ArticleJA clinical reports2021
Analysis of intraoperative modifiable factors to prevent acute kidney injury after elective noncardiac surgery: intraoperative hypotension and crystalloid administration related to acute kidney injury.
Article in JA clinical reports, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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3 citing papers in PubMed, 12 citations in OpenAlex.
- Effects of intraoperative blood pressure variability on development of postoperative acute kidney injury among Japanese.Perioperative medicine (London, England) · 2026Article
- Risk factors for acute kidney injury in preterm neonates after noncardiac surgery: a single-center retrospective cohort study.Scientific reports · 2024Article
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2 authors at 2 institutions in 1 country.
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Abstract
backgroundThe optimal intraoperative blood pressure range and crystalloid administration protocol for the prevention of acute kidney injury (AKI) after elective noncardiac surgery remain unknown.
methodsThis single-center retrospective cohort study included 6296 patients aged ≥ 50 years who had undergone elective noncardiac surgery under general anesthesia. We evaluated the relationship between duration of intraoperative hypotension and AKI. To assess whether the effects of crystalloid administration differed according to baseline estimated glomerular filtration rate (eGFR), we examined the interaction between intraoperative crystalloid administration and eGFR. We calculated univariable and multivariable adjusted odds ratios (ORs) and their 95% confidence intervals (95% CIs) for the prevalence of AKI.
resultsAKI occurred in 431 (6.8%) patients and was associated with intraoperative hypotension. Effects of intraoperative crystalloid administration differed significantly according to baseline eGFR. Increased risk of AKI was noted in patients with eGFR ≤45 ml min
conclusionsOur findings suggest that anesthesiologists should avoid intraoperative hypotension as well as either restrictive or liberal (as opposed to moderately restrictive) crystalloid administration in patients with decreased eGFR. Intraoperative blood pressure and crystalloid administration protocol are major modifiable factors that must be optimized to prevent postoperative AKI.
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