ArticleIntensive care medicine2024
Acute kidney disease beyond day 7 after major surgery: a secondary analysis of the EPIS-AKI trial.
Article in Intensive care medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.
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Who cites it
20 citing papers in PubMed, 27 citations in OpenAlex.
- Article
- Incidence, time trends and predictors of acute kidney injury in the region of Stockholm, Sweden.Scientific reports · 2026Article
- Renal consequences of complex abdominal wall reconstruction.Hernia : the journal of hernias and abdominal wall surgery · 2026Review
- Plasma NGAL-detected kidney injury following paediatric spine surgery: role of intraoperative hypotension.BMC nephrology · 2026Article
- Reply to the Commentary: Should Injectable Meloxicam Be Approved for Use in Cats?Journal of veterinary pharmacology and therapeutics · 2026Article
- Perioperative neutrophil-to-lymphocyte ratio trajectories and creatinine-defined acute kidney disease after cardiac surgery: a study using the INSPIRE database.Frontiers in cardiovascular medicine · 2026Article
- Risk prediction for acute kidney disease and adverse outcomes in patients with chronic obstructive pulmonary disease: an interpretable machine learning approach.Renal failure · 2025Article
- Article
- Acute kidney injury: pathogenesis and therapeutic interventions.Molecular biomedicine · 2025Review
- Article
- Preventing acute kidney injury and its longer-term impact in the critically ill.Intensive care medicine · 2025Review
- The burden of acute kidney disease: an epidemiological review and importance of follow-up care.Clinical kidney journal · 2025Review
- Article
- Kidney Injury Following Cardiac Surgery: A Review of Our Current Understanding.American journal of cardiovascular drugs : drugs, devices, and other interventions · 2025Review
- Ten tips on how to reduce iatrogenic acute kidney injury.Clinical kidney journal · 2025Review
- Article
- Recent advances of photoresponsive nanomaterials for diagnosis and treatment of acute kidney injury.Journal of nanobiotechnology · 2024Review
- Factors associated with acute kidney injury after on-pump coronary artery bypass grafting.Journal of cardiothoracic surgery · 2024Article
- Efficacy and safety of therapeutic alpha-1-microglobulin RMC-035 in reducing kidney injury after cardiac surgery: a multicentre, randomised, double-blind, parallel group, phase 2a trial.EClinicalMedicine · 2024Article
- Validation of a Prediction Model for Acute Kidney Injury after Cardiac Surgery in a Retrospective Asian Cohort.Journal of clinical medicine · 2024Article
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Authors and funding
14 authors at 9 institutions in 4 countries.
Funding
Abstract
purposeAcute kidney disease (AKD) is a significant health care burden worldwide. However, little is known about this complication after major surgery.
methodsWe conducted an international prospective, observational, multi-center study among patients undergoing major surgery. The primary study endpoint was the incidence of AKD (defined as new onset of estimated glomerular filtration rate (eCFR) < 60 ml/min/1.73 m
resultsWe studied 9510 patients without pre-existing CKD. Of these, 940 (9.9%) developed AKD after 7 days of whom 34.1% experiencing an episode of early postoperative-AKI. Rates of AKD after 7 days significantly increased with the severity (19.1% Kidney Disease Improving Global Outcomes [KDIGO] 1, 24.5% KDIGO2, 34.3% KDIGO3; P < 0.001) and duration (15.5% transient vs 38.3% persistent AKI; P < 0.001) of early postoperative-AKI. Independent risk factors for AKD included early postoperative-AKI, exposure to perioperative nephrotoxic agents, and postoperative pneumonia. Early postoperative-AKI carried an independent odds ratio for AKD of 2.64 (95% confidence interval [CI] 2.21-3.15). Of 663 patients with pre-existing CKD, 42 (6.3%) had worsening CKD at day 90. In patients with CKD and an episode of early AKI, CKD progression occurred in 11.6%.
conclusionOne in ten major surgery patients developed AKD beyond 7 days after surgery, in most cases without an episode of early postoperative-AKI. However, early postoperative-AKI severity and duration were associated with an increased rate of AKD and early postoperative-AKI was strongly associated with AKD independent of all other potential risk factors.
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