title: Identification of Risk Factors Associated With Postoperative Acute Kidney Injury After Esophagectomy for Esophageal Cancer.
abstract: OBJECTIVE
  To identify risks factors associated with acute kidney injury (AKI) after esophageal cancer surgery.
  
  
  METHODS
  This was a retrospective study.
  
  
  METHODS
  Single academic center.
  
  
  METHODS
  Subjects with non-metastatic esophageal cancer. Patients were excluded if they were younger than 18 years and had missing data.
  
  
  RESULTS
  Primary outcome of the study was AKI according to AKI Network criteria. Demographic and perioperative variables were compared in patients with and without AKI. A multivariate Cox proportional model was used to assess the association between perioperative variables and AKI; p<0.05 was considered statistically significant. AKI was found in 107 (11.9%) of the 898 patients included in the study. The multivariate analysis also showed that BMI (odds ratio [OR] 1.07, 95% confidence interval [CI] 1.03-1.11), number of comorbidities (OR 1.52, 95% CI 1.20-1.93, p = 0.001), and preoperative creatinine concentrations (OR 2.37, 95% CI 1.14-4.92, p = 0.02) were independent predictors for AKI. The use of dexamethasone was associated with a reduced risk for AKI.
  
  
  CONCLUSIONS
  In support of previous reports in the literature, the authors found that AKI was not an uncommon complication after esophageal surgery. Obesity, cardiovascular comorbidities, and high preoperative concentrations were predictors of AKI. Dexamethasone administration during surgery appeared to have a protective effect. This finding opens an opportunity to further study in a randomized controlled trial the efficacy of dexamethasone in the prevention of AKI.
authors.affiliation: Departments of Anesthesiology and Perioperative Medicine, University of Texas MD Anderson Cancer Center, Houston, TX.
authors.forename: Prameela
authors.initials: P
authors.lastname: Konda
authors.affiliation: Department of Pathology, Baylor Scott and White Health, Temple, TX.
authors.forename: Di
authors.initials: D
authors.lastname: Ai
authors.affiliation: Department of Anesthesiology, Henry Ford Hospital, Wayne State University, Detroit, MI.
authors.forename: Carlos E
authors.initials: CE
authors.lastname: Guerra
authors.affiliation: Departments of Anesthesiology and Perioperative Medicine, University of Texas MD Anderson Cancer Center, Houston, TX.
authors.forename: Andrea
authors.initials: A
authors.lastname: Rodriguez-Restrepo
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, University of Texas MD Anderson Cancer Center, Houston, TX.
authors.forename: Reza J
authors.initials: RJ
authors.lastname: Mehran
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, University of Texas MD Anderson Cancer Center, Houston, TX.
authors.forename: David
authors.initials: D
authors.lastname: Rice
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, University of Texas MD Anderson Cancer Center, Houston, TX.
authors.forename: Wayne
authors.initials: W
authors.lastname: Hofstetter
authors.affiliation: Departments of Anesthesiology and Perioperative Medicine, University of Texas MD Anderson Cancer Center, Houston, TX.
authors.forename: Jagtar
authors.initials: J
authors.lastname: Heir
authors.affiliation: Departments of Anesthesiology and Perioperative Medicine, University of Texas MD Anderson Cancer Center, Houston, TX.
authors.forename: Peter
authors.initials: P
authors.lastname: Kwater
authors.affiliation: Departments of Anesthesiology and Perioperative Medicine, University of Texas MD Anderson Cancer Center, Houston, TX.
authors.forename: Vijaya
authors.initials: V
authors.lastname: Gottumukkala
authors.affiliation: Department of Biostatistics, University of Texas MD Anderson Cancer Center, Houston, TX.
authors.forename: Mike
authors.initials: M
authors.lastname: Hernandez
authors.affiliation: Anesthesiology and Surgical Oncology Research Group, Houston, TX. Electronic address: jcata@mdanderson.org.
authors.forename: Juan P
authors.initials: JP
authors.lastname: Cata
mesh_terms: D058186:Acute Kidney Injury / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology; D000368:Aged; D015331:Cohort Studies; D003404:Creatinine / Q000097:blood; D004938:Esophageal Neoplasms / Q000097:blood / Q000453:epidemiology / Q000601:surgery*; D016629:Esophagectomy / Q000009:adverse effects* / Q000639:trends; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology; D011183:Postoperative Complications / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D003404:Creatinine
keywords: acute kidney injury; esophageal neoplasms; esophagectomy; outcomes; risk factors