Patients in study:
(1) 475 consecutive patients over a 12 year period
(2) 25% developed acute renal failure
(3) 9% required hemodialysis
Factors identified by multivariate analysis:
(1) preoperative creatinine
(2) age
(3) use of Cell-Saver (blood recovery autotransfusion) during surgery
(4) units of packed red blood cells used during surgery
(5) duration of left renal ischemia
|
Risk Factor for Acute Renal Failure
|
Odds Ratio
|
95% CI
|
|
preoperative creatinine > 120 µmol/L
|
2.76
|
1.70 – 4.48
|
|
age > 50 years
|
2.90
|
1.52 – 5.53
|
|
Cell-Saver > 5 units
|
2.31
|
1.34 – 3.96
|
|
packed red blood cells > 5 units
|
2.04
|
1.24 – 3.37
|
|
left renal ischemia > 30 minutes
|
2.01
|
1.27 – 3.17
|
from Table 3, page 1231
Factors found not to be predictive of post-operative renal failure:
(1) reimplantation of visceral, renal arteries and the Adamkievicz artery
(2) duration of visceral, spinal and right kidney ischemia
(3) use of fresh frozen plasma
(4) administration of aprotinin
(5) extracorporeal circulation
(6) procedures with circulatory arrest and profound hypothermia
|
Risk Factor for Acute Renal Failure Requiring Hemodialysis
|
Odds Ratio
|
95% CI
|
|
preoperative creatinine > 120 µmol/L
|
2.26
|
1.13 – 4.53
|
|
age > 50 years
|
5.59
|
1.31 – 23.91
|
|
packed red blood cells > 5 units
|
3.91
|
1.58 – 9.67
|
from Table 3, page 1231
Other factors associated with acute renal failure:
(1) pre-existing renal arterial stenosis
(2) development of multiple organ failure
(3) use of nephrotoxic drugs
