Postoperative Acute Kidney Injury Is Associated With Progression of Chronic Kidney Disease Independent of Severity.
To access publisher's full text version of this article click on the hyperlink below Background: Both postoperative acute kidney injury (AKI) and preoperative chronic kidney disease (CKD) are associated with significantly worse outcomes following surgery. The relationship of both of these condi...
Published in: | Anesthesia & Analgesia |
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Format: | Article in Journal/Newspaper |
Language: | English |
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Lippincott Williams & Wilkins
2022
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Online Access: | http://hdl.handle.net/2336/622081 https://doi.org/10.1213/ANE.0000000000005702 |
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ftlandspitaliuni:oai:www.hirsla.lsh.is:2336/622081 |
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Hirsla - Landspítali University Hospital research archive |
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ftlandspitaliuni |
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English |
topic |
Skurðlækningar Nýrnabilun Nýrnasjúkdómar Acute Kidney Injury Disease Progression Postoperative Period Renal Insufficiency Chronic |
spellingShingle |
Skurðlækningar Nýrnabilun Nýrnasjúkdómar Acute Kidney Injury Disease Progression Postoperative Period Renal Insufficiency Chronic Privratsky, Jamie R Krishnamoorthy, Vijay Raghunathan, Karthik Ohnuma, Tetsu Rasouli, Mohammad R Long, Thorir E Sigurdsson, Martin I Postoperative Acute Kidney Injury Is Associated With Progression of Chronic Kidney Disease Independent of Severity. |
topic_facet |
Skurðlækningar Nýrnabilun Nýrnasjúkdómar Acute Kidney Injury Disease Progression Postoperative Period Renal Insufficiency Chronic |
description |
To access publisher's full text version of this article click on the hyperlink below Background: Both postoperative acute kidney injury (AKI) and preoperative chronic kidney disease (CKD) are associated with significantly worse outcomes following surgery. The relationship of both of these conditions with each other and with CKD progression after surgery remains poorly studied. Our objective was to assess if there was an interaction between preoperative kidney function estimated by preoperative estimated glomerular filtration rate (eGFR)/CKD stage, postoperative AKI, and eGFR/CKD progression within 1 year of surgery. Our hypothesis was that AKI severity would be associated with a faster time to eGFR/CKD stage progression within 1 year of surgery in a graded-fashion, which would be exacerbated by preoperative kidney dysfunction. Methods: This was a retrospective cohort study at Landspitali University Hospital in Iceland, which serves about 75% of the population. Participants included adults receiving their first major anesthetic between 2005 and 2018. Patients with CKD stage 5, undergoing major urologic procedures, or having missing creatinine values for follow-up of eGFR stage were excluded from analysis. The primary exposure was postoperative AKI stage within 7 days after surgery classified by the kidney disease improving global outcome (KDIGO) criteria. The primary outcome was time to progression of CKD by at least 1 eGFR/CKD stage within 1-year following surgery. Multivariable Cox proportional hazards models were used to estimate hazard of eGFR/CKD stage progression, including an interaction between AKI and preoperative CKD on eGFR/CKD stage progression. Results: A total of 5548 patients were studied. In the multivariable model adjusting for baseline eGFR/CKD stage, when compared to patients without AKI, postoperative AKI stage 1 (hazard ratio [HR], 5.91; 95% confidence interval [CI], 4.34-8.05), stage 2 (HR, 3.86; 95% CI, 1.82-8.16), and stage 3 (HR, 3.61; 95% CI, 1.49-8.74) were all independently ... |
author2 |
1From the Critical Care and Perioperative Population Health Research (CAPER) Unit. 2Center for Perioperative Organ Protection (CPOP), Department of Anesthesiology, Duke University Medical Center, Durham, North Carolina. 3Anesthesiology Service Division, Durham Veterans Affairs Medical Center, Durham, North Carolina. 4Department of Anesthesiology, Stanford University, Palo Alto, California. 5Division of Nephrology, Department of Medicine. 6Division of Anesthesia and Intensive Care Medicine, Landspitali-The National University Hospital of Iceland, Reykjavik, Iceland. 7Faculty of Medicine, University of Iceland, Reykjavik, Iceland. |
format |
Article in Journal/Newspaper |
author |
Privratsky, Jamie R Krishnamoorthy, Vijay Raghunathan, Karthik Ohnuma, Tetsu Rasouli, Mohammad R Long, Thorir E Sigurdsson, Martin I |
author_facet |
Privratsky, Jamie R Krishnamoorthy, Vijay Raghunathan, Karthik Ohnuma, Tetsu Rasouli, Mohammad R Long, Thorir E Sigurdsson, Martin I |
author_sort |
Privratsky, Jamie R |
title |
Postoperative Acute Kidney Injury Is Associated With Progression of Chronic Kidney Disease Independent of Severity. |
title_short |
Postoperative Acute Kidney Injury Is Associated With Progression of Chronic Kidney Disease Independent of Severity. |
title_full |
Postoperative Acute Kidney Injury Is Associated With Progression of Chronic Kidney Disease Independent of Severity. |
title_fullStr |
Postoperative Acute Kidney Injury Is Associated With Progression of Chronic Kidney Disease Independent of Severity. |
title_full_unstemmed |
Postoperative Acute Kidney Injury Is Associated With Progression of Chronic Kidney Disease Independent of Severity. |
title_sort |
postoperative acute kidney injury is associated with progression of chronic kidney disease independent of severity. |
publisher |
Lippincott Williams & Wilkins |
publishDate |
2022 |
url |
http://hdl.handle.net/2336/622081 https://doi.org/10.1213/ANE.0000000000005702 |
genre |
Iceland |
genre_facet |
Iceland |
op_source |
Anesthesia and analgesia 134 1 49 58 United States |
op_relation |
https://journals.lww.com/anesthesia-analgesia/Fulltext/2022/01000/Postoperative_Acute_Kidney_Injury_Is_Associated.11.aspx Privratsky JR, Krishnamoorthy V, Raghunathan K, et al. Postoperative Acute Kidney Injury Is Associated With Progression of Chronic Kidney Disease Independent of Severity. Anesth Analg. 2022;134(1):49-58. doi:10.1213/ANE.0000000000005702 34908546 doi:10.1213/ANE.0000000000005702 http://hdl.handle.net/2336/622081 1526-7598 Anesthesia and analgesia |
op_rights |
Copyright © 2021 International Anesthesia Research Society. Landspitali Access - LSH-aðgangur |
op_doi |
https://doi.org/10.1213/ANE.0000000000005702 |
container_title |
Anesthesia & Analgesia |
container_volume |
Publish Ahead of |
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1766042403072901120 |
spelling |
ftlandspitaliuni:oai:www.hirsla.lsh.is:2336/622081 2023-05-15T16:52:15+02:00 Postoperative Acute Kidney Injury Is Associated With Progression of Chronic Kidney Disease Independent of Severity. Privratsky, Jamie R Krishnamoorthy, Vijay Raghunathan, Karthik Ohnuma, Tetsu Rasouli, Mohammad R Long, Thorir E Sigurdsson, Martin I 1From the Critical Care and Perioperative Population Health Research (CAPER) Unit. 2Center for Perioperative Organ Protection (CPOP), Department of Anesthesiology, Duke University Medical Center, Durham, North Carolina. 3Anesthesiology Service Division, Durham Veterans Affairs Medical Center, Durham, North Carolina. 4Department of Anesthesiology, Stanford University, Palo Alto, California. 5Division of Nephrology, Department of Medicine. 6Division of Anesthesia and Intensive Care Medicine, Landspitali-The National University Hospital of Iceland, Reykjavik, Iceland. 7Faculty of Medicine, University of Iceland, Reykjavik, Iceland. 2022-02 http://hdl.handle.net/2336/622081 https://doi.org/10.1213/ANE.0000000000005702 en eng Lippincott Williams & Wilkins https://journals.lww.com/anesthesia-analgesia/Fulltext/2022/01000/Postoperative_Acute_Kidney_Injury_Is_Associated.11.aspx Privratsky JR, Krishnamoorthy V, Raghunathan K, et al. Postoperative Acute Kidney Injury Is Associated With Progression of Chronic Kidney Disease Independent of Severity. Anesth Analg. 2022;134(1):49-58. doi:10.1213/ANE.0000000000005702 34908546 doi:10.1213/ANE.0000000000005702 http://hdl.handle.net/2336/622081 1526-7598 Anesthesia and analgesia Copyright © 2021 International Anesthesia Research Society. Landspitali Access - LSH-aðgangur Anesthesia and analgesia 134 1 49 58 United States Skurðlækningar Nýrnabilun Nýrnasjúkdómar Acute Kidney Injury Disease Progression Postoperative Period Renal Insufficiency Chronic Article 2022 ftlandspitaliuni https://doi.org/10.1213/ANE.0000000000005702 2022-05-29T08:22:42Z To access publisher's full text version of this article click on the hyperlink below Background: Both postoperative acute kidney injury (AKI) and preoperative chronic kidney disease (CKD) are associated with significantly worse outcomes following surgery. The relationship of both of these conditions with each other and with CKD progression after surgery remains poorly studied. Our objective was to assess if there was an interaction between preoperative kidney function estimated by preoperative estimated glomerular filtration rate (eGFR)/CKD stage, postoperative AKI, and eGFR/CKD progression within 1 year of surgery. Our hypothesis was that AKI severity would be associated with a faster time to eGFR/CKD stage progression within 1 year of surgery in a graded-fashion, which would be exacerbated by preoperative kidney dysfunction. Methods: This was a retrospective cohort study at Landspitali University Hospital in Iceland, which serves about 75% of the population. Participants included adults receiving their first major anesthetic between 2005 and 2018. Patients with CKD stage 5, undergoing major urologic procedures, or having missing creatinine values for follow-up of eGFR stage were excluded from analysis. The primary exposure was postoperative AKI stage within 7 days after surgery classified by the kidney disease improving global outcome (KDIGO) criteria. The primary outcome was time to progression of CKD by at least 1 eGFR/CKD stage within 1-year following surgery. Multivariable Cox proportional hazards models were used to estimate hazard of eGFR/CKD stage progression, including an interaction between AKI and preoperative CKD on eGFR/CKD stage progression. Results: A total of 5548 patients were studied. In the multivariable model adjusting for baseline eGFR/CKD stage, when compared to patients without AKI, postoperative AKI stage 1 (hazard ratio [HR], 5.91; 95% confidence interval [CI], 4.34-8.05), stage 2 (HR, 3.86; 95% CI, 1.82-8.16), and stage 3 (HR, 3.61; 95% CI, 1.49-8.74) were all independently ... Article in Journal/Newspaper Iceland Hirsla - Landspítali University Hospital research archive Anesthesia & Analgesia Publish Ahead of |