Elective Surgery in Patients with End Stage Renal Disease: What's the Risk?

Abstract

Little research has been performed in regards to the morbidity and outcomes associated with elective general surgery performed on patients with end stage renal disease (ESRD). With minimal data about the severity of disease in these patients, we sought to quantify the differences in the ESRD patient undergoing elective surgical procedures compared with matched controls. A review of all ESRD patients undergoing elective surgical procedures at a University Medical Center between 2001 and 2005 was performed. Outcomes included length of hospital stay, 1 year morbidity, and mortality. These patients were then compared with a control group with normal renal function matched 2:1. Fifty-two consecutive ESRD patients undergoing elective general surgery procedures were compared with 104 matched controls. The ESRD group experienced more complications (25 vs 16, P = 0.05) and had a larger number of overall complications compared with the controls (33 vs 19, P < 0.05). Length of stay was significantly longer in the ESRD group as well (8 vs 2.65 days, P < 0.0001). Incidence of death (4%) in the ESRD group was increased as well. Patients with ESRD require longer hospital stays and have an increased overall incidence and frequency of complications than patients with normal renal function undergoing elective general surgery procedures. The significantly increased morbidity should be considered when evaluating expected outcomes.

Clinical course after parathyroidectomy in adults with end-stage renal disease on maintenance dialysis

“…Second, our sample size is relatively small and from a single center. We were unable to determine whether the adverse outcomes were due to the PTX procedure or the fact that ESRF patients have an increased morbidity while undergoing elective general surgery procedures [ 15 ].…”

Postoperative mortality in patients on chronic dialysis following elective surgery: A systematic review and meta-analysis

“…Twenty-one studies defined normal kidney function by serum creatinine. Non-emergent cardiac surgery was the most commonly reported type of surgery (15 studies, 31%), [20][21][22][23][24][25][26][27][28][29][30][31][32][33][34] followed by general surgery (12 studies, 25%), [4,[35][36][37][38][39][40][41][42][43][44][45] vascular surgery (9 studies, 18%), [41,[46][47][48][49][50][51][52][53] orthopaedic surgery (9 studies,18%) [54][55][56][57][58][59][60][61] and urologic/gynaecologic surgery (4 studies, 8%)(62-65). Twenty-two of the 49 studies assessed a single surgical procedure, [24-27, 29, 31-34, 39, 41, PLOS ONE https://doi.org/10.1371/journal.pone.0234402.g001 Thirty six studies did not report dialysis modality, eleven studies specifically examined haemodialysis patients only,…”

Why Renal Nurses Cope So Well With Their Workplace Stressors

“…The number of individuals with end‐stage renal disease (ESRD) is increasing worldwide (Ashwanden 2003; Coresh et al 2007; Schneider et al 2009; de Boer et al 2011) with subsequent increasing demand for either kidney transplant or dialysis to survive (Poppel et al 2003; Neil et al 2009). Patient demand for services has outstripped recruitment and retention of specialised renal nursing staff (Chow et al 2008).…”