Analysis of risk factor for acute kidney injury after lung transplantation and its prognosis

Objective To determine the incidence, risk factor and outcome of acute kidney injury(AKI)after lung transplantation(LT). Methods Clinical data of adult patients undergone LT were retrospectively analyzed. Acute Kidney Injury Net(AKIN) criteria were applied to define and classify the postoperative AKI.Logistic regression analysis was used to determine the risk factor for AKI. Results Of the 88 patients in the period of investigation, 47 patients(53.4%) presented AKI. The percentage of stage I, stage II, and stage III AKI was 30.7%, 12.5%, and 10.2%, respectively. Three patients with AKI(6.4%) needed renal replacement therapy. Multivariate logistic regression analysis showed that intraoperative blood loss(OR=1.238) and change of mean artery pressure(OR=3.221) were the independent risk factors for stage I AKI. Preoperative proteinuria(OR=3.185), RBC transfusion during operation(OR=1.653), and hypertension(OR=2.285) were the independent risk factors for stage II and stage III AKI. The support of ECOM(OR=0.113) was a protect factor for AKI. Conclusions The incidence of AKI after LT is quite high and the prognosis is poor. We should pay more attention to the potential risk factors for AKI to improve the prognosis of LT patients.