Role of MELD score and serum creatinine as prognostic tools for the development of acute kidney injury after liver transplantation.

<h4>Background</h4>The role of the Model for End-Stage Liver Disease (MELD) score in predicting complications, such as Acute Kidney Injury (AKI), after orthotopic liver transplantation (OLT) has yet to be evaluated and serum creatinine may be too heavily weighted in the existing MELD for...

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Autores principales:	Thiago Gomes Romano, Ivana Schmidtbauer, Fernanda Maria de Queiroz Silva, Carlos Eduardo Pompilio, Luiz Augusto Carneiro D'Albuquerque, Etienne Macedo
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2013
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/2559a5a9eac84a3faf3be63678ee07ac
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spelling	oai:doaj.org-article:2559a5a9eac84a3faf3be63678ee07ac2021-11-18T07:44:24ZRole of MELD score and serum creatinine as prognostic tools for the development of acute kidney injury after liver transplantation.1932-620310.1371/journal.pone.0064089https://doaj.org/article/2559a5a9eac84a3faf3be63678ee07ac2013-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/23717537/pdf/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>The role of the Model for End-Stage Liver Disease (MELD) score in predicting complications, such as Acute Kidney Injury (AKI), after orthotopic liver transplantation (OLT) has yet to be evaluated and serum creatinine may be too heavily weighted in the existing MELD formula, since it has many pitfalls in cirrhotic patients.<h4>Methods</h4>Retrospective data of the perioperative period from consecutive adult OLTs performed from January to December 2009 were recorded. Univariate and multivariate analysis were performed to analyze the risk factors for AKI and mortality after OLT.<h4>Results</h4>There were 114 OLTs performed in the study period, 22 (19,2%) were submitted to dialysis prior OLT and were excluded from the analysis for AKI. The median age was 52 years and 66% were male. Median creatinine value was 0.85mg/dL and MELD was 19. Fifty-two of the 92 patients (56,5%) developed AKI in the first 72 hours after OLT. The only independent risk factor for AKI was calculated MELD and when the components of the MELD score were analyzed, INR had a much stronger impact in predicting AKI then serum creatinine. Overall mortality rate was 32,5% and anesthesia duration was the only variable associated with higher mortality rate.<h4>Conclusions</h4>Although MELD score seems to have a good performance in predicting AKI after OLT, serum creatinine had no impact on its prediction despite its importance on MELD calculation. Modifying the MELD score, which could include novel AKI biomarkers, may improve its prognostic accuracy and provide a better tool for public health planning.Thiago Gomes RomanoIvana SchmidtbauerFernanda Maria de Queiroz SilvaCarlos Eduardo PompilioLuiz Augusto Carneiro D'AlbuquerqueEtienne MacedoPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 8, Iss 5, p e64089 (2013)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Thiago Gomes Romano Ivana Schmidtbauer Fernanda Maria de Queiroz Silva Carlos Eduardo Pompilio Luiz Augusto Carneiro D'Albuquerque Etienne Macedo Role of MELD score and serum creatinine as prognostic tools for the development of acute kidney injury after liver transplantation.
description	<h4>Background</h4>The role of the Model for End-Stage Liver Disease (MELD) score in predicting complications, such as Acute Kidney Injury (AKI), after orthotopic liver transplantation (OLT) has yet to be evaluated and serum creatinine may be too heavily weighted in the existing MELD formula, since it has many pitfalls in cirrhotic patients.<h4>Methods</h4>Retrospective data of the perioperative period from consecutive adult OLTs performed from January to December 2009 were recorded. Univariate and multivariate analysis were performed to analyze the risk factors for AKI and mortality after OLT.<h4>Results</h4>There were 114 OLTs performed in the study period, 22 (19,2%) were submitted to dialysis prior OLT and were excluded from the analysis for AKI. The median age was 52 years and 66% were male. Median creatinine value was 0.85mg/dL and MELD was 19. Fifty-two of the 92 patients (56,5%) developed AKI in the first 72 hours after OLT. The only independent risk factor for AKI was calculated MELD and when the components of the MELD score were analyzed, INR had a much stronger impact in predicting AKI then serum creatinine. Overall mortality rate was 32,5% and anesthesia duration was the only variable associated with higher mortality rate.<h4>Conclusions</h4>Although MELD score seems to have a good performance in predicting AKI after OLT, serum creatinine had no impact on its prediction despite its importance on MELD calculation. Modifying the MELD score, which could include novel AKI biomarkers, may improve its prognostic accuracy and provide a better tool for public health planning.
format	article
author	Thiago Gomes Romano Ivana Schmidtbauer Fernanda Maria de Queiroz Silva Carlos Eduardo Pompilio Luiz Augusto Carneiro D'Albuquerque Etienne Macedo
author_facet	Thiago Gomes Romano Ivana Schmidtbauer Fernanda Maria de Queiroz Silva Carlos Eduardo Pompilio Luiz Augusto Carneiro D'Albuquerque Etienne Macedo
author_sort	Thiago Gomes Romano
title	Role of MELD score and serum creatinine as prognostic tools for the development of acute kidney injury after liver transplantation.
title_short	Role of MELD score and serum creatinine as prognostic tools for the development of acute kidney injury after liver transplantation.
title_full	Role of MELD score and serum creatinine as prognostic tools for the development of acute kidney injury after liver transplantation.
title_fullStr	Role of MELD score and serum creatinine as prognostic tools for the development of acute kidney injury after liver transplantation.
title_full_unstemmed	Role of MELD score and serum creatinine as prognostic tools for the development of acute kidney injury after liver transplantation.
title_sort	role of meld score and serum creatinine as prognostic tools for the development of acute kidney injury after liver transplantation.
publisher	Public Library of Science (PLoS)
publishDate	2013
url	https://doaj.org/article/2559a5a9eac84a3faf3be63678ee07ac
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Role of MELD score and serum creatinine as prognostic tools for the development of acute kidney injury after liver transplantation.

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