Hippokratio" Hospital, Thessaloniki, Greece.
authors.forename: M
authors.initials: M
authors.lastname: Piperidou
authors.affiliation: Division of Transplantation, Department of Surgery, Aristotle University Medical School, "Hippokratio" Hospital, Thessaloniki, Greece.
authors.forename: G
authors.initials: G
authors.lastname: Imvrios
authors.affiliation: Division of Transplantation, Department of Surgery, Aristotle University Medical School, "Hippokratio" Hospital, Thessaloniki, Greece.
authors.forename: I
authors.initials: I
authors.lastname: Fouzas
authors.affiliation: Intensive Care Unit, "Hippokratio" Hospital, Thessaloniki, Greece.
authors.forename: N
authors.initials: N
authors.lastname: Gritsi-Gerogianni
mesh_terms: D058186:Acute Kidney Injury / Q000453:epidemiology* / Q000628:therapy; D000368:Aged; D058625:End Stage Liver Disease / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006115:Greece / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D017582:Renal Replacement Therapy / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate / Q000639:trends; D013997:Time Factors