Impact of intraoperative zero-balance fluid therapy on the occurrence of acute kidney injury in patients who had undergone colorectal cancer resection within an enhanced recovery after surgery protocol: a propensity score matching analysis
Purpose An enhanced recovery after surgery (ERAS) protocol for colorectal cancer resection encourages perioperative euvolemic status, and zero-balance fluid therapy is recommended for low-risk patients. Recently, several studies have reported concerns of increased acute kidney injury (AKI) in patien...
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| Veröffentlicht in: | International journal of colorectal disease 2020-08, Vol.35 (8), p.1537-1548 |
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| container_title | International journal of colorectal disease |
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| creator | Shim, Jung-Woo Kwak, Jueun Roh, Kyungmoon Ro, Hojun Lee, Chul Seung Han, Seung Rim Lee, Yoon Suk Lee, In Kyu Park, Jaesik Lee, Hyung Mook Chae, Min Suk Lee, Hae-Jin Hong, Sang Hyun |
| description | Purpose
An enhanced recovery after surgery (ERAS) protocol for colorectal cancer resection encourages perioperative euvolemic status, and zero-balance fluid therapy is recommended for low-risk patients. Recently, several studies have reported concerns of increased acute kidney injury (AKI) in patients within an ERAS protocol. In the present study, we investigated the impact of intraoperative zero-balance fluid therapy within an ERAS protocol on postoperative AKI.
Methods
Patients who underwent elective surgery for primary colorectal cancer were divided into zero-balance and non-zero-balance fluid therapy groups according to intraoperative fluid amount and balance. After propensity score (PS) matching, 210 patients from each group were selected. Incidences of AKI were compared between the two groups according to the Kidney Disease Improving Global Outcomes criteria. Postoperative kidney functions and surgical outcomes were also compared.
Results
AKI was significantly higher in the zero-balance fluid therapy group compared to the non-zero-balance fluid therapy group (21.4% vs. 13.8%,
p
= 0.040) in PS-matched patients. The decrease in the estimated glomerular filtration rate on the day of surgery was significantly higher in the zero-balance fluid therapy group (− 5.9 mL/min/1.73 m
2
vs. − 1.4 mL/min/1.73 m
2
,
p
= 0.005). There were no differences in general morbidity or mortality rate, although surgery-related complications were more common in the zero-balance group.
Conclusions
Despite the proven benefits of zero-balance fluid therapy in colorectal ERAS protocols, care should be taken to monitor for postoperative AKI. Further studies regarding the clinical significance of postoperative AKI occurrence and optimised intraoperative fluid therapy are needed in a colorectal ERAS setting. |
| doi_str_mv | 10.1007/s00384-020-03616-9 |
| format | Article |
| fullrecord | <record><control><sourceid>gale_proqu</sourceid><recordid>TN_cdi_proquest_miscellaneous_2400536239</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A714487891</galeid><sourcerecordid>A714487891</sourcerecordid><originalsourceid>FETCH-LOGICAL-c442t-70bdc3f412db5aeef4850797528ccd636b15309df11e023c9c1bc67ba90851b43</originalsourceid><addsrcrecordid>eNp9kk1v1DAQhiMEotvCH-CALHHhkuKvfHGrKiiVKnGBs-U4k10viR1sp9Xyp_kLjNlCBUIoB3s87_t44pmieMHoOaO0eRMpFa0sKaclFTWry-5RsWFS8JLxmj8uNpQ1Xcm6qj0pTmPcU4zrRj4tTgQXbVV11ab4fj0v2iTiR2JdCtovEHSyt0C-QfBlryftDJBxWu1A0g6Ty4F4l7fEG7OGADmPdm3WBOSLHRwckLVfQ17IgjRwKZK7nSc7PZDVDRC23gExfvIBTNITMfmWQAJEjC3y72zaoVs7Am6XkwMmjb8FpOoxoTauYZujJfjkEfWW6LxfwEWbDiQaZJNZJ4OcLYL0dIg2PiuejHqK8Px-PSs-v3_36fJDefPx6vry4qY0UvJUNrQfjBgl40NfaYBRthVtuqbirTFDLeqeVYJ2w8gYUC5MZ1hv6qbXHW0r1ktxVrw-crGkryvEpGYbDUz4nODXqLiktBI1Fx1KX_0l3fs1YL1ZxRmrcrMfVFs9gbJu9Ngtk6HqomFStk3bMVSd_0OF3wCzNfjoo8XzPwz8aDDBxxhgVEuwsw4HxajKF6vjlCmcMvVzylSu-OV9xWs_w_Db8musUCCOgogph216-KX_YH8Ae4DicA</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2421151007</pqid></control><display><type>article</type><title>Impact of intraoperative zero-balance fluid therapy on the occurrence of acute kidney injury in patients who had undergone colorectal cancer resection within an enhanced recovery after surgery protocol: a propensity score matching analysis</title><source>SpringerLink Journals - AutoHoldings</source><creator>Shim, Jung-Woo ; Kwak, Jueun ; Roh, Kyungmoon ; Ro, Hojun ; Lee, Chul Seung ; Han, Seung Rim ; Lee, Yoon Suk ; Lee, In Kyu ; Park, Jaesik ; Lee, Hyung Mook ; Chae, Min Suk ; Lee, Hae-Jin ; Hong, Sang Hyun</creator><creatorcontrib>Shim, Jung-Woo ; Kwak, Jueun ; Roh, Kyungmoon ; Ro, Hojun ; Lee, Chul Seung ; Han, Seung Rim ; Lee, Yoon Suk ; Lee, In Kyu ; Park, Jaesik ; Lee, Hyung Mook ; Chae, Min Suk ; Lee, Hae-Jin ; Hong, Sang Hyun</creatorcontrib><description>Purpose
An enhanced recovery after surgery (ERAS) protocol for colorectal cancer resection encourages perioperative euvolemic status, and zero-balance fluid therapy is recommended for low-risk patients. Recently, several studies have reported concerns of increased acute kidney injury (AKI) in patients within an ERAS protocol. In the present study, we investigated the impact of intraoperative zero-balance fluid therapy within an ERAS protocol on postoperative AKI.
Methods
Patients who underwent elective surgery for primary colorectal cancer were divided into zero-balance and non-zero-balance fluid therapy groups according to intraoperative fluid amount and balance. After propensity score (PS) matching, 210 patients from each group were selected. Incidences of AKI were compared between the two groups according to the Kidney Disease Improving Global Outcomes criteria. Postoperative kidney functions and surgical outcomes were also compared.
Results
AKI was significantly higher in the zero-balance fluid therapy group compared to the non-zero-balance fluid therapy group (21.4% vs. 13.8%,
p
= 0.040) in PS-matched patients. The decrease in the estimated glomerular filtration rate on the day of surgery was significantly higher in the zero-balance fluid therapy group (− 5.9 mL/min/1.73 m
2
vs. − 1.4 mL/min/1.73 m
2
,
p
= 0.005). There were no differences in general morbidity or mortality rate, although surgery-related complications were more common in the zero-balance group.
Conclusions
Despite the proven benefits of zero-balance fluid therapy in colorectal ERAS protocols, care should be taken to monitor for postoperative AKI. Further studies regarding the clinical significance of postoperative AKI occurrence and optimised intraoperative fluid therapy are needed in a colorectal ERAS setting.</description><identifier>ISSN: 0179-1958</identifier><identifier>EISSN: 1432-1262</identifier><identifier>DOI: 10.1007/s00384-020-03616-9</identifier><identifier>PMID: 32385595</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Analysis ; Cancer ; Cancer patients ; Care and treatment ; Colorectal cancer ; Colorectal carcinoma ; Gastroenterology ; Glomerular filtration rate ; Health aspects ; Hepatology ; Internal Medicine ; Kidney diseases ; Kidneys ; Medical research ; Medicine ; Medicine & Public Health ; Medicine, Experimental ; Morbidity ; Original Article ; Patients ; Proctology ; Recovery (Medical) ; Risk groups ; Surgery ; Surgical outcomes</subject><ispartof>International journal of colorectal disease, 2020-08, Vol.35 (8), p.1537-1548</ispartof><rights>Springer-Verlag GmbH Germany, part of Springer Nature 2020</rights><rights>COPYRIGHT 2020 Springer</rights><rights>Springer-Verlag GmbH Germany, part of Springer Nature 2020.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c442t-70bdc3f412db5aeef4850797528ccd636b15309df11e023c9c1bc67ba90851b43</citedby><cites>FETCH-LOGICAL-c442t-70bdc3f412db5aeef4850797528ccd636b15309df11e023c9c1bc67ba90851b43</cites><orcidid>0000-0002-7091-8963</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00384-020-03616-9$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00384-020-03616-9$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27922,27923,41486,42555,51317</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32385595$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Shim, Jung-Woo</creatorcontrib><creatorcontrib>Kwak, Jueun</creatorcontrib><creatorcontrib>Roh, Kyungmoon</creatorcontrib><creatorcontrib>Ro, Hojun</creatorcontrib><creatorcontrib>Lee, Chul Seung</creatorcontrib><creatorcontrib>Han, Seung Rim</creatorcontrib><creatorcontrib>Lee, Yoon Suk</creatorcontrib><creatorcontrib>Lee, In Kyu</creatorcontrib><creatorcontrib>Park, Jaesik</creatorcontrib><creatorcontrib>Lee, Hyung Mook</creatorcontrib><creatorcontrib>Chae, Min Suk</creatorcontrib><creatorcontrib>Lee, Hae-Jin</creatorcontrib><creatorcontrib>Hong, Sang Hyun</creatorcontrib><title>Impact of intraoperative zero-balance fluid therapy on the occurrence of acute kidney injury in patients who had undergone colorectal cancer resection within an enhanced recovery after surgery protocol: a propensity score matching analysis</title><title>International journal of colorectal disease</title><addtitle>Int J Colorectal Dis</addtitle><addtitle>Int J Colorectal Dis</addtitle><description>Purpose
An enhanced recovery after surgery (ERAS) protocol for colorectal cancer resection encourages perioperative euvolemic status, and zero-balance fluid therapy is recommended for low-risk patients. Recently, several studies have reported concerns of increased acute kidney injury (AKI) in patients within an ERAS protocol. In the present study, we investigated the impact of intraoperative zero-balance fluid therapy within an ERAS protocol on postoperative AKI.
Methods
Patients who underwent elective surgery for primary colorectal cancer were divided into zero-balance and non-zero-balance fluid therapy groups according to intraoperative fluid amount and balance. After propensity score (PS) matching, 210 patients from each group were selected. Incidences of AKI were compared between the two groups according to the Kidney Disease Improving Global Outcomes criteria. Postoperative kidney functions and surgical outcomes were also compared.
Results
AKI was significantly higher in the zero-balance fluid therapy group compared to the non-zero-balance fluid therapy group (21.4% vs. 13.8%,
p
= 0.040) in PS-matched patients. The decrease in the estimated glomerular filtration rate on the day of surgery was significantly higher in the zero-balance fluid therapy group (− 5.9 mL/min/1.73 m
2
vs. − 1.4 mL/min/1.73 m
2
,
p
= 0.005). There were no differences in general morbidity or mortality rate, although surgery-related complications were more common in the zero-balance group.
Conclusions
Despite the proven benefits of zero-balance fluid therapy in colorectal ERAS protocols, care should be taken to monitor for postoperative AKI. Further studies regarding the clinical significance of postoperative AKI occurrence and optimised intraoperative fluid therapy are needed in a colorectal ERAS setting.</description><subject>Analysis</subject><subject>Cancer</subject><subject>Cancer patients</subject><subject>Care and treatment</subject><subject>Colorectal cancer</subject><subject>Colorectal carcinoma</subject><subject>Gastroenterology</subject><subject>Glomerular filtration rate</subject><subject>Health aspects</subject><subject>Hepatology</subject><subject>Internal Medicine</subject><subject>Kidney diseases</subject><subject>Kidneys</subject><subject>Medical research</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Medicine, Experimental</subject><subject>Morbidity</subject><subject>Original Article</subject><subject>Patients</subject><subject>Proctology</subject><subject>Recovery (Medical)</subject><subject>Risk groups</subject><subject>Surgery</subject><subject>Surgical outcomes</subject><issn>0179-1958</issn><issn>1432-1262</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><recordid>eNp9kk1v1DAQhiMEotvCH-CALHHhkuKvfHGrKiiVKnGBs-U4k10viR1sp9Xyp_kLjNlCBUIoB3s87_t44pmieMHoOaO0eRMpFa0sKaclFTWry-5RsWFS8JLxmj8uNpQ1Xcm6qj0pTmPcU4zrRj4tTgQXbVV11ab4fj0v2iTiR2JdCtovEHSyt0C-QfBlryftDJBxWu1A0g6Ty4F4l7fEG7OGADmPdm3WBOSLHRwckLVfQ17IgjRwKZK7nSc7PZDVDRC23gExfvIBTNITMfmWQAJEjC3y72zaoVs7Am6XkwMmjb8FpOoxoTauYZujJfjkEfWW6LxfwEWbDiQaZJNZJ4OcLYL0dIg2PiuejHqK8Px-PSs-v3_36fJDefPx6vry4qY0UvJUNrQfjBgl40NfaYBRthVtuqbirTFDLeqeVYJ2w8gYUC5MZ1hv6qbXHW0r1ktxVrw-crGkryvEpGYbDUz4nODXqLiktBI1Fx1KX_0l3fs1YL1ZxRmrcrMfVFs9gbJu9Ngtk6HqomFStk3bMVSd_0OF3wCzNfjoo8XzPwz8aDDBxxhgVEuwsw4HxajKF6vjlCmcMvVzylSu-OV9xWs_w_Db8musUCCOgogph216-KX_YH8Ae4DicA</recordid><startdate>20200801</startdate><enddate>20200801</enddate><creator>Shim, Jung-Woo</creator><creator>Kwak, Jueun</creator><creator>Roh, Kyungmoon</creator><creator>Ro, Hojun</creator><creator>Lee, Chul Seung</creator><creator>Han, Seung Rim</creator><creator>Lee, Yoon Suk</creator><creator>Lee, In Kyu</creator><creator>Park, Jaesik</creator><creator>Lee, Hyung Mook</creator><creator>Chae, Min Suk</creator><creator>Lee, Hae-Jin</creator><creator>Hong, Sang Hyun</creator><general>Springer Berlin Heidelberg</general><general>Springer</general><general>Springer Nature B.V</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>H94</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-7091-8963</orcidid></search><sort><creationdate>20200801</creationdate><title>Impact of intraoperative zero-balance fluid therapy on the occurrence of acute kidney injury in patients who had undergone colorectal cancer resection within an enhanced recovery after surgery protocol: a propensity score matching analysis</title><author>Shim, Jung-Woo ; Kwak, Jueun ; Roh, Kyungmoon ; Ro, Hojun ; Lee, Chul Seung ; Han, Seung Rim ; Lee, Yoon Suk ; Lee, In Kyu ; Park, Jaesik ; Lee, Hyung Mook ; Chae, Min Suk ; Lee, Hae-Jin ; Hong, Sang Hyun</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c442t-70bdc3f412db5aeef4850797528ccd636b15309df11e023c9c1bc67ba90851b43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Analysis</topic><topic>Cancer</topic><topic>Cancer patients</topic><topic>Care and treatment</topic><topic>Colorectal cancer</topic><topic>Colorectal carcinoma</topic><topic>Gastroenterology</topic><topic>Glomerular filtration rate</topic><topic>Health aspects</topic><topic>Hepatology</topic><topic>Internal Medicine</topic><topic>Kidney diseases</topic><topic>Kidneys</topic><topic>Medical research</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Medicine, Experimental</topic><topic>Morbidity</topic><topic>Original Article</topic><topic>Patients</topic><topic>Proctology</topic><topic>Recovery (Medical)</topic><topic>Risk groups</topic><topic>Surgery</topic><topic>Surgical outcomes</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Shim, Jung-Woo</creatorcontrib><creatorcontrib>Kwak, Jueun</creatorcontrib><creatorcontrib>Roh, Kyungmoon</creatorcontrib><creatorcontrib>Ro, Hojun</creatorcontrib><creatorcontrib>Lee, Chul Seung</creatorcontrib><creatorcontrib>Han, Seung Rim</creatorcontrib><creatorcontrib>Lee, Yoon Suk</creatorcontrib><creatorcontrib>Lee, In Kyu</creatorcontrib><creatorcontrib>Park, Jaesik</creatorcontrib><creatorcontrib>Lee, Hyung Mook</creatorcontrib><creatorcontrib>Chae, Min Suk</creatorcontrib><creatorcontrib>Lee, Hae-Jin</creatorcontrib><creatorcontrib>Hong, Sang Hyun</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>International journal of colorectal disease</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Shim, Jung-Woo</au><au>Kwak, Jueun</au><au>Roh, Kyungmoon</au><au>Ro, Hojun</au><au>Lee, Chul Seung</au><au>Han, Seung Rim</au><au>Lee, Yoon Suk</au><au>Lee, In Kyu</au><au>Park, Jaesik</au><au>Lee, Hyung Mook</au><au>Chae, Min Suk</au><au>Lee, Hae-Jin</au><au>Hong, Sang Hyun</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Impact of intraoperative zero-balance fluid therapy on the occurrence of acute kidney injury in patients who had undergone colorectal cancer resection within an enhanced recovery after surgery protocol: a propensity score matching analysis</atitle><jtitle>International journal of colorectal disease</jtitle><stitle>Int J Colorectal Dis</stitle><addtitle>Int J Colorectal Dis</addtitle><date>2020-08-01</date><risdate>2020</risdate><volume>35</volume><issue>8</issue><spage>1537</spage><epage>1548</epage><pages>1537-1548</pages><issn>0179-1958</issn><eissn>1432-1262</eissn><abstract>Purpose
An enhanced recovery after surgery (ERAS) protocol for colorectal cancer resection encourages perioperative euvolemic status, and zero-balance fluid therapy is recommended for low-risk patients. Recently, several studies have reported concerns of increased acute kidney injury (AKI) in patients within an ERAS protocol. In the present study, we investigated the impact of intraoperative zero-balance fluid therapy within an ERAS protocol on postoperative AKI.
Methods
Patients who underwent elective surgery for primary colorectal cancer were divided into zero-balance and non-zero-balance fluid therapy groups according to intraoperative fluid amount and balance. After propensity score (PS) matching, 210 patients from each group were selected. Incidences of AKI were compared between the two groups according to the Kidney Disease Improving Global Outcomes criteria. Postoperative kidney functions and surgical outcomes were also compared.
Results
AKI was significantly higher in the zero-balance fluid therapy group compared to the non-zero-balance fluid therapy group (21.4% vs. 13.8%,
p
= 0.040) in PS-matched patients. The decrease in the estimated glomerular filtration rate on the day of surgery was significantly higher in the zero-balance fluid therapy group (− 5.9 mL/min/1.73 m
2
vs. − 1.4 mL/min/1.73 m
2
,
p
= 0.005). There were no differences in general morbidity or mortality rate, although surgery-related complications were more common in the zero-balance group.
Conclusions
Despite the proven benefits of zero-balance fluid therapy in colorectal ERAS protocols, care should be taken to monitor for postoperative AKI. Further studies regarding the clinical significance of postoperative AKI occurrence and optimised intraoperative fluid therapy are needed in a colorectal ERAS setting.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>32385595</pmid><doi>10.1007/s00384-020-03616-9</doi><tpages>12</tpages><orcidid>https://orcid.org/0000-0002-7091-8963</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0179-1958 |
| ispartof | International journal of colorectal disease, 2020-08, Vol.35 (8), p.1537-1548 |
| issn | 0179-1958 1432-1262 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2400536239 |
| source | SpringerLink Journals - AutoHoldings |
| subjects | Analysis Cancer Cancer patients Care and treatment Colorectal cancer Colorectal carcinoma Gastroenterology Glomerular filtration rate Health aspects Hepatology Internal Medicine Kidney diseases Kidneys Medical research Medicine Medicine & Public Health Medicine, Experimental Morbidity Original Article Patients Proctology Recovery (Medical) Risk groups Surgery Surgical outcomes |
| title | Impact of intraoperative zero-balance fluid therapy on the occurrence of acute kidney injury in patients who had undergone colorectal cancer resection within an enhanced recovery after surgery protocol: a propensity score matching analysis |
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