Published online Jul 28, 2016. doi: 10.4254/wjh.v8.i21.891
Peer-review started: February 27, 2016
First decision: May 13, 2016
Revised: June 2, 2016
Accepted: June 27, 2016
Article in press: June 29, 2016
Published online: July 28, 2016
Currently, partial hepatectomy is the treatment of choice for a wide variety of liver and biliary conditions. Among the possible complications of partial hepatectomy, acute kidney injury (AKI) should be considered as an important cause of increased morbidity and postoperative mortality. Difficulties in the data analysis related to postoperative AKI after liver resections are mainly due to the multiplicity of factors to be considered in the surgical patients, moreover, there is no consensus of the exact definition of AKI after liver resection in the literature, which hampers comparison and analysis of the scarce data published on the subject. Despite this multiplicity of risk factors for postoperative AKI after partial hepatectomy, there are main factors that clearly contribute to its occurrence. First factor relates to large blood losses with renal hypoperfusion during the operation, second factor relates to the occurrence of post-hepatectomy liver failure with consequent distributive circulatory changes and hepatorenal syndrome. Eventually, patients can have more than one factor contributing to post-operative AKI, and frequently these combinations of acute insults can be aggravated by sepsis or exposure to nephrotoxic drugs.
Core tip: In the specific scenario of liver resections, there are limited and heterogeneous data regarding the occurrence of acute kidney injury (AKI) in the postoperative period, and its clinical relevance (mortality, morbidity and hospital stay) were not conclusively explored and clarified. Difficulties in the data analysis related to postoperative AKI after liver resections are mainly due the scarce data published on the subject.