Evidence map›Paper›PMID 26337133›Full record

Observational studyAmerican journal of kidney diseases : the official journal of the National Kidney Foundation2016

Acute Kidney Injury After Major Surgery: A Retrospective Analysis of Veterans Health Administration Data.

Morgan E Grams, Yingying Sang, Josef Coresh, Shoshana Ballew, Kunihiro Matsushita, Miklos Z Molnar, Zoltan Szabo, Kamyar Kalantar-Zadeh, Csaba P Kovesdy

2 registry-linked trialsAbstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in American journal of kidney diseases : the official journal of the National Kidney Foundation, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 176 papers, 12 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
176citing papers in PubMed, 12 pooled it
14.7field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03880110 unknown statusnot on this mapstarted 2019, after this paper: background citation

Combination of Biomarkers, Urine Sedimentation and Renal Resistive Index for Early Prediction of Acute Kidney Injury in High Risk Patients After Non-cardiac Surgery: a Prospective Observational Cohort Study

TypeobservationalSponsorPeking University First HospitalRan2019 to 2021Enrolled1,000ConditionsAcute Kidney Injury
NCT06857630 recruitingnot on this mapstarted 2025, after this paper: background citation

The Association Between Preoperative Hemoglobin and Acute Kidney Injury in Emergency Surgery: A Prospective Observational Study

Typeobservational_patient_registrySponsorSamsun UniversityRan2025 to 2027Enrolled420ConditionsEmergency Surgery, Acute Kidney Injury, HemoglobinArmsObservational
3 · Its place in the literature

Who cites it

176 citing papers in PubMed, 12 syntheses or guidelines pooled it, 348 citations in OpenAlex.

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  3. Long-term risks of adverse kidney outcomes after acute kidney injury: a systematic review and meta-analysis.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2025
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116 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors at 5 institutions in 2 countries.

Morgan E GramsDepartment of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD. Electronic address: mgrams2@jhmi.edu.
Yingying SangDepartment of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD.
Josef CoreshDepartment of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD; Department of Biostatistics, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD.
Shoshana BallewDepartment of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD.
Kunihiro MatsushitaDepartment of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD.
Miklos Z MolnarDivision of Nephrology, University of Tennessee Health Science Center, Memphis, TN.
Zoltan SzaboDepartment of Cardiothoracic Surgery and Cardiothoracic Anesthesia, Linköping University Hospital, Linköping, Sweden; Division of Cardiovascular Medicine, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
Kamyar Kalantar-ZadehHarold Simmons Center for Chronic Disease Research & Epidemiology, University of California Irvine Medical Center, Irvine, CA; Division of Nephrology & Hypertension, University of California Irvine Medical Center, Orange, CA.
Csaba P KovesdyDivision of Nephrology, University of Tennessee Health Science Center, Memphis, TN; Nephrology Section, Memphis Veterans Affairs Medical Center, Memphis, TN.
Johns Hopkins University · USUniversity of Tennessee Health Science Center · USJohns Hopkins Medicine · USLinköping University Hospital · SEUniversity of California, Irvine Medical Center · US

Funding

Chronic Kidney Disease Prognosis Consortium (CKD-PC)R01DK100446 · NIDDK · NEW YORK UNIVERSITY SCHOOL OF MEDICINE · PI JOSEF CORESH, Morgan Erika Grams · 2014 to 2026
$10.7M
Racial and Cardiovascular Risk Factor Anomalies in CKDR01DK096920 · NIDDK · UNIVERSITY OF TENNESSEE HEALTH SCI CTR · PI KALANTAR-ZADEH, KAMYAR, KOVESDY, CSABA PAL · 2013 to 2015
$909k
The comparative effectiveness of kidney transplantation in advanced CKDK08DK092287 · NIDDK · JOHNS HOPKINS UNIVERSITY · PI GRAMS, MORGAN ERIKA · 2012 to 2016
$793k
HSRD VA SDR 02-237NIDDK NIH HHS K08 DK092287NIDDK NIH HHS R01 DK096920NIDDK NIH HHS R01 DK100446
6 · The paper itself

Abstract

backgroundFew trials of acute kidney injury (AKI) prevention after surgery have been conducted, and most observational studies focus on AKI following cardiac surgery. The frequency of, risk factors for, and outcomes after AKI following other types of major surgery have not been well characterized and may present additional opportunities for trials in AKI. STUDY

designObservational cohort study. SETTING &

participants3.6 million US veterans followed up from 2004 to 2011 for the receipt of major surgery (cardiac; general; ear, nose, and throat; thoracic; vascular; urologic; and orthopedic) and postoperative outcomes. FACTORS: Demographics, health characteristics, and type of surgery. OUTCOMES: Postoperative AKI defined by the KDIGO creatinine criteria, postoperative length of stay, end-stage renal disease, and mortality.

resultsPostoperative AKI occurred in 11.8% of the 161,185 major surgery hospitalizations (stage 1, 76%; stage 2, 15%, stage 3 [without dialysis], 7%; and AKI requiring dialysis, 2%). Cardiac surgery had the highest postoperative AKI risk (relative risk [RR], 1.22; 95% CI, 1.17-1.27), followed by general (reference), thoracic (RR, 0.92; 95% CI, 0.87-0.98), orthopedic (RR, 0.70; 95% CI, 0.67-0.73), vascular (RR, 0.68; 95% CI, 0.64-0.71), urologic (RR, 0.65; 95% CI, 0.61-0.69), and ear, nose, and throat (RR, 0.32; 95% CI, 0.28-0.37) surgery. Risk factors for postoperative AKI included older age, African American race, hypertension, diabetes mellitus, and, for estimated glomerular filtration rate < 90mL/min/1.73m(2), lower estimated glomerular filtration rate. Participants with postoperative AKI had longer lengths of stay (15.8 vs 8.6 days) and higher rates of 30-day hospital readmission (21% vs 13%), 1-year end-stage renal disease (0.94% vs 0.05%), and mortality (19% vs 8%), with similar associations by type of surgery and more severe stage of AKI relating to poorer outcomes. LIMITATIONS: Urine output was not available to classify AKI; cohort included mostly men.

conclusionsAKI was common after major surgery, with similar risk factor and outcome associations across surgery type. These results can inform the design of clinical trials in postoperative AKI to the noncardiac surgery setting.

Indexed as

Veterans HealthAcute Kidney InjuryAgedCohort StudiesFemaleHumansMaleMiddle AgedPostoperative ComplicationsRetrospective StudiesRisk FactorsAcute kidney injury (AKI)end-stage renal disease (ESRD)hospital length of stayKDIGO creatinine criteriakidney functionmortalitypostoperative AKIsurgerysurgical complication

Identifiers

PMID26337133
PMCPMC4775458
OpenAlexW1802532219

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.