Kim, Tae Lim; Kim, Namo; Shin, Hye Jung; Cho, Matthew R; Park, Hae Ri; Kim, So Yeon
Scientific reports
2023Feb ; 13 ( 1 ) :3318.
PMID : 36849611
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Kim, Tae Lim - Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea.
Kim, Namo - Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research
Shin, Hye Jung - Biostatistics Collaboration Unit, Yonsei University College of Medicine, Seoul,
Cho, Matthew R - Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research
Park, Hae Ri - Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research
Kim, So Yeon - Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research
ABSTRACT
Intraoperative hemodynamics can affect postoperative kidney function. We aimed to investigate the effect of intraoperative mean arterial pressure (MAP) as well as other risk factors on the occurrence of acute kidney injury (AKI) after robot-assisted laparoscopic prostatectomy (RALP). We retrospectively evaluated the medical records of 750 patients who underwent RALP. The average real variability (ARV)-MAP, standard deviation (SD)-MAP, time-weighted average (TWA)-MAP, area under threshold (AUT)-65?mmHg, and area above threshold (AAT)-120?mmHg were calculated using MAPs collected within a 10-s interval. Eighteen (2.4%) patients developed postoperative AKI. There were some univariable associations between TWA-MAP, AUT-65?mmHg, and AKI occurrence; however, multivariable analysis found no association. Alternatively, American Society of Anesthesiologists physical status?¡Ã?III and the low intraoperative urine output were independently associated with AKI occurrence. Moreover, none of the five MAP parameters could predict postoperative AKI, with the area under the receiver operating characteristic curve values for ARV-MAP, SD-MAP, TWA-MAP, AUT-65?mmHg, and AAT-120?mmHg being 0.561 (95% confidence interval [CI], 0.424-0.697), 0.561 (95% CI, 0.417-0.704), 0.584 (95% CI, 0.458-0.709), 0.590 (95% CI, 0.462-0.718), and 0.626 (95% CI, 0.499-0.753), respectively. Therefore, intraoperative MAP changes may not be a determining factor for AKI after RALP. CI - ¨Ï 2023. The Author(s).
Risk factors, Acute kidney injury, Prostate cancer, Medical research
MESH
Male, Humans, Retrospective Studies, Arterial Pressure, *Robotics, *Acute Kidney Injury/etiology, *Laparoscopy/adverse effects, Prostatectomy/adverse effects
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