{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T21:33:30Z","timestamp":1785879210090,"version":"3.56.0"},"reference-count":55,"publisher":"BMJ","issue":"11","license":[{"start":{"date-parts":[[2020,11,13]],"date-time":"2020-11-13T00:00:00Z","timestamp":1605225600000},"content-version":"unspecified","delay-in-days":12,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2020,10,12]]},"published-print":{"date-parts":[[2020,11]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>\n                      We examine the association between vitamin B\n                      <jats:sub>12<\/jats:sub>\n                      level and risk for acute kidney injury (AKI) in patients undergoing living donor liver transplantation (LDLT).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Retrospective observational cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>University hospital, from January 2009 to December 2018.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>\n                      A total of 591 patients who underwent elective LDLT were analysed in this study. Those with a preoperative history of kidney dysfunction, vitamin B\n                      <jats:sub>12<\/jats:sub>\n                      supplementation due to alcoholism, low vitamin B\n                      <jats:sub>12<\/jats:sub>\n                      (&lt;200\u2009pg\/mL) or missing laboratory data were excluded.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary and secondary outcome measures<\/jats:title>\n                    <jats:p>\n                      The population was classified into AKI and non-AKI groups according to Kidney Disease Improving Global Outcomes (KDIGO) criteria, and associations between perioperative factors and AKI were analysed. After 1:1 propensity score (PS) matching, the association between high vitamin B\n                      <jats:sub>12<\/jats:sub>\n                      (&gt;900\u2009pg\/mL) and postoperative AKI was evaluated.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Preoperative vitamin B\n                      <jats:sub>12<\/jats:sub>\n                      was higher in the AKI group. Potentially significant perioperative factors from univariate analyses were entered into multivariate analyses, including preoperative factors (vitamin B\n                      <jats:sub>12<\/jats:sub>\n                      , diabetes), intraoperative factors (hourly urine output) and donor graft fatty change in LDLT patients. PS matching analyses with adjustment using PS revealed that high serum vitamin B\n                      <jats:sub>12<\/jats:sub>\n                      (&gt;900\u2009pg\/mL) was associated with risk for AKI, and the risk was 2.8-fold higher in patients with high vitamin B\n                      <jats:sub>12<\/jats:sub>\n                      than in those with normal vitamin B\n                      <jats:sub>12<\/jats:sub>\n                      . Higher vitamin B\n                      <jats:sub>12<\/jats:sub>\n                      was also related to a higher AKI stage. In addition, inflammatory factors (C reactive protein, white blood cells and albumin) were associated with vitamin B\n                      <jats:sub>12<\/jats:sub>\n                      level.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      Our study may improve the accuracy of predicting postoperative AKI by introducing preoperative vitamin B\n                      <jats:sub>12<\/jats:sub>\n                      into risk assessments for patients undergoing LDLT.\n                    <\/jats:p>\n                  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