术后急性肾损伤（AKI）与不良的临床结果相关。识别术后 AKI 的危险因素具有临床重要意义。在供氧不足的情况下，血清乳酸会增加，并广泛用于评估患者的临床病程。我们调查了术中血清乳酸水平与脑肿瘤切除术后 AKI 之间的关联。 回顾性收集了 4131 名接受过脑肿瘤切除术的患者的人口统计学、医疗和手术史、肿瘤特征、手术、麻醉、术前和术中血液检查结果以及术后临床结果。脑肿瘤切除术。根据术中最大血清乳酸水平 3.35 mmol/L，将患者分为高乳酸组 (n=1078) 和低乳酸组 (n=3053)。倾向评分匹配后，每组纳入 1005 名患者。 AKI 是根据手术后 7 天内的血清肌酐水平，使用肾脏病改善全球结局标准进行诊断的。术后 AKI 在 53 名 (1.3%) 患者中观察到，并且在术前乳酸水平较高的患者中更为常见 (3.2% [n]) =35] vs. 0.6% [n=18]；P < 0.001）以及倾向评分匹配后（3.3% [n=33] vs. 0.6% [n=6]；P < 0.001）。术后 AKI 的术中预测因素为最大血清乳酸水平 > 3.35 mmol/L（优势比 [95% 置信区间]，3.57 [1.45-8.74]，P = 0.005）、最低血液 pH 值（每 1 单位的优势比，0.01 [0.00） -0.24]，P = 0.004），最低血细胞比容（每 1% 的优势比，0.91 [0.84-1.00]，P = 0.037），平均血糖水平 > 200 mg/dL（优势比，6.22 [1.75-22.16] ，P = 0.005)。术中高血清乳酸水平与脑肿瘤切除术后 AKI 相关。版权所有 © 2024 Wolters Kluwer Health, Inc. 保留所有权利。

Postoperative acute kidney injury (AKI) is associated with poor clinical outcomes. Identification of risk factors for postoperative AKI is clinically important. Serum lactate can increase in situations of inadequate oxygen delivery and is widely used to assess a patient's clinical course. We investigated the association between intraoperative serum lactate levels and AKI after brain tumor resection.Demographics, medical and surgical history, tumor characteristics, surgery, anesthesia, preoperative and intraoperative blood test results, and postoperative clinical outcomes were retrospectively collected from 4131 patients who had undergone brain tumor resection. Patients were divided into high (n=1078) and low (n=3053) lactate groups based on an intraoperative maximum serum lactate level of 3.35 mmol/L. After propensity score matching, 1005 patients were included per group. AKI was diagnosed using the Kidney Disease Improving Global Outcomes criteria, based on serum creatinine levels within 7 days after surgery.Postoperative AKI was observed in 53 (1.3%) patients and was more frequent in those with high lactate both before (3.2% [n=35] vs. 0.6% [n=18]; P < 0.001) and after (3.3% [n=33] vs. 0.6% [n=6]; P < 0.001) propensity score matching. Intraoperative predictors of postoperative AKI were maximum serum lactate levels > 3.35 mmol/L (odds ratio [95% confidence interval], 3.57 [1.45-8.74], P = 0.005), minimum blood pH (odds ratio per 1 unit, 0.01 [0.00-0.24], P = 0.004), minimum hematocrit (odds ratio per 1%, 0.91 [0.84-1.00], P = 0.037), and mean serum glucose levels > 200 mg/dL (odds ratio, 6.22 [1.75-22.16], P = 0.005).High intraoperative serum lactate levels were associated with AKI after brain tumor resection.Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.