The association between pre‐operative variables, including blood pressure, and postoperative kidney function

• Published in: Anaesthesia 2016-12, Vol.71 (12), p.1417-1423
• Main Authors: Kendale, S. M., Lapis, P. N., Melhem, S. M., Blitz, J. D.
• Format: Article
• Language: English
• Subjects: Anesthesia; Blood pressure; Circulatory system; Kidneys; logistic regression: odds ratio; peri‐operative antihypertensive drug management; peri‐operative renal failure: predictor; Pneumoviridae; Postoperative period; Risk factors
• ISSN: 0003-2409; 1365-2044
• DOI: 10.1111/anae.13632

Summary We used multivariate analyses to assess the association of pre‐operative variables with kidney function in 41,523 adults after scheduled surgery in a single large academic hospital. Eight variables were independently associated with a reduction in postoperative estimated glomerular filtration rate: pre‐operative renal function; age; ASA physical status; cardiac failure; anaemia; cancer; type of surgery; and the lowest quartile of pre‐operative mean arterial blood pressure (< 71 mmHg). The estimated glomerular filtration rate fell by a mean (95% CI) of 2.7 (0.04–5.40) ml.min−1.1.73 m−2 for patients with a pre‐operative mean arterial pressure < 71 mmHg, p = 0.047. The same variables and male sex were associated with postoperative acute kidney injury. The odds ratio (95% CI) for acute postoperative kidney injury was 1.9 (1.2–2.9) for patients with a pre‐operative mean arterial blood pressure < 71 mmHg, p = 0.005. ☛ CPD available at http://www.learnataagbi.org