CKD Elevates Risk of Post-Op AKI
NATIONAL HARBOR, Md.—Patients with chronic kidney disease (CKD) before undergoing surgical procedures are at increased risk of acute kidney injury (AKI) post-operatively, researchers reported at the National Kidney Foundation Spring Clinical Meetings.
A study of 255,188 general surgical cases revealed that the proportion of patients who experienced AKI increased as renal function decreased. Post-operative AKI developed in 0.42% of patients with normal kidney function, 0.58% of those with reduced kidney function (estimated glomerular filtration rate [eGFR] of 60-89 mL/min/1.73 m2), 2.3% of those with CKD stage 3 (eGFR 30-59), and 9% of subjects with CKD stage 4 (eGFR 15-29).
Patients with CKD stage 4 had a 34-fold increased risk of acute renal failure (ARF) than patients with normal kidney function, said investigator Linda W. Moore, RD, of The Methodist Hospital in Houston, who presented study findings.In a substudy of 465 colectomy cases with CKD stage 4 and matched colectomy cases without CKD, the CKD patients had a 12 times increased risk of AKI. CKD stage 4 was associated with a fivefold increase risk of 30-day mortality compared with patients who did not have CKD. Within the CKD stage 4 group, AKI increased the risk of death 3.6 times compared with no AKI. AKI did not affect the risk of death in the non-CKD group.