Acute Kidney Injury after Endoscopic Retrograde Cholangiopancreatography-A Hospital-Based Prospective Observational
Florica Gadalean1,2,3, Florina Parv2,3,4, Oana Milas1,2,3
1Department of Internal Medicine II-Division of Nephrology, "Victor Babeș" University of Medicine and Pharmacy Timisoara, Eftimie Murgu Sq. No. 2, 300041 Timisoara, Romania.
Biomedicines
|December 23, 2022
Summary
Acute kidney injury (AKI) affects 26% of patients after endoscopic retrograde cholangiopancreatography (ERCP), leading to longer hospital stays and increased mortality. Moderate-to-severe AKI is a significant independent risk factor for in-hospital death.
Area of Science:
- Gastroenterology
- Nephrology
- Clinical Endoscopy
Background:
- Endoscopic retrograde cholangiopancreatography (ERCP) is a key gastrointestinal endoscopic procedure.
- Acute kidney injury (AKI) following ERCP is not well understood.
- This study investigates the incidence, risk factors, and outcomes of AKI post-ERCP.
Purpose of the Study:
- To determine the incidence of AKI after ERCP.
- To identify risk factors associated with post-ERCP AKI.
- To evaluate the prognostic impact of AKI on patient outcomes, including hospital stay and mortality.
Main Methods:
- A prospective study of 396 patients undergoing ERCP.
- AKI defined by serum creatinine increase ≥ 0.3 mg/dL or ≥ 50% within 48 hours post-procedure.
- Logistic regression analysis used to identify AKI predictors and in-hospital mortality factors.
Main Results:
- 26% of patients (103/396) developed post-ERCP AKI.
- Predictors of AKI included lower estimated glomerular filtration rate, higher nonrenal Charlson Comorbidity Index, choledocholithiasis, and elevated bilirubin.
- Post-ERCP AKI was linked to longer hospital stays and significantly increased in-hospital mortality (7.76% vs. 0.36%).
Conclusions:
- Post-ERCP AKI is a significant complication associated with prolonged hospitalization.
- Moderate-to-severe AKI (stage 2 and 3) independently predicts higher in-hospital mortality.
- Risk stratification and proactive management are crucial for patients undergoing ERCP.
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