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Erschienen in: World Journal of Surgery 6/2021

15.03.2021 | Original Scientific Report

Male Patients may be More Vulnerable to Acute Kidney Injury After Colorectal Surgery in an Enhanced Recovery Program: A Propensity Score Matching Analysis

verfasst von: Jung-Woo Shim, Hojun Ro, Chul Seung Lee, Jaesik Park, Hyung Mook Lee, Yong-Suk Kim, Young Eun Moon, Sang Hyun Hong, Min Suk Chae

Erschienen in: World Journal of Surgery | Ausgabe 6/2021

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Abstract

Background

Although many reports have shown that enhanced recovery after surgery (ERAS) programs improve the perioperative outcomes of patients undergoing colorectal surgery, the prevalence of early acute kidney injury (AKI) after surgery in such patients requires attention. Protective roles of the female sex in terms of chronic kidney disease and progression of ischemic renal injury have been described in many studies. We thus explored whether a sex difference was evident in terms of postoperative AKI in a colorectal ERAS setting.

Methods

From January 2017 to August 2019, 453 patients underwent laparoscopic colorectal cancer resection in an enhanced recovery program. Of these, 217 female patients were propensity score (PS)-matched with 236 male patients. Then, 215 patients of either sex were compared in terms of postoperative renal function and complications.

Results

Among the PS-matched patients, the incidence of AKI was significantly higher in male than female patients (24.2% vs. 9.8%, P < 0.001). Male patients also exhibited a greater reduction in the postoperative estimated glomerular filtration rate, compared with female patients. The male sex was associated with an approximately threefold increase in the risk of AKI. The rate of surgical complications was significantly higher in male than female patients.

Conclusions

Caution must be taken to prevent postoperative AKI in patients (particularly males) participating in colorectal ERAS programs. The mechanism underlying the sex difference remains unclear. Additional studies are required to determine whether male patients require perioperative management that differs from that of females, to prevent postoperative AKI.
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Metadaten
Titel
Male Patients may be More Vulnerable to Acute Kidney Injury After Colorectal Surgery in an Enhanced Recovery Program: A Propensity Score Matching Analysis
verfasst von
Jung-Woo Shim
Hojun Ro
Chul Seung Lee
Jaesik Park
Hyung Mook Lee
Yong-Suk Kim
Young Eun Moon
Sang Hyun Hong
Min Suk Chae
Publikationsdatum
15.03.2021
Verlag
Springer International Publishing
Erschienen in
World Journal of Surgery / Ausgabe 6/2021
Print ISSN: 0364-2313
Elektronische ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-021-06041-3

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