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.