Incidence, risk factors, and outcomes of perioperative acute kidney injury in noncardiac and nonvascular surgery

Biteker, Murat; Dayan, Akın; Tekkeşin, Ahmet İlker; Can, Mehmet Mustafa; Taycı, İbrahim; Erkan, I.; Şahin, Gülizar Manga

doi:10.1016/j.amjsurg.2013.04.006

Cited by 152 publications

(122 citation statements)

References 28 publications

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“…3,22 Further, the generalizability of our observations could be limited since our study was performed in a single tertiary center. In particular, the frequency of AKI, 2,3 but not the frequency of mortality, 50 observed in our study was higher than reported from recent large-scale studies. Several reasons could account for this discrepancy in the frequency of AKI including patient characteristics, intraoperative management, and use of the KDIGO definition of AKI.…”

Section: Limitationscontrasting

confidence: 84%

Baseline Pulse Pressure, Acute Kidney Injury, and Mortality After Noncardiac Surgery

Oprea

Lombard

Liu

et al. 2016

Anesthesia & Analgesia

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Section: Limitationscontrasting

confidence: 84%

Baseline Pulse Pressure, Acute Kidney Injury, and Mortality After Noncardiac Surgery

Oprea

Lombard

Liu

et al. 2016

Anesthesia & Analgesia

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“…However, AKI in noncardiac surgery patients is largely understudied. In one study where AKI was defined as a >50% increase in SCr levels after noncardiac surgery, 7% developed AKI [43]. In patients undergoing cardiac surgery the incidence of AKI is between 1% and 50% depending on the type of procedure and the classification of AKI [2].…”

Section: Diagnosticsmentioning

confidence: 99%

Acute kidney injury—an overview of diagnostic methods and clinical management

Hertzberg¹,

Rydén²,

Pickering³

et al. 2017

Clinical Kidney Journal

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Acute kidney injury (AKI) is a common condition in multiple clinical settings. Patients with AKI are at an increased risk of death, over both the short and long term, and of accelerated renal impairment. As the condition has become more recognized and definitions more unified, there has been a rapid increase in studies examining AKI across many different clinical settings. This review focuses on the classification, diagnostic methods and clinical management that are available, or promising, for patients with AKI. Furthermore, preventive measures with fluids, acetylcysteine, statins and remote ischemic preconditioning, as well as when dialysis should be initiated in AKI patients are discussed. The classification of AKI includes both changes in serum creatinine concentrations and urine output. Currently, no kidney injury biomarkers are included in the classification of AKI, but proposals have been made to include them as independent diagnostic markers. Treatment of AKI is aimed at addressing the underlying causes of AKI, and at limiting damage and preventing progression. The key principles are: to treat the underlying disease, to optimize fluid balance and optimize hemodynamics, to treat electrolyte disturbances, to discontinue or dose-adjust nephrotoxic drugs and to dose-adjust drugs with renal elimination.

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“…Postoperative AKI associated with cardiovascular surgery is common and well studied . In contrast, postoperative AKI after non‐cardiac surgery is less common, but has a significant clinical impact …”

Section: Introductionmentioning

confidence: 99%

Incidence and risk factors for acute kidney injury after radical cystectomy

et al. 2016

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Abbreviations & Acronyms AKI = acute kidney injury AKIN = Acute Kidney Injury Network BMI = body mass index CI = confidence interval CVD = cardiovascular disease DM = diabetes mellitus eGFR = estimated glomerular filtration rate HT = hypertension IHD = ischemic heart disease KDIGO = Kidney Disease: Improving Global Outcomes NAC = neoadjuvant chemotherapy NSAID = non-steroidal antiinflammatory drugs OR = odds ratio POD = postoperative day RC = radical cystectomy RIFLE = Risk, Injury, Failure, Loss, End-Stage Renal Disease RRT = renal replacement therapy sCr = serum creatinine UD = urinary diversion UTI = urinary tract infection Objectives: To clarify the incidence, risk factors and clinical impact of acute kidney injury after radical cystectomy. Methods: A total of 210 patients who underwent radical cystectomy at Sapporo Medical University Hospital, Sapporo, Japan, from January 2006 through December 2012 were evaluated. The incidence of acute kidney injury was evaluated over the first 7 days postoperatively, during which time a ureteral catheter was inserted. Risk factors for postoperative acute kidney injury and its impacts on short-term clinical outcomes were evaluated. Results: Finally, 145 patients were eligible for this study. Postoperative acute kidney injury was observed in 48 patients (33.1%), with stages 1, 2, and 3 found in 33 (22.7%), 14 (9.6%) and 1 (0.7%), respectively. All patients with stage 1 and 2 acute kidney injury recovered by postoperative day 7, except for one with stage 1. Hypertension (P < 0.001), preoperative estimated glomerular filtration rate <60 mL/min/1.73 m 2 (P = 0.04) and neoadjuvant chemotherapy (P = 0.03) were independent risk factors for postoperative acute kidney injury. Furthermore, postoperative acute kidney injury was an independent risk factor for acute kidney injury after ureteral stent removal, but not of persistent elevated serum creatinine, prolonged hospital stay or the new onset of cardiovascular disorders during the hospital stay. Conclusions: The incidence of acute kidney injury after radical cystectomy is relatively high, although most cases are low grade and can be resolved. We should be aware of the risk for postoperative acute kidney injury, especially in patients who have comorbid hypertension, impaired renal function and received naoadjuvant chemotherapy.

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Incidence, risk factors, and outcomes of perioperative acute kidney injury in noncardiac and nonvascular surgery

Cited by 152 publications

References 28 publications

Baseline Pulse Pressure, Acute Kidney Injury, and Mortality After Noncardiac Surgery

Baseline Pulse Pressure, Acute Kidney Injury, and Mortality After Noncardiac Surgery

Acute kidney injury—an overview of diagnostic methods and clinical management

Incidence and risk factors for acute kidney injury after radical cystectomy

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