Acute kidney injury in peripheral arterial surgery patients: a cohort study

Abstract

Purpose: The aim of the study was to evaluate the prevalence of acute kidney injury (AKI) in a cohort of surgically treated patients with peripheral artery disease (PAD) and its association with the short-term and long-term outcome. Materials and methods: We conducted a retrospective cohort study on all the consecutive PAD inpatients in 2008. Data on the patients' demographic characteristics, medical history, treatment, outcome and laboratory tests measurements were retrieved from the medical records. Results: We analyzed 166 patients (71.6% males, mean age 63.2 years AE SD 10.7 years) and found an AKI prevalence of 12.7%. The AKI patients' group had more chronic kidney disease (CKD) (23.8% vs. 6.2%, p ¼ 0.005), diabetes mellitus (DM) (61.9% vs. 33.1%, p ¼ 0.011) and a higher length of hospital stay (19.48 vs. 15.42 days, p ¼ 0.047). At one year, the mortality was 33.3% in the AKI group compared to 1.3% in non-AKI group, with a strong association between AKI and death (OR ¼ 35.7; 95%CI ¼ 6.7 to 189) and AKI and major cardiovascular events (OR ¼ 29

Index complications predict secondary complications after infrainguinal lower extremity bypass for critical limb ischemia

“…5,11,12 shown to be associated with a higher risk of mortality and cardiovascular events in patients with peripheral artery disease undergoing revascularization or amputation. 13 Our study strengthens the support for the association of ARF with mortality and cardiovascular events and expands its association to other secondary complications.…”

Mortality and Cost of Acute and Chronic Kidney Disease after Vascular Surgery

“…Postoperative acute kidney injury was the most common postoperative complication occurring in almost half of all patients. While our cohort consisted of patients receiving an array of diverse vascular surgical procedures, the prevalence of AKI using consensus criteria in our cohort appears consistent with the reported values in the vascular surgical literature: 12.7% of patients developed AKI after surgical intervention for peripheral arterial disease 11 while 76% of patients developed AKI after ruptured abdominal aortic aneurysmal repair. 14 Postoperative AKI, when defined using the KDIGO consensus criteria, is a common postoperative complication after major inpatient vascular surgery.…”

“…7-10 With the emergence of consensus criteria to standardize the definition of this postoperative complication, especially with mild and moderate degrees of AKI, recent studies within the vascular literature have demonstrated that AKI prevalence ranges from 13%-76% and is associated with adverse perioperative outcomes. 11-14 Many of these studies have focused on the prevalence of AKI after a specific procedure using small patient cohorts.…”

Remote Ischaemic Preconditioning Reduces Kidney Injury Biomarkers in Patients Undergoing Open Surgical Lower Limb Revascularisation: A Randomised Trial

“…Perioperative kidney injury has been found to affect 12.7% of patients undergoing lower limb revascularisation surgery, and only 23.8% of them have a prior history of chronic kidney disease [1]. In addition to chronic kidney failure, patients with peripheral artery disease (PAD) have frequently multiple risk factors for acute kidney injury (AKI) such as smoking, other cardiovascular diseases, diabetes mellitus, and usage of nephrotoxic medication, including painkillers [2,3].…”