Perioperative medicine & outcomes
Progression of chronic kidney disease after non-cardiac surgery: A retrospective cohort study
Main finding · eGFR change from baseline to follow-upResult — go to the resultDifference in means 8.9 95 % CI 8.5–9.3Authors' conclusion
Contrary to expectations, patients with preoperative CKD experienced a significant improvement in eGFR postoperatively. Patients without CKD exhibited minimal change. Postoperative AKI negated the eGFR improvement in CKD patients and exacerbated the decline in non-CKD patients.
Study context
- Population
- Noncardiac surgery patients with creatinine documented preoperatively and 1–2 years after surgery17 % preoperative chronic-kidney-disease (CKD)
- Participants
- 58,175 patients
- Exposure
- Preoperative CKD vs no CKD
- Outcome
- Long-term course of kidney function: change in eGFR (mL/min/1.73m2)
- Follow-up
- Between 1 and 2 years after surgery
Methodological detailssingle-centre
- Single-centre
Main finding
eGFR change from baseline to follow-up
Difference in means
8.9
95 % CI 8.5–9.3
P < 0.0001
Change by group
non-CKD
90.1
mean · SD 16.7 · mL/min/1.73m2
CKD
45.6
mean · SD 11.9 · mL/min/1.73m2
CKD vs non-CKD
difference in means 8.9 (95 % CI 8.5–9.3); P < 0.0001
As reported in the abstract
Observational data: associations, not effects.
Further findings
| Outcome | Values |
|---|---|
| eGFR change by postoperative AKI stage (subgroup), CKDeGFR increase from baseline | CKD, no AKI 11.7 (SD 18.0) · CKD, AKI stage 1 7.7 (SD 17.9) · CKD, AKI stage 2 2.4 (SD 15.0) · CKD, AKI stage 3 7.3 (SD 25.8) |
| eGFR change by postoperative AKI stage (subgroup), non-CKD | non-CKD, no AKI 2.3 (SD 13.7) · non-CKD, AKI stage 1 5.5 (SD 19.0) · non-CKD, AKI stage 2 7.7 (SD 21.8) · non-CKD, AKI stage 3 9.3 (SD 21.3) |
- Estimated glomerular filtration rate (eGFR) change by postoperative acute kidney injury (AKI) stage (subgroup), CKD: interaction P = 0.001 (CKD-dependent eGFR change × postoperative AKI)
- eGFR change by postoperative AKI stage (subgroup), non-CKD: increase with no AKI; decrease with AKI stages 1–3
Original publication
Progression of chronic kidney disease after non-cardiac surgery: A retrospective cohort study. J Clin Anesth. Published 16 January 2025. doi:10.
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