Association Between Preoperative CKD and Postoperative Outcomes 

Although chronic kidney disease (CKD) is associated with a greater incidence of major surgery, previous studies have not examined the association between preoperative kidney function and postoperative outcomes across a wide range of procedures. To address this gap, Carlos Riveros , MD, and colleagues evaluated the association between CKD and 30-day postoperative outcomes across eight surgical specialties. 

A total of 1,912,682 adult patients were included in the study. The primary endpoint was major complications, death, unplanned reoperation, cardiac complication, or stroke within 30 days following surgery. Secondary endpoints included Clavien-Dindo high-grade complications and cardiac, pulmonary, infectious, and thromboembolic complications. 

The researchers used multivariable regression to evaluate the association between CKD and 30-day postoperative complications, adjusting for baseline characteristics, surgical specialty, and operative time. Patients with CKD stage 5 had higher odds of major complications (adjusted odds ratio [aOR], 2.14; 95% CI, 2.07-2.21), death (aOR, 3.03; 95% CI, 2.88-3.19), unplanned reoperation (aOR, 1.57; 95% CI, 1.51-1.64), cardiac complication (aOR, 3.51; 95% CI, 3.25-3.80), and stroke (aOR, 1.89; 95% CI, 1.64-2.17) than those with stage 1. The pattern was similar for the secondary endpoints. 

In summary, the authors wrote, “This population-based study demonstrates the negative impact of CKD on operative outcomes across a diverse range of procedures and patients.” 

Source: BMC Nephrology.