Acute Kidney Injury after Endoscopic Retrograde Cholangiopancreatography-A Hospital-Based Prospective Observational Study

• Published in: Biomedicines Vol. 10; no. 12; p. 3166
• Main Authors: Gadalean, Florica, Parv, Florina, Milas, Oana, Petrica, Ligia, Ratiu, Iulia, Miutescu, Bogdan, Goldis, Adrian, Gluhovschi, Cristina, Bob, Flaviu, Simulescu, Anca, Patruica, Mihaela, Apostol, Adrian, Ivan, Viviana, Schiller, Adalbert, Radu, Daniela
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 07-12-2022; MDPI
• Subjects: acute kidney injury; Acute renal failure; Bilirubin; Comorbidity; Creatinine; endoscopic retrograde cholangiopancreatography; Endoscopy; Gastroenterology; Glomerular filtration rate; Heart failure; Hospitalization; Hydration; in-hospital mortality; Kidney diseases; Kidneys; Mortality; Normal distribution; Observational studies; Patients; Physiological aspects; Regression analysis; Renal replacement therapy; Risk factors; Teaching hospitals; Romania; United States > US; endoscopic retrograde cholangiopancreatography; in-hospital mortality; risk factors; acute kidney injury
• ISSN: 2227-9059; 2227-9059
• DOI: 10.3390/biomedicines10123166

Background: Endoscopic retrograde cholangiopancreatography (ERCP) represents a major pivotal point in gastrointestinal endoscopy. Little is known about acute kidney injury (AKI) post-ERCP. This study analyses the incidence, risk factors, and prognosis of post-ERCP AKI. Methods: A total of 396 patients were prospectively studied. AKI was defined by an increase in serum creatinine (SCr) ≥ 0.3 mg/dL or by an increase in SCr ≥ 50% in the first 48 h post-ERCP. Logistic regression analysis was used to identify the predictors of AKI and in-hospital mortality. A two-tailed p value < 0.05 was considered significant. Results: One hundred and three patients (26%) developed post-ERCP AKI. Estimated glomerular filtration rate (adjusted odds ratio (aOR) = 0.95, 95% confidence interval (CI): 0.94−0.96, p < 0.001), nonrenal Charlson Comorbidity Index (Aor = 1.19, 95% CI: 1.05−1.35, p = 0.006), choledocholithiasis (aOR = 4.05, 95% CI: 1.98−8.29, p < 0.001), and bilirubin (aOR = 1.1, 95% CI: 1.05−1.15, p < 0.001) were associated with post-ERCP AKI. Post-ERCP AKI was associated with longer hospital stay (p < 0.001) and with increased in-hospital mortality (7.76% versus 0.36%, p < 0.001). Moderate-to-severe (stage 2 and 3) AKI was independently associated with in-hospital mortality (aOR = 6.43, 95% CI: 1.48−27.88, p < 0.013). Conclusions: Post-ERCP AKI represented an important complication associated with longer hospital stay. Moderate-to-severe post-ERCP AKI was an independent risk factor for in-hospital mortality.