title: Risk factors for acute kidney injury and 30-day mortality after liver transplantation.
abstract: BACKGROUND
  The aim of this study is to evaluate the risk factors for acute kidney injury (AKI) and 30-day mortality after liver transplantation.
  
  
  METHODS
  This is a retrospective cohort of consecutive adults undergoing orthotopic liver transplantation (OLT) at a referral hospital in Brazil, from January 2013 to January 2014. Risk factors for AKI and death were investigated.
  
  
  RESULTS
  A total 134 patients were included, with median age of 56 years. AKI was found in 46.7% of patients in the first 72 h after OLT. Risk factors for AKI were: viral hepatitis (OR 2.9, 95% CI = 1.2-7), warm ischemia time (OR 1.1, 95% CI = 1.01-1.2) and serum lactate (OR 1.3, 95%CI = 1.02-1.89). The length of intensive care unit (ICU) stay was longer in AKI group: 4 (3-7) days vs. 3 (2-4) days (p = 0.001), as well as overall hospitalization stay: 16 (9-26) days vs. 10 (8- 14) days (p = 0.001). The 30-day mortality was 15%. AKI was an independent risk factor for mortality (OR 4.3, 95% CI = 1.3-14.6). MELD-Na ≥ 22 was a predictor for hemodialysis need (OR 8.4, 95%CI = 1.5-46.5). Chronic kidney disease (CKD) was found in 36 patients (56.2% of AKI patients).
  
  
  CONCLUSIONS
  Viral hepatitis, longer warm ischemia time and high levels of serum lactate are risk factors for AKI after OLT. AKI is a risk factor for death and can lead to CKD in a high percentage of patients after OLT. A high MELD-Na score is a predictor for hemodialysis need.
authors.affiliation: Post-Graduation Program in Medical Sciences, Department of Internal Medicine, School of Medicine, Federal University of Ceara. Fortaleza, Ceara, Brazil.
authors.forename: Adller G C
authors.initials: AG
authors.lastname: Barreto
authors.affiliation: Post-Graduation Program in Medical Sciences, Department of Internal Medicine, School of Medicine, Federal University of Ceara. Fortaleza, Ceara, Brazil.
authors.forename: Elizabeth F
authors.initials: EF
authors.lastname: Daher
authors.affiliation: School of Medicine, Post-Graduation Program in Collective Health, Health Sciences Center, University of Fortaleza. Fortaleza, Ceara, Brazil.
authors.forename: Geraldo B
authors.initials: GB
authors.lastname: Silva Junior
authors.affiliation: Liver Transplantation Center, Walter Cantidio University Hospital, Federal University of Ceará. Fortaleza, Ceara, Brazil.
authors.forename: José Huygens P
authors.initials: JH
authors.lastname: Garcia
authors.affiliation: Post-Graduation Program in Medical Sciences, Department of Internal Medicine, School of Medicine, Federal University of Ceara. Fortaleza, Ceara, Brazil.
authors.forename: Clarissa B A
authors.initials: CB
authors.lastname: Magalhães
authors.affiliation: Post-Graduation Program in Medical Sciences, Department of Internal Medicine, School of Medicine, Federal University of Ceara. Fortaleza, Ceara, Brazil.
authors.forename: José Milton C
authors.initials: JM
authors.lastname: Lima
authors.affiliation: Liver Transplantation Center, Walter Cantidio University Hospital, Federal University of Ceará. Fortaleza, Ceara, Brazil.
authors.forename: Cyntia F G
authors.initials: CF
authors.lastname: Viana
authors.affiliation: Post-Graduation Program in Medical Sciences, Department of Internal Medicine, School of Medicine, Federal University of Ceara. Fortaleza, Ceara, Brazil.
authors.forename: Eanes D B
authors.initials: ED
authors.lastname: Pereira
mesh_terms: D058186:Acute Kidney Injury / Q000175:diagnosis / Q000209:etiology* / Q000401:mortality* / Q000628:therapy; D015415:Biomarkers / Q000097:blood; D001938:Brazil; D016009:Chi-Square Distribution; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D019344:Lactic Acid / Q000097:blood; D007902:Length of Stay; D016031:Liver Transplantation / Q000009:adverse effects* / Q000401:mortality*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D006435:Renal Dialysis; D051436:Renal Insufficiency, Chronic / Q000209:etiology; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D015854:Up-Regulation; D052096:Warm Ischemia / Q000009:adverse effects / Q000401:mortality
chemical_list: D015415:Biomarkers; D019344:Lactic Acid