Incidence of Early Acute Kidney Injury in Lung Transplant Patients: A Single-Center Experience.
BACKGROUND
Acute kidney injury (AKI) is a common complication in the early period of lung transplantation (LTx). We aimed to describe the incidence and perioperative risk factors associated with AKI following LTx.


METHODS
Clinical data of 30 patients who underwent LTx were retrospectively reviewed. Primary outcomes were development of AKI and patient mortality within 30 postoperative days. Postoperative AKI is determined based on creatinine criteria from Acute Kidney Injury Network (AKIN) classification. Secondary outcomes included the association between AKI and demographic and clinical parameters of patients and treatment modalities in the pre- and postoperative periods.


RESULTS
Of the 30 LTx recipients included, AKI occurred in 16 patients (53.4%) within the first 30 days. Length of intensive care unit (P = .06) and hospital stay (P = .008) and mechanical ventilation duration (P = .03) were significantly higher in patients with AKI compared with patients without AKI. Factors independently associated with AKI were intraoperative hypotension (odds ratio [OR] 0.500; 95% confidence interval [CI], 1.145 to 26.412, P = .02), longer duration of mechanical ventilation (OR 1.204; 95% CI 0.870 to 1.665, P = .03), and systemic infection (OR 8.067; 95% CI 1.538 to 42.318, P = .014) in the postoperative period. Short-term mortality was similar in patients with and patients without AKI.


CONCLUSIONS
By the AKIN definition, AKI occurred in half of the patients following LTx. Several variables including intraoperative hypotension, longer duration of mechanical ventilation, and systemic infection in the postoperative period independently predict AKI in LTx recipients.
Kartal Kosuyolu Yuksek Ihtisas Training Hospital, Lung Transplantation Clinic, Istanbul, Turkey. Electronic address: drmkalamanoglu@gmail.com.
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MK
Balci
Kartal Kosuyolu Yuksek Ihtisas Training Hospital, Lung Transplantation Clinic, Istanbul, Turkey.
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M
Vayvada
Sureyyapasa Chest Diseases and Thoracic Surgery Training Hospital, Intensive Care Unit, Istanbul, Turkey.
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C
Salturk
Kartal Kosuyolu Yuksek Ihtisas Training Hospital, Lung Transplantation Clinic, Istanbul, Turkey.
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CA
Kutlu
Kartal Training Hospital, Department of Nephrology, Istanbul, Turkey.
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Ari
D058186:Acute Kidney Injury / Q000209:etiology*; D000328:Adult; D003404:Creatinine / Q000378:metabolism; D003422:Critical Care / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007902:Length of Stay / Q000706:statistics & numerical data; D016040:Lung Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012121:Respiration, Artificial / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors
D007166:Immunosuppressive Agents; D003404:Creatinine