NDLI: Who is at increased risk for acute kidney injury following noncardiac surgery?

Content Provider	Springer Nature : BioMed Central
Author	Murray, Patrick
Abstract	Abelha and colleagues evaluated the incidence and determinants of postoperative acute kidney injury (AKI) after major noncardiac surgery in patients with previously normal renal function. In this retrospective study of 1,166 patients with no previous renal insufficiency, who were admitted to a postsurgical intensive care unit (ICU) over a 2-year period, the incidence of AKI was 7.5%. Multivariate analysis identified American Society of Anesthesiologists physical status, Revised Cardiac Risk Index, high-risk surgery and congestive heart disease as preoperative AKI risk factors. AKI was an independent risk factor for hospital mortality (odds ratio = 3.12, 95% confidence interval = 1.41 to 6.93; P = 0.005), and was associated with higher severity of illness scores (Simplified Acute Physiology Score II and Acute Physiology and Chronic Health Evaluation II), longer ICU length of stay, higher ICU mortality, increased hospital mortality and higher mortality at 6-month follow up. Although the study design excluded 121 patients with significant preoperative renal insufficiency by design, the relatively crude serum creatinine cut-offs used certainly permitted inclusion of numerous patients with preoperative renal impairment. Accordingly, the study design failed to quantify the impact of preoperative renal impairment on risk and outcomes of perioperative AKI in noncardiac surgery, and this should be a goal of such studies in the future. Nonetheless, the study is an important addition to the literature in an under-studied population of patients at high risk for AKI.
Related Links	https://ccforum.biomedcentral.com/counter/pdf/10.1186/cc7942.pdf
Ending Page	2
Page Count	2
Starting Page	1
File Format	HTM / HTML
ISSN	13648535
DOI	10.1186/cc7942
Journal	Critical Care
Issue Number	4
Volume Number	13
Language	English
Publisher	BioMed Central
Publisher Date	2009-07-30
Access Restriction	Open
Subject Keyword	Intensive Critical Care Medicine Emergency Medicine Chronic Kidney Disease Acute Kidney Injury Anesthesiologist Physical Status Revise Cardiac Risk Index Cardiac Risk Index
Content Type	Text
Subject	Critical Care and Intensive Care Medicine
Journal Impact Factor	8.8/2023
5-Year Journal Impact Factor	10.4/2023

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