Nadide Aysun POSTACI, Namık ÖZCAN, Umut Cahit ERSOY

Majör Jinekolojik-Onkoloji Cerrahi Geçiren Geriatrik Hastalarda KDİGO Kriterlerine Göre Akut Böbrek Hasarı Gelişimi: Olgu Serisi

Akut böbrek hasarı, yaşlı hastalarda yaygın bir postoperatif komplikasyon olup preoperatif dönemde yaşa bağlı var olan böbrek rezervindeki azalma ve çoklu komorbiditeler nedeniyle özellikle major abdominal cerrahi sonrası artan yaşlı nüfus ile birlikte daha sık görülmektedir. Postoperatif erken dönemde gelişen akut böbrek hasarı geri dönüşümlü ve genel postoperatif mortalite oranı düşük olsa da artan yoğun bakımda kalış, ilaç maliyetleri ve hastane içi mortalite ile ilişkilidir. Bu olgu serisinde major abdominal jinekolojik-onkolojik cerrahi geçiren 65 yaş ve üstü, 6 hastada erken postoperatif dönemde gelişen geçici akut böbrek hasarı olgularını sunmayı amaçladık.

Anahtar Kelimeler:

Major abdominal cerrahi, akut böbrek hasarı, KDİGO kriterleri, geriatrik anestezi

Development of Acute Kidney Injury According to KDIGO Criteria In Geriatric Patients Undergoing Major Gyneco-oncologic Surgery: A Case Series

Acute kidney injury is a common postoperative complication in elderly patients. Due to decreasing age-related renal reserve and various co-morbidities in the perioperative period, it is seen more commonly in the elderly population, especially following major abdominal surgery. Although acute kidney injury that develops early after surgery is reversible and has a low overall postoperative mortality rate, it is associated with longer stays in the critical care unit, higher drug expenses, and higher in-hospital mortality. In this case series, we aimed to present six patients over 65 years old who developed acute kidney injury in the early postoperative period after major abdominal gynecological-oncological surgery.

Keywords:

Major abdominal surgery, acut kidney injury, KDIGO criteria, geriatric anaesthesia,

PDF

___

11. M Çivilibal, B Yavaş Aksu. Güncel Kılavuzlar Eşliğinde Akut Böbrek Hasarı. Haseki Tıp Bülteni 2015; 53: 116-9.
2. C T Chao, HB Tsai, YF Lin, WJ Ko. Acute kidney injury in the elderly: Only the tip of the iceberg. J of Clinical Gerontology & Geriatrics 2014; 5: 7e12.
3. T Mizota, L Dong, C Takeda, A Shiraki, S Matsukawa, S Shimizu et al. Transient acute kidney injury after major abdominal surgery increases chronic kidney disease risk and 1-year mortality. J of Critical Care 2019;50: 17–22.
4. J Prowle, LG Forni, M Bell, M S Chew, M Edwards, M E Grams et al. Postoperative acute kidney injury in adult non-cardiac surgery: joint consensus report of the Acute Disease Quality Initiative and Peri Operative Quality Initiative. Nature reviews nephrology, Consensus Statement 2021;17: 605-18.
5. A Khwaja. KDIGO Clinical Practice Guidelines for Acute Kidney Injury. Nephron Clin Pract 2012;120:c179–c184.
6. S Turhanoğlu. Yaşlanmanın Diğer Organ Sistemlerine Etkileri. Geriatrik Anestezi. Bölüm 7. S: 49. Birinci Baskı. Ankara: Güneş Tıp Kitabevleri, 2021
7. R Bellomo, JA Kellum, C Ronco. Acute kidney injury. Lancet 2012; 380: 756–66.
8. J Martensson and R Bellomo. Perioperative renal failure in elderly patients. Cur Opin Anesthesiol 2015;28:123-130.
9. LG Yokota, B M Sampaio, E P Rocha, AL Balbi, IRS Prado, D Ponce. Acute kidney injury network staging in geriatric postoperative acute kidney injury patients: shortcomings and improvements. J Am Coll Surg 2013; 217:240–250. 10. Y Kobayashi and K Yamaoka. Analysis of intraoperative modifiable factors to prevent acute kidney injury after elective noncardiac surgery:intraoperative hypotension and crystaloid administration related to acute kidney injury. JA Clinical Report 2021; 7:27:1-12.
11. O Goren and I Matot. Perioperative acut kidney injury. Br J Anaesthesia 2015; 115 (S2): ii3–ii14.
12. LY Sun, DN Wijeysundera, GA Tait, WS Beattie. Association of intraoperative hypotension with acute kidney injury after elective noncardiac surgery. Anesthesiology 2015; 123: 515–23.
13. X Wu, W Zhang, H Ren, X Chen, J Xie, and Nan Chen. Diuretics associated acute kidney injury: clinical and pathological analysis Ren Fail, 2014; 36(7): 1051–1055.