The impact of renal insufficiency on the outcome of carotid surgery is influenced by the definition used

Abstract

Severe RI is a risk factor for complications after carotid surgery. Creatinine clearance calculated according to the MDRD formula correlates most closely with these complications. Symptomatic patients with severe RI, according to the creatinine clearance, are at high risk with a very high level of postoperative complications.

Impact of Chronic Kidney Disease on Outcomes of Surgical Resection for Primary Colorectal Cancer

“…In the past, only a few articles have described details of cardiovascular complications after major surgery. Kretz et al 26 reported that 30-day myocardial infarction rate was not affected by different eGFR, whereas the frequency of stroke was significantly high in cases with severe CKD after carotid endarterectomy. In a recent study investigating the same type of surgery, no remarkable difference was observed in these morbidity rates among different CKD stages.…”

“…16 The majority of articles reported that maintenance dialysis was at a higher risk of postoperative complications after major surgery, including surgery on the heart, lung, spine, and abdominal aortic aneurysm, and laparoscopic cholecystectomy, [17][18][19][20][21][22] whereas there have been controversial results in carotid endarterectomy. [23][24][25][26][27] Moreover, postoperative morbidity and mortality rates were much higher in emergency abdominal surgery than elective operations in patients on hemodialysis. 28 When restricted to resection for CRC, there was only 1 English article 29 found by our extensive search.…”

The effect of chronic renal insufficiency by use of glomerular filtration rate versus serum creatinine level on late clinical outcome of carotid endarterectomy

“…CRI is a major comorbidity that has been examined in the last two decades; however, most of the reported studies have analyzed the impact of CRI on perioperative CEA outcomes, 5–10 whereas only a few have analyzed late outcomes. 11–14 …”

“…Several authorities have shown that Cr levels alone are suboptimal markers of renal function, which was thought to be secondary to several factors that may affect Cr metabolism/clearance and discrepancies in reported laboratory values. 5,10,11 …”

“…10–12 In 2008, Sidawy et al 10 reported that patients with moderate CRI were found to have higher comorbidity and mortality rates, with higher rates of stroke and death in patients who were symptomatic. In 2010, Kretz et al 11 also reported that a significant increase in perioperative death was found in patients with severe CRI based on serum Cr level alone (Cr >3.0 mg/dL). However, based on the Cockroft-Gault and MDRD formulas, there was an increase in perioperative neurologic events and combined stroke and death rates in patients with severe CRI.…”