Acute Renal Injury and Dysfunction Following Elective Abdominal Aortic Surgery

Tallgren, Minna; Niemi, Tomi; Pöyhiä, Reino; Raininko, E.; Railo, Mikael; Salmenperä, Markku; Lepäntalo, Mauri; Hynninen, Marja

doi:10.1016/j.ejvs.2006.12.005

Cited by 105 publications

(89 citation statements)

References 25 publications

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“…5,6 Studies evaluating kidney function in abdominal aorta surgery demonstrated both glomerular (albuminuria) and tubular (increased urinary NAG-creatinine ratio) injury in up to 96% of the subjects, although only 22% had RIFLE-defined acute kidney injury, and a worse short-term (30 days) and long-term (10 years) survival of the AAA (abdominal aortic aneurysm) surgery patients who experienced a temporary AKI, even if their renal function completely recovered. 7,8 The aim of our study was to evaluate the prevalence of AKI, its association with the short-term (within 30-days postoperatively) and long-term (1 year postoperatively) prognosis in a cohort of patients with severe peripheral artery disease (PAD) undergoing surgical procedures of lower extremity revascularization or amputation and the most important comorbidities associated with AKI development.…”

Section: Introductionmentioning

confidence: 99%

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

Schiller¹,

Mihaescu²,

Timar³

et al. 2013

Renal Failure

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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

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Section: Introductionmentioning

confidence: 99%

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

Schiller¹,

Mihaescu²,

Timar³

et al. 2013

Renal Failure

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“…Their study, however did not attempt to quantify proteinuria beyond dipstick, nor did they comment on the role of postoperative proteinuria. To our knowledge, only four very small studies (largest, n=69) have commented on the role of postoperative proteinuria as a predictor of AKI (21,(39)(40)(41).…”

Section: Discussionmentioning

confidence: 99%

Association of Postoperative Proteinuria with AKI after Cardiac Surgery among Patients at High Risk

Molnar

Parikh

Sint

et al. 2012

Clinical Journal of the American Society of Nephrology

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SummaryBackground and objectives Preoperative proteinuria is associated with a higher incidence of postoperative AKI. Whether the same is true for postoperative proteinuria is uncertain. This study tested the hypothesis that increased proteinuria after cardiac surgery is associated with an increased risk for AKI.Design, setting, participants, & measurements This prospective cohort study included 1198 adults undergoing cardiac surgery at six hospitals between July 2007 and December 2009. Albuminuria, urine albumin-to-creatinine ratio (ACR), and dipstick proteinuria were measured 0-6 hours after surgery. The primary outcome was AKI, defined as a doubling in serum creatinine or receipt of acute dialysis during the hospital stay. Analyses were adjusted for patient characteristics, including preoperative albuminuria.Results Compared with the lowest quintile, the highest quintile of albuminuria and highest grouping of dipstick proteinuria were associated with greatest risk for AKI (adjusted relative risks Conclusions Higher levels of proteinuria after cardiac surgery identify patients at increased risk for AKI during their hospital stay.

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“…Third, renal failure is an important confounding factor that may limit the predictive role of PCT in the early diagnosis of postoperative infections, also considering the fact that postoperative renal function deterioration is quite frequent after abdominal aortic surgery. 30 Finally, physicians were not blinded to PCT values; therefore, they might have ordered more radiological and microbiological examinations, if PCT was seen to be high. New topics for future researches could be the interpretation of PCT values in relation to the deterioration of renal function, the comparison of PCT curves in patients with different types of postoperative complications (not only infections), and the role of PCT in guiding therapy to prevent postoperative complications in association with other markers.…”

Section: Discussionmentioning

confidence: 99%