Association of Preoperative Risk Factors with Postoperative Acute Renal Failure

• Published in: Anesthesia and analgesia Vol. 78; no. 1; pp. 143 - 149
• Main Authors: Novis, Bruce K., Roizen, Michael F., Aronson, Solomon, Thisted, Ronald A.
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD International Anesthesia Research Society 01-01-1994; Lippincott
• Subjects: Acute Kidney Injury - epidemiology; Acute Kidney Injury - etiology; Age Factors; Aged; Biological and medical sciences; Female; Heart - physiology; Humans; Kidneys; Male; Medical sciences; Middle Aged; Nephrology. Urinary tract diseases; Postoperative Complications - epidemiology; Preoperative Care; Risk Factors; Sex Factors; Urinary system involvement in other diseases. Miscellaneous; Human; Postoperative; Surgery; Risk factor; Renal failure; Complication; Intraoperative
• ISSN: 0003-2999; 1526-7598
• DOI: 10.1213/00000539-199401000-00023

We performed a systematic review of 28 studies that examined preoperative risk factors for postoperative renal failure. Included in the studies were 10,865 patients who underwent either vascular, cardiac, general, or biliary surgery. No two studies used the same criteria for acute renal failure. Variability in definitions of renal failure, lack of consistent criteria for establishing risk factors, and nonuniformity in the statistical methods employed result in a literature that is not adequate to support a comprehensive quantitative review. Of the 30 variables considered in the studies, preoperative renal risk factors, such as increased serum creatinine, increased blood urea nitrogen, and preoperative renal dysfunction were repeatedly found to predict postoperative renal dysfunction. The literature provides little quantitative information concerning the degree of risk associated with other factors. Cardiac risk factors, such as left ventricular dysfunction, were reported to be predictive of postoperative renal failure more consistently than was advanced age.