Perioperative medicine & outcomes
Advanced chronic kidney disease after surgery and the contribution of acute kidney disease: a national observational cohort study
Authors' conclusion
Advanced CKD within 1 yr after surgery is uncommon but clinically important in patients without preoperative renal dysfunction. Advanced AKD after surgery constitutes a major risk factor for advanced CKD and MAKE365.
Study context
- Population
- Adults without renal dysfunction before noncardiac surgery in Sweden, 2007–2013
- Participants
- 237,124 adults
- Exposure
- Advanced acute kidney disease (AKD) vs no advanced AKD after surgery
- Advanced AKDn = 1,661
- Outcome
- Advanced CKD (eGFR <30 ml min-1 1.73 m-2) and MAKE365 (eGFR <30 ml min-1 1.73 m-2, chronic dialysis, death)
- Follow-up
- 1 yr
Methodological detailsmulticentre, national registry linkage
- Multicentre
- National registry linkage
Main finding
As reported in the abstract
Incidence of advanced CKD and MAKE365
Advanced chronic kidney disease (CKD)
1597
0.67%
MAKE365
16,789
7.1%
Observational data: associations, not effects.
Further findings
| Outcome | Advanced AKD | Estimate | |
|---|---|---|---|
| Advanced CKD by advanced AKD · 1 yr | 36% | SHR 44.5 (95% CI 38.7–51.1) | |
| MAKE365 by advanced AKD · 1 yr | 51% | HR 6.60 (95% CI 6.07–7.17) | |
| 0.050.21520Ratio (log scale) |
Risk factors for advanced CKD
- Higher ASA physical status, urological surgery, extended surgical duration, prolonged postoperative LOS, repeated surgery, postoperative renin-angiotensin-aldosterone system blockers
Original publication
Advanced chronic kidney disease after surgery and the contribution of acute kidney disease: a national observational cohort study. Br J Anaesth. Published 28 March 2024. doi:10.
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