Document Detail


Acute renal injury and dysfunction following elective abdominal aortic surgery.
MedLine Citation:
PMID:  17276098     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To evaluate the incidence of kidney injury and acute renal dysfunction (ARD) and associated risk factors in open abdominal aortic surgery. MATERIALS AND METHODS: 69 patients undergoing elective infrarenal aortic repair were included in a prospective study. Anaesthesia and haemodynamic management were standardised targeting a mean arterial pressure (MAP) of 70-90 mmHg, pulmonary artery occlusion pressure of 12-14 mmHg and cardiac index >or=2.4 l/min/m(2). Urinary albumin-creatinine and N-acetyl-B-D-glucosaminidase-creatinine ratios were measured as indicators of kidney injury. The definition of ARD was based on the RIFLE criteria. RESULTS: Kidney injury was found in most patients. ARD developed in 22% of the patients, and acute renal failure in 4%. The patients with ARD were older, and had lower plasma creatinine and estimated GFR before surgery. ARD was associated with intraoperative hypotension (MAP <60 mmHg >15 min), low cardiac index (<2.4 l/min/m(2)), rhabdomyolysis, and early reoperation. Intraoperative hypotension and postoperative low cardiac output were independent risk factors for ARD in multivariate analysis. CONCLUSIONS: Kidney injury occurs in most patients undergoing infrarenal aortic surgery, but only 22% develop acute renal dysfunction. Hypotension and low cardiac output are risk factors that could be avoided by optimizing perioperative management.
Authors:
M Tallgren; T Niemi; R Pöyhiä; E Raininko; M Railo; M Salmenperä; M Lepäntalo; M Hynninen
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2007-02-02
Journal Detail:
Title:  European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery     Volume:  33     ISSN:  1078-5884     ISO Abbreviation:  Eur J Vasc Endovasc Surg     Publication Date:  2007 May 
Date Detail:
Created Date:  2007-04-16     Completed Date:  2007-06-20     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9512728     Medline TA:  Eur J Vasc Endovasc Surg     Country:  England    
Other Details:
Languages:  eng     Pagination:  550-5     Citation Subset:  IM    
Affiliation:
Department of Anaesthesia and Intensive Care Medicine, Helsinki University Hospital, Helsinki, Finland. minna.tallgren@hus.fi
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MeSH Terms
Descriptor/Qualifier:
Acetylglucosaminidase / blood
Aged
Albuminuria / epidemiology
Aortic Aneurysm, Abdominal / surgery*
Cardiac Output, Low
Creatinine / blood
Female
Glomerular Filtration Rate
Humans
Kidney Failure, Acute / epidemiology
Male
Renal Insufficiency, Acute / epidemiology*
Risk Factors
Surgical Procedures, Elective
Vascular Surgical Procedures / adverse effects*
Chemical
Reg. No./Substance:
60-27-5/Creatinine; EC 3.2.1.52/Acetylglucosaminidase

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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