Review
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Jul 28, 2016; 8(21): 891-901
Published online Jul 28, 2016. doi: 10.4254/wjh.v8.i21.891
Acute renal injury after partial hepatectomy
Luis Alberto Batista Peres, Luis Cesar Bredt, Raphael Flavio Fachini Cipriani
Luis Alberto Batista Peres, Department of Nephrology, University Hospital of Western Paraná, State University of Western Paraná, Cascavel, Paraná 85819-110, Brazil
Luis Cesar Bredt, Department of Surgical Oncology and Hepatobiliary Surgery, University Hospital of Western Paraná, State University of Western Paraná, Cascavel, Paraná 85819-110, Brazil
Raphael Flavio Fachini Cipriani, Department of General Surgery, University Hospital of Western Paraná, State University of Western Paraná, Cascavel, Paraná 85819-110, Brazil
Author contributions: Peres LAB, Bredt LC and Cipriani RFF contributed equally to this review article; all authors equally contributed to this paper with conception and design of the study, literature review and analysis, drafting and critical revision and editing, and final approval of the final version.
Conflict-of-interest statement: No potential conflicts of interest. No financial support.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Luis Cesar Bredt, Professor, Department of Surgical Oncology and Hepatobiliary Surgery, University Hospital of Western Paraná, State University of Western Paraná, Dom Pedro II Street, 2099, apto 701, Cascavel, Paraná 85819-110, Brazil. lcbredt@gmail.com
Telephone: +55-45-99369943 Fax: +55-45-33215151
Received: February 25, 2016
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
Processing time: 101 Days and 17.6 Hours
Abstract

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.

Keywords: Hepatectomy; Liver resection; Acute renal injury; Hepatorenal syndrome; Kidney

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.