Minor Postoperative Increases of Creatinine Are Associated With Higher Mortality and Longer Hospital Length of Stay in Surgical Patients

Abstract

Background-Surgical patients frequently experience postoperative increases in creatinine levels. The authors hypothesized that even small increases in postoperative creatinine levels are associated with adverse outcomes.

Acute kidney injury and mortality 1 year after major non-cardiac surgery

“…In a systematic review of AKI after major abdominal surgery, a pooled estimate for the incidence of AKI was 13 per cent, and the occurrence of AKI was associated with an unadjusted 12‐fold relative risk of death in the postoperative period. The development of AKI has been associated with postoperative mortality in a range of surgical settings. The occurrence of AKI in the week after surgery appears to be of prognostic significance beyond the acute surgical episode, having been associated with the development of chronic kidney disease (CKD) and late death, even in patients with apparent recovery of baseline renal function at hospital discharge.…”

Renal function following xenon anesthesia for partial nephrectomy—An explorative analysis of a randomized controlled study

“…CKD is associated with a significant individual morbidity and mortality, and a high socioeconomic burden. A therapeutic approach enhancing kidney-resilience to IRI would be of outstanding clinical relevance [6]. …”

Back‐calculating baseline creatinine overestimates prevalence of acute kidney injury with poor sensitivity

“…In this analysis, the data set of the NEPHRANEST trial's cohort was used to conduct a secondary analysis (Kork et al . ). The NEPHRANEST trial was a single‐centre retrospective analysis of 39 369 surgical patients, investigating the incidence and relevance of post‐operative AKI (for a detailed description of the numbers of patients and the data collection process, please refer to the primary publication).…”

“…1.25–1.49 times higher than baseline but ≤0.3 mg mL −1 ) was associated with adverse outcomes (Kork et al . ). We therefore added this category as subclinical AKI to AKI stages when examining AKI severity.…”

“…Therefore, we conducted a secondary analysis in the NEPHRANEST's trial cohort, a large single‐centre retrospective analysis in a broad surgical population investigating the impact of AKI on mortality and morbidity (Kork et al . ). We evaluated three different equations for eGFR that do not require height and weight for back‐calculating baseline serum creatinine: the MDRD equation (Levey et al .…”