ArticleDiseases of the colon and rectum2018
Acute Kidney Injury in the Age of Enhanced Recovery Protocols.
Article in Diseases of the colon and rectum, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 3 of them syntheses that pooled it.
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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.
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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.
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Who cites it
11 citing papers in PubMed, 3 syntheses or guidelines pooled it, 16 citations in OpenAlex.
- Risk factors for postoperative acute kidney injury in colorectal cancer: a systematic review and meta-analysis.International journal of colorectal disease · 2025Pooled it
- Prophylactic ureteral stent in colorectal surgery: a meta-analysis and systematic review.International urology and nephrology · 2025Pooled it
- Pooled it
- Impact of a kidney-adjusted ERASLangenbeck's archives of surgery · 2024Article
- Acute Kidney Injury within an Enhanced Recovery after Surgery (ERAS) Program for Colorectal Surgery.World journal of surgery · 2022Article
- Enhanced Recovery: A Decade of Experience and Future Prospects at the Mayo Clinic.Healthcare (Basel, Switzerland) · 2021Article
- Association of plasma and urine NGAL with acute kidney injury after elective colorectal surgery: A cohort study.Annals of medicine and surgery (2012) · 2021Article
- Postoperative Complications After Colorectal Surgery: Where Are We in the Era of Enhanced Recovery?Current gastroenterology reports · 2020Review
- Observational
- Using Electronic Medical Records to Identify Enhanced Recovery After Surgery Cases.EGEMS (Washington, DC) · 2019Article
- Early Acute Kidney Injury Within an Established Enhanced Recovery Pathway: Uncommon and Transitory.World journal of surgery · 2019Article
Corrections and comments
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Authors and funding
7 authors at 1 institution in 1 country.
Funding
Abstract
backgroundAcute kidney injury is a prevalent complication after abdominal surgery. With increasing adoption of enhanced recovery protocols, concern exists for concomitant increase in acute kidney injury.
objectiveThis study evaluated effects of enhanced recovery on acute kidney injury through identification of risk factors.
designThis was a retrospective cohort study comparing acute kidney injury rates before and after implementation of enhanced recovery protocol. SETTINGS: The study was conducted at a large academic medical center. PATIENTS: All of the patients undergoing elective colorectal surgery between 2010 and 2016, excluding patients with stage 5 chronic kidney disease, were included.
main outcome measuresPatients before and after enhanced recovery implementation were compared, with rate of acute kidney injury as the primary outcome. Acute kidney injury was defined as a rise in serum creatinine ≥1.5 times baseline within 30 days of surgery. Multivariable logistic regression identified risk factors for acute kidney injury.
resultsA total of 900 cases were identified, including 461 before and 439 after enhanced recovery; 114 cases were complicated by acute kidney injury, including 11.93% of patients before and 13.44% after implementation of enhanced recovery (p = 0.50). Five patients required hemodialysis, with 2 cases after protocol implementation. Multivariable logistic regression identified hypertension, functional status, ureteral stents, nonsteroidal anti-inflammatory drugs, operative time >200 minutes, and increased intravenous fluid administration on postoperative day 1 as predictors of acute kidney injury. Laparoscopic surgery decreased the risk of acute kidney injury. The enhanced recovery protocol was not independently associated with acute kidney injury. LIMITATIONS: The study was limited by its retrospective and nonrandomized before-and-after design.
conclusionsNo difference in rates of acute kidney injury was detected before and after implementation of a colorectal enhanced recovery protocol. Independent predictors of acute kidney injury were identified and could be used to alter the protocol in high-risk patients. Future study is needed to determine whether protocol modifications will further decrease rates of acute kidney injury in this population. See Video Abstract at http://links.lww.com/DCR/A568.
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