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Skin autofluorescence as a novel predictor of acute kidney injury after liver resection
World Journal of Surgical Oncology ( IF 3.2 ) Pub Date : 2021-09-15 , DOI: 10.1186/s12957-021-02394-0
Maciej Krasnodębski 1 , Karolina Grąt 2 , Marcin Morawski 1 , Jan Borkowski 1 , Piotr Krawczyk 1 , Andriy Zhylko 1 , Michał Skalski 1 , Piotr Kalinowski 1 , Krzysztof Zieniewicz 1 , Michał Grąt 1
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Skin autofluorescence (SAF) reflects accumulation of advanced glycation end-products (AGEs). The aim of this study was to evaluate predictive usefulness of SAF measurement in prediction of acute kidney injury (AKI) after liver resection. This prospective observational study included 130 patients undergoing liver resection. The primary outcome measure was AKI. SAF was measured preoperatively and expressed in arbitrary units (AU). AKI was observed in 32 of 130 patients (24.6%). SAF independently predicted AKI (p = 0.047), along with extent of resection (p = 0.019) and operative time (p = 0.046). Optimal cut-off for SAF in prediction of AKI was 2.7 AU (area under the curve [AUC] 0.611), with AKI rates of 38.7% and 20.2% in patients with high and low SAF, respectively (p = 0.037). Score based on 3 independent predictors (SAF, extent of resection, and operative time) well stratified the risk of AKI (AUC 0.756), with positive and negative predictive values of 59.3% and 84.0%, respectively. In particular, SAF predicted AKI in patients undergoing major and prolonged resections (p = 0.010, AUC 0.733) with positive and negative predictive values of 81.8%, and 62.5%, respectively. AGEs accumulation negatively affects renal function in patients undergoing liver resection. SAF measurement may be used to predict AKI after liver resection, particularly in high-risk patients.

中文翻译:

皮肤自体荧光作为肝切除术后急性肾损伤的新预测指标

皮肤自发荧光 (SAF) 反映晚期糖基化终产物 (AGEs) 的积累。本研究的目的是评估 SAF 测量在预测肝切除术后急性肾损伤 (AKI) 中的预测效用。这项前瞻性观察研究包括 130 名接受肝切除术的患者。主要结局指标是 AKI。SAF 在术前测量并以任意单位 (AU) 表示。在 130 名患者中的 32 名 (24.6%) 中观察到 AKI。SAF 独立预测 AKI (p = 0.047),以及切除范围 (p = 0.019) 和手术时间 (p = 0.046)。SAF 预测 AKI 的最佳截止值为 2.7 AU(曲线下面积 [AUC] 0.611),高和低 SAF 患者的 AKI 发生率分别为 38.7% 和 20.2%(p = 0.037)。基于 3 个独立预测因子(SAF、切除范围、和手术时间)很好地分层了 AKI 的风险(AUC 0.756),阳性和阴性预测值分别为 59.3% 和 84.0%。特别是,SAF 在接受大手术和长期切除的患者中预测 AKI(p = 0.010,AUC 0.733),阳性和阴性预测值分别为 81.8% 和 62.5%。AGEs 积累对接受肝切除术的患者的肾功能产生负面影响。SAF 测量可用于预测肝切除术后的 AKI,特别是在高危患者中。AGEs 积累对接受肝切除术的患者的肾功能产生负面影响。SAF 测量可用于预测肝切除术后的 AKI,特别是在高危患者中。AGEs 积累对接受肝切除术的患者的肾功能产生负面影响。SAF 测量可用于预测肝切除术后的 AKI,特别是在高危患者中。
更新日期:2021-09-15
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