Risk factors for postoperative renal dysfunction following open surgical repair of abdominal aortic aneurysms retrospective analysis

Abstract

ObjectivesTo identify the risk factors for postoperative renal dysfunction after open surgical repair (OSR) of abdominal aortic aneurysms (AAAs) and to establish a scoring system.ResultsThe overall 30-day mortality rates were 22.0%(ruptured) vs 2.6% (unruptured), respectively. For the ruptured group, the independent risk factors were hemodynamic instability (P = 0.002) blood loss >1 L (P = 0.041) and preoperative creatinine >150 μmol/L (P < 0.001). By contrast, for the unruptured group, factors were smoking (P = 0.028), blood loss >1 L (P = 0.018), and antihypertensive drugs (P < 0.001). The areas under the curve of the WCRDA scoring system are 0.794 (95% confidence interval (CI) 0.686–0.902, P < 0.001) and 0.811 (95% CI 0.691–0.932, P < 0.001) for the ruptured and unruptured groups, respectively.ConclusionsHemodynamic instability, blood loss >1 L and Hb <90 g/L are independent risk factors for postoperative renal dysfunction following rAAA OSR, whereas smoking, blood loss >1 L, and antihypertensive drugs are independent risk factors. WCRDA performs well in predicting postoperative renal dysfunction.Materials and Methods287 patients from the Vascular Department of West China Hospital, Sichuan University, who were planned to perform OSR for AAA from November 2003 to January 2017. 274 patients underwent OSR for AAA were finally included in the study. A total of 118 patients had ruptured AAA and 156 unruptured AAA.The patients were divided into the ruptured and unruptured groups. Logistic regression was used to identify the independent risk factors for postoperative renal dysfunction. The receiver operating characteristic curve was used to evaluate the scoring system.

Comparison of Postoperative Acute Kidney Injury Between Laparoscopic and Laparotomy Procedures in Elderly Patients Undergoing Colorectal Surgery

“…So far, no study has used the Acute Kidney Injury Network (AKIN) definition to investigate the impact of LSP on AKI after colorectal cancer surgery in elderly patients. 7,8 The AKIN is a newly introduced and rapidly adopted AKI definition, with high sensitivity and early diagnostic superiority. 9 We performed this study aiming to investigate whether LSP in elderly patients who underwent colorectal cancer surgery was negatively associated with postoperative AKI determined by the AKIN criteria.…”

Is cystatin C a good predictor of acute kidney injury after elective aortic surgery?

“…A Chinese study in 2017. about risk factors after abdominal aortic aneurysm surgery showed a predictive score for AKI (WCRDA score), which for elective surgeries, contains the following elements: smoking, blood loss > 1 l and antihypertensive therapy. A score of 0 has a predicted risk of developing AKI of 2%, while a maximum score of 4 carries a risk of 78% 52 . A recent Korean study obtained its predictive model for the development of AKI after aortic surgery, which includes age> 60 years, decreased preoperative GFR, preoperatively reduced left ventricular systolic function, prolonged operative time, intraoperative oliguria, intraoperative furosemide therapy 53 .…”