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Study Reports Risk Factors for Postoperative Renal Failure

Incidence of acute renal failure following non-cardiac surgery reported at 0.8 percent

THURSDAY, Nov. 29 (HealthDay News) -- Intraoperative vasopressor and diuretic use are independent predictors of postoperative acute renal failure in patients with previously normal renal function who undergo non-cardiac surgery, and those who develop acute renal failure have worsened short- and long-term mortality, according to research published in the December issue of Anesthesiology.

Sachin Kheterpal, M.D., of the University of Michigan in Ann Arbor, and colleagues followed 15,102 patients with previously normal renal function who underwent non-cardiac surgery at a single tertiary care hospital in order to determine the incidence and risk factors for postoperative acute renal failure, defined as a creatinine clearance of 50 mL/min or less, occurring within the first seven postoperative days.

In all, 121 patients developed acute renal failure (0.8 percent), of whom 14 required renal replacement therapy. Preoperative factors identified as independent predictors of acute renal failure included age, body mass index, emergent and high-risk surgery, and presence of liver disease, peripheral vascular occlusive disease, and chronic obstructive pulmonary disease requiring chronic bronchodilator therapy. Intraoperative factors that independently predicted acute renal failure included use of vasopressors and diuretics. Acute renal failure was associated with increased 30-day, 60-day and one-year mortality.

"By identifying the risk factors for acute renal failure after non-cardiac surgery, we are now able to provide patients and their clinicians with an estimation of their risk acute renal failure; this may be critical during surgical planning, counseling, and consenting processes," the authors write.

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