Postoperative Acute Kidney Injury in Colorectal Surgery.


Journal

Diseases of the colon and rectum
ISSN: 1530-0358
Titre abrégé: Dis Colon Rectum
Pays: United States
ID NLM: 0372764

Informations de publication

Date de publication:
01 03 2022
Historique:
entrez: 9 2 2022
pubmed: 10 2 2022
medline: 3 3 2022
Statut: ppublish

Résumé

A 73-year-old woman with hypertension controlled by an angiotensin-converting enzyme inhibitor (ACEi) undergoes a laparoscopic converted to open low anterior resection with diverting loop ileostomy (DLI) for locally advanced rectal adenocarcinoma. On postoperative day 5, her serum creatinine (sCr) is 1.4 mg/dL compared to a baseline of 0.9 mg/dL. Nonsteroidal anti-inflammatory drugs (NSAIDs) are stopped, she is resuscitated with balanced crystalloid until her sCr returns to the nadir, and she is discharged. At her postoperative visit, she has mild tachycardia and reports 1 week of 1500 to 2000 mL/day of ileostomy output. She is admitted with an sCr of 2.4 mg/dL and a blood urea nitrogen of 50. She is discharged after infectious complications are excluded, her ileostomy output is controlled, and her sCr is 1.7 mg/dL. Before initiation of adjuvant chemotherapy, her sCr is 1.8 mg/dL, and her estimated glomerular filtration rate (eGFR) is 28 to 32 mL/minute/1.73m2. This severe renal impairment prompts dose reduction of adjuvant chemotherapy.

Identifiants

pubmed: 35138283
doi: 10.1097/DCR.0000000000002390
pii: 00003453-202203000-00004
doi:

Substances chimiques

Angiotensin-Converting Enzyme Inhibitors 0
Creatinine AYI8EX34EU

Types de publication

Case Reports Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

308-312

Commentaires et corrections

Type : CommentIn

Informations de copyright

Copyright © The ASCRS 2022.

Références

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Prowle JR, Forni LG, Bell M, et al. Postoperative acute kidney injury in adult non-cardiac surgery: joint consensus report of the acute disease quality initiative and perioperative quality initiative. Nat Rev Nephrol. 2021;17:605–618.
Slagelse C, Gammelager H, Iversen LH, Sørensen HT, Christiansen CF. Acute kidney injury and 1-year mortality after colorectal cancer surgery: a population-based cohort study. BMJ Open. 2019;9:e024817.
Loria A, Melucci A, Speranza J, et al. Acute kidney injury is a common and significant complication following ileostomy formation. [published online ahead of print, September 18, 2021]. Colorectal Dis. 2021. 10.1111/codi.15917
doi: 10.1111/codi.15917
Smith SA, Ronksley PE, Tan Z, et al. New ileostomy formation and subsequent community-onset acute and chronic kidney disease: a population-based cohort study. Ann Surg. 2021;274:352–358.
United States Renal Data System. 2020 USRDS Annual Data Report: Epidemiology of Kidney Disease in the United States. National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, 2020.
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doi: 10.1093/ecco-jcc/jjab182
Hendren S, Hammond K, Glasgow SC, et al. Clinical practice guidelines for ostomy surgery. Dis Colon Rectum. 2015;58:375–387.
Migdanis A, Koukoulis G, Mamaloudis I, et al. Administration of an oral hydration solution prevents electrolyte and fluid disturbances and reduces readmissions in patients with a diverting ileostomy after colorectal surgery: a prospective, randomized, controlled trial. Dis Colon Rectum. 2018;61:840–846.
Göcze I, Jauch D, Götz M, et al. Biomarker-guided intervention to prevent acute kidney injury after major surgery: the prospective randomized BigpAK study. Ann Surg. 2018;267:1013–1020.

Auteurs

Anthony Loria (A)

Department of Surgery, Division of Colorectal Surgery, University of Rochester Medical Center, Rochester, New York.
Surgical Health Outcomes and Research Enterprise (SHORE), Department of Surgery, University of Rochester Medical Center, Rochester, New York.

Fergal J Fleming (FJ)

Department of Surgery, Division of Colorectal Surgery, University of Rochester Medical Center, Rochester, New York.
Surgical Health Outcomes and Research Enterprise (SHORE), Department of Surgery, University of Rochester Medical Center, Rochester, New York.

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