Perioperative medicine & outcomes
Perioperative Hypotension in Chronic Kidney Disease Patients with Dialysis Undergoing Noncardiac Surgery: A Retrospective Cohort Study
Authors' conclusion
Perioperative hypotension is more severe and common among patients who undergo chronic maintenance dialysis compared to similar patients without dialysis dependence.
Study context
- Population
- Adults having inpatient noncardiac surgery >2 h under GA, Cleveland Clinic, January 2012–December 2021matched from 123,761
- Participants
- 5,658 adults
- Exposure
- Dialysis-dependent CKD vs nondialysis CKD vs no kidney disease
- Dialysis-dependent CKDn = 1,886
- Nondialysis CKDn = 1,886reference
- No kidney diseasen = 1,886reference
- Outcome
- Total area under the curve of mean arterial pressure (MAP) <65 mmHg during surgery and postoperative MAP <70 mmHg
- Follow-up
- Intraoperative; 48 h after surgery
Methodological detailspropensity-score matched, 1:1:1 matched groups, single-centre
- Propensity-score matched
- 1:1:1 matched groups
- Single-centre
Main finding
As reported in the abstract
Intraoperative area under the curve of MAP <65 mmHg; postoperative MAP <70 mmHg
Difference in medians, mmHg-min (98.75% CI)P value
Dialysis-dependent CKD vs Nondialysis CKDintraoperative AUC MAP <65 mmHg
18.4(11.3–25.6)
P < 0.001Dialysis-dependent CKD vs No kidney diseaseintraoperative AUC MAP <65 mmHg
15.5(6.6–24.4)
P < 0.001Rate ratio (98.75% CI)P value
Dialysis-dependent CKD vs Nondialysis CKDpostoperative MAP <70 mmHg
1.52(1.48–1.57)
P < 0.0001Dialysis-dependent CKD vs No kidney diseasepostoperative MAP <70 mmHg
1.43(1.38–1.47)
P < 0.0001Observational data: associations, not effects.
Original publication
Perioperative Hypotension in Chronic Kidney Disease Patients with Dialysis Undergoing Noncardiac Surgery: A Retrospective Cohort Study. Anesthesiology. Published 7 October 2024. doi:10.
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