Association between intravenous 5 % albumin administration and acute kidney injury after partial nephrectomy. A retrospective study

Document Type

Article

Publication Date

6-1-2025

Publication Title

Journal of clinical anesthesia

Keywords

Humans, Acute Kidney Injury, Retrospective Studies, Male, Female, Middle Aged, Nephrectomy, Postoperative Complications, Aged, Risk Factors, Propensity Score, Intraoperative Care, Length of Stay, Incidence, Albumins, Adult, Crystalloid Solutions

Abstract

BACKGROUND: Acute kidney injury (AKI) after partial nephrectomy is a frequent postoperative complication that can affect nearly half of patients, according to various studies. In the current study, we investigated the association of intraoperative administration of 5 % albumin, compared with crystalloids alone, with AKI after partial nephrectomy.

METHODS: This single-center retrospective study included adult patients undergoing partial nephrectomy. The primary endpoint was AKI within 72 h after surgery using the KIDGO definition. Secondary endpoints were time-to-AKI, reoperations, AKI severity and length of hospital stay. We used propensity score-based nearest-neighbor methods balance the patient baseline characteristics.

RESULTS: A total of 1688 patients were included in the analysis, with 809 receiving 5 % albumin and 879 in the control group. After matching, 729 patients received 5 % albumin, while 674 were controls. The incidence of acute kidney injury (AKI) was significantly higher in the 5 % albumin group (32.78 %) compared to the control group (25.51 %). Multivariate analysis revealed that receiving 5 % albumin was associated with a 32 % increased risk of developing AKI. Furthermore, the analysis indicated that this association was dose-dependent.

CONCLUSION: Our study suggests that intraoperative administration of 5 % albumin may not be a risk factor for AKI after partial nephrectomy. Given the discrepancy between these results and previous studies, a future prospective randomized controlled trial is needed to confirm our findings.

Medical Subject Headings

Humans; Acute Kidney Injury; Retrospective Studies; Male; Female; Middle Aged; Nephrectomy; Postoperative Complications; Aged; Risk Factors; Propensity Score; Intraoperative Care; Length of Stay; Incidence; Albumins; Adult; Crystalloid Solutions

PubMed ID

40373496

Volume

104

First Page

111873

Last Page

111873

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