Renal-function change after transjugular intra-hepatic portosystemic shunt placement and its relationship with survival:a single-center experience

作     者：Min Lang Angela L.Lang Brian Q.Tsui Weiping Wang Brian K.Erly Bo Shen Baljendra Kapoor 

作者机构：Department of RadiologyMassachusetts General HospitalHarvard Medical SchoolBostonMAUSA Department of AnesthesiaCritical Careand Pain ManagementMassachusetts General HospitalHarvard Medical SchoolBostonMAUSA Department of RadiologyUCLA Medical CenterLos AngelesCAUSA Department of RadiologyMayo ClinicJacksonvilleFLUSA Colorado School of Public HealthAuroraColoradoUSA The Inflammatory Bowel Disease Center at ColumbiaColumbia University Irving Medical CenterNew YorkNYUSA Division of Vascular and Interventional RadiologyImaging InstituteCleveland ClinicClevelandOHUSA 

出 版 物：《Gastroenterology Report》 (胃肠病学报道（英文）)

年 卷 期：2021年第9卷第4期

页      面：306-312,I0001,I0002页

核心收录：

学科分类：1002[医学-临床医学] 100210[医学-外科学(含：普外、骨外、泌尿外、胸心外、神外、整形、烧伤、野战外)] 10[医学] 

主　　题：TIPS transjugular intra-hepatic portosystemic shunt portal hypertension renal function renal failure mortality 

摘      要：Background:The effect of transjugular intra-hepatic portosystemic shunt(TIPS)placement on renal function and the correlation of post-TIPS Cr with mortality remain *** study aimed to assess the effect of TIPS placement on renal function and to examine the relationship between post-TIPS Cr and mortality ***:A total of 593 patients who underwent de novo TIPS placement between 2004 and 2017 at a single institution were included in the *** pre-TIPS Cr level(T0;within 7 days before TIPS placement)and post-TIPS Cr levels,at 1–2 days(T1),5–12 days(T2),and 15–40 days(T3),were *** of Cr change after TIPS placement and the 1-year mortality rate were analysed using multivariable linear-regression and Cox proportional-hazards models,***:Overall,21.4%of patients(n=127)had elevated baseline Cr(≤1.5 mg/dL;mean,2.5161.49 mg/dL)and 78.6%(n=466)had normal baseline Cr(1.5 mg/dL;mean,0.9260.26 mg/dL).Patients with elevated pre-TIPS Cr demonstrated a decrease in post-TIPS Cr(difference,-0.60 mg/dL),whereas patients with normal baseline Cr exhibited no change(difference,0.01 mg/dL).The 30-day,90-day,and 1-year mortality rates were 13%,20%,and 32%,*** bleeding as a TIPS-placement indication(hazard ratio=1.731;P=0.036),higher T0 Cr(hazard ratio=1.834;P=0.012),and higher T3 Cr(hazard ratio=3.524;P0.001)were associated with higher 1-year mortality ***:TIPS placement improved renal function in patients with baseline renal dysfunction and the post-TIPS Cr level was a strong predictor of 1-year mortality risk.