Elevated Preoperative Serum Renin Predicts Vasopressor Need and Acute Kidney Injury in Liver Transplant Patients

Highlight

• Serum renin can be elevated up to 100-fold prior to liver transplantation in patients with cirrhosis.
• Preoperative renin levels strongly correlate with intraoperative vasopressor requirements during the dissection phase, measured in norepinephrine equivalents.
• Elevated renin predicts postoperative acute kidney injury independent of preexisting renal function, while no association with early allograft dysfunction was observed.
• Measurement of serum renin may guide individualized vasopressor strategies, including consideration of angiotensin II infusion during liver transplantation.

Study Background