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. 2023 Apr 28;23(1):107.
doi: 10.1186/s12893-023-02016-4.

Risk factors of acute renal failure in patients with protective ileostomy after rectal cancer surgery

Marghich Omar  1 , Anis Tarek  2 , Bouassria Abdeslam  2 , Efoé-Ga Yawod Olivier Amouzou  3 , Ousadden Abdelmalek  2 , Ait Taleb Khalid  2 , El Bouhaddouti Hicham  2 , Mouaqit Ouadii  2 , Mazaz Khalid  2 , Rahili Mohamed Amine  3 , Benjelloun El Bachir  4 , Benizri Emmanuel  3
Affiliations

Risk factors of acute renal failure in patients with protective ileostomy after rectal cancer surgery

Marghich Omar et al. BMC Surg. .

Abstract

Background: Despite the potential benefits of protective ileostomy in rectal surgery, diverting loop ileostomy construction is not free of specific medical consequences implying unplanned hospital readmissions. The most common reason for readmission in these patients is a dehydration with a prevalence of acute renal failure (ARF) of 20%. The objective of this study was to establish the predictive factors of ARF in patients with protective ileostomy after surgery for rectal cancer from a bicentric study.

Methods: we conducted a bicentric retrospective cohort study to identify the risk factor of ARF. This study was carried out on 277 patients operated for rectal cancer with necessity of a protective ileostomy during the study period. ARF was measured at any endpoint between ileostomy creation and reversal. Multiple logistic regressions were performed to identify independent risk factors.

Results: A total of 277 patients were included, and 18% (n = 50) were readmitted for ARF. In multivariate logistic regression, increased age (OR 1.02, p = 0.01), Psychiatric diseases (OR 4.33, p = 0.014), Angiotensin II receptor blockers (OR 5.15, p < 0.001) and the ASA score ≥ 3 (OR 9.5, p < 0.001) were significantly associated with ARF.

Conclusion: Acute renal failure is a prevalent and significant event in the postoperative course of ileostomy patients. Patients at risk should be risk stratified before discharge and targeted for intensive preventive measures.

Keywords: Acute renal failure; Protective ileostomy; Rectal cancer; Risk factors.

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Conflict of interest statement

The authors declare that they have no competing interests.

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