• Prameela Konda, Di Ai, Carlos E Guerra, Andrea Rodriguez-Restrepo, Reza J Mehran, David Rice, Wayne Hofstetter, Jagtar Heir, Peter Kwater, Vijaya Gottumukkala, Mike Hernandez, and Juan P Cata.
• Departments of Anesthesiology and Perioperative Medicine, University of Texas MD Anderson Cancer Center, Houston, TX.
• J. Cardiothorac. Vasc. Anesth. 2017 Apr 1; 31 (2): 474-481.

ObjectiveTo identify risks factors associated with acute kidney injury (AKI) after esophageal cancer surgery.DesignThis was a retrospective study.SettingSingle academic center.ParticipantsSubjects with non-metastatic esophageal cancer. Patients were excluded if they were younger than 18 years and had missing data.Measurements And Main ResultsPrimary outcome of the study was AKI according to AKI Network criteria. Demographic and perioperative variables were compared in patients with and without AKI. A multivariate Cox proportional model was used to assess the association between perioperative variables and AKI; p<0.05 was considered statistically significant. AKI was found in 107 (11.9%) of the 898 patients included in the study. The multivariate analysis also showed that BMI (odds ratio [OR] 1.07, 95% confidence interval [CI] 1.03-1.11), number of comorbidities (OR 1.52, 95% CI 1.20-1.93, p = 0.001), and preoperative creatinine concentrations (OR 2.37, 95% CI 1.14-4.92, p = 0.02) were independent predictors for AKI. The use of dexamethasone was associated with a reduced risk for AKI.ConclusionsIn support of previous reports in the literature, the authors found that AKI was not an uncommon complication after esophageal surgery. Obesity, cardiovascular comorbidities, and high preoperative concentrations were predictors of AKI. Dexamethasone administration during surgery appeared to have a protective effect. This finding opens an opportunity to further study in a randomized controlled trial the efficacy of dexamethasone in the prevention of AKI.Copyright © 2017 Elsevier Inc. All rights reserved.

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