Abstract：
BACKGROUND: Postoperative acute kidney injury (AKI) after lung transplantation (LTx) is an important factor affecting the short-term outcomes. The focus item of transplantation centers is how to improve the incidence of AKI through optimal management during the perioperative period.
OBJECTIVE: The purpose of the study is to investigate the influence of perioperative volume in the development of early AKI following LTx.
METHODS: The study involved patients who had undergone LTx between October 2018 to December 2021 at China-Japan Friendship Hospital in Beijing. The patients were monitored for AKI occurring within 72 hours after LTx, as well as the renal outcomes within 30 days. The perioperative volumes were compared and analyzed to determine the impact on various clinical outcomes.
RESULTS: 248 patients were enrolled in the study ultimately, with almost half of them (49.6 %) experiencing AKI. 48.8 % of AKI patients received continuous renal replacement therapy (CRRT), with 57.7 % recovered by the end of the 30-day follow-up period. A J-shaped relationship was demonstrated between perioperative volume and AKI incidence. Moreover, maintaining a positive fluid balance would increase the 30-day mortality and lead to poor renal outcomes.
CONCLUSIONS: Perioperative volume is an independent risk factor of early AKI after LTx. Positive fluid balance increases the risk of AKI, 30-day mortality, and adverse renal prognosis. The LTx recipients may benefit from a relatively restrict fluid strategy during and after the lung transplantation.
OBJECTIVE: The purpose of the study is to investigate the influence of perioperative volume in the development of early AKI following LTx.
METHODS: The study involved patients who had undergone LTx between October 2018 to December 2021 at China-Japan Friendship Hospital in Beijing. The patients were monitored for AKI occurring within 72 hours after LTx, as well as the renal outcomes within 30 days. The perioperative volumes were compared and analyzed to determine the impact on various clinical outcomes.
RESULTS: 248 patients were enrolled in the study ultimately, with almost half of them (49.6 %) experiencing AKI. 48.8 % of AKI patients received continuous renal replacement therapy (CRRT), with 57.7 % recovered by the end of the 30-day follow-up period. A J-shaped relationship was demonstrated between perioperative volume and AKI incidence. Moreover, maintaining a positive fluid balance would increase the 30-day mortality and lead to poor renal outcomes.
CONCLUSIONS: Perioperative volume is an independent risk factor of early AKI after LTx. Positive fluid balance increases the risk of AKI, 30-day mortality, and adverse renal prognosis. The LTx recipients may benefit from a relatively restrict fluid strategy during and after the lung transplantation.
摘要：
背景：肺移植（LTx）术后急性肾损伤（AKI）是影响短期预后的重要因素。移植中心关注的重点是如何通过围手术期的优化管理来提高AKI的发生率。
目的：本研究的目的是探讨围手术期容量对LTx术后早期AKI发生的影响。
方法：该研究涉及2018年10月至2021年12月在北京中日友好医院接受LTx的患者。监测患者在LTx后72小时内发生的AKI，以及30天内的肾脏结局。比较和分析围手术期容量，以确定对各种临床结局的影响。
结果：248名患者最终被纳入研究，其中近一半（49.6％）患有AKI。48.8%的AKI患者接受了连续性肾脏替代治疗(CRRT),到30天随访期结束时，57.7%的患者痊愈。围手术期容量与AKI发生率呈J型关系。此外，维持体液正平衡会增加30日死亡率,并导致肾脏结局不佳.
结论：围手术期体积是LTx术后早期AKI的独立危险因素。积极的体液平衡会增加AKI的风险，30天死亡率，和不良的肾脏预后。LTx接受者可以受益于肺移植期间和之后的相对限制的流体策略。
目的：本研究的目的是探讨围手术期容量对LTx术后早期AKI发生的影响。
方法：该研究涉及2018年10月至2021年12月在北京中日友好医院接受LTx的患者。监测患者在LTx后72小时内发生的AKI，以及30天内的肾脏结局。比较和分析围手术期容量，以确定对各种临床结局的影响。
结果：248名患者最终被纳入研究，其中近一半（49.6％）患有AKI。48.8%的AKI患者接受了连续性肾脏替代治疗(CRRT),到30天随访期结束时，57.7%的患者痊愈。围手术期容量与AKI发生率呈J型关系。此外，维持体液正平衡会增加30日死亡率,并导致肾脏结局不佳.
结论：围手术期体积是LTx术后早期AKI的独立危险因素。积极的体液平衡会增加AKI的风险，30天死亡率，和不良的肾脏预后。LTx接受者可以受益于肺移植期间和之后的相对限制的流体策略。
