Expert Commentary on Postoperative Acute Kidney Injury in Colorectal Surgery

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Evangelos Messaris
Keyword(s):  
Acute Kidney Injury ◽  
Colorectal Surgery ◽  
Kidney Injury ◽  
Expert Commentary

scholarly journals P7: ACUTE KIDNEY INJURY AFTER ELECTIVE COLORECTAL SURGERY: RESULTS OF A NATIONAL CLOSED-LOOP AUDIT

2021 ◽  
Vol 108 (Supplement_1) ◽  
Author(s):  
Keyword(s):  
Acute Kidney Injury ◽  
Quality Improvement ◽  
Colorectal Surgery ◽  
Prognostic Score ◽  
Univariate Analysis ◽  
Kidney Injury ◽  
Elective Colorectal Surgery ◽  
National Quality ◽  
Significant Difference ◽  
The Uk

Abstract Introduction The aim of this study was to re-audit the rates of acute kidney injury (AKI) after elective colorectal surgery, following local presentations of results. Method Outcomes After Kidney injury in Surgery (OAKS) and Ileus Management International (IMAGINE), were prospective multicentre audits on consecutive elective colorectal resections, in the UK and Ireland. These were performed over 3-month periods in 2015 and 2018 respectively. During the interim period, results were presented at participating centres to stimulate local quality improvement initiatives. Risk-adjusted 7-day postoperative AKI rates were calculated through multilevel logistic regression based on the OAKS prognostic score. Result Of the 4,917 patients included, 3,133 (63.7%) originated from OAKS and 1,784 (36.3%) from IMAGINE. On univariate analysis, there was no significant difference (p=0.737) in the 7-day AKI rate between OAKS (n=346, 11.8%) and IMAGINE (n=205, 11.5%). However, the risk-adjusted AKI rate in IMAGINE was significantly lower compared to OAKS (-1.8%, 95% CI: -2.3% to -1.3%, p<0.001). Of 47 centres (40.1%) with a recorded local presentation, there was no significant difference in the subsequent AKI rate in IMAGINE (-0.7%, -2.0% to 0.6%, p=0.278). Conclusion Rates of AKI after elective colorectal surgery significantly reduced on re-audit. However, this may be related to increased awareness from participation or national quality improvement initiatives, rather than local presentation of results. Abbrev. AKI - Acute Kidney Injury, OAKS - Outcomes After Kidney injury in Surgery, IMAGINE - Ileus Management International Take-home message Risk-adjusted AKI rates significantly reduced on re-audit, however, this was most likely due to factors separate from the local presentation of initial results.

Ureteral stents increase risk of postoperative acute kidney injury following colorectal surgery

2018 ◽  
Vol 32 (7) ◽  
pp. 3342-3348 ◽  
Author(s):  
Taryn E. Hassinger ◽  
J. Hunter Mehaffey ◽  
Matthew G. Mullen ◽  
Alex D. Michaels ◽  
Nathan R. Elwood ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Colorectal Surgery ◽  
Kidney Injury ◽  
Ureteral Stents ◽  
Increase Risk

The Association of Enhanced Recovery Pathway and Acute Kidney Injury in Patients Undergoing Colorectal Surgery

2020 ◽  
Vol 63 (2) ◽  
pp. 233-241 ◽  
Author(s):  
Jameson G.D. Wiener ◽  
Lauren Goss ◽  
Tyler S. Wahl ◽  
Morgan A. Terry ◽  
Kaitlin G. Burge ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Colorectal Surgery ◽  
Enhanced Recovery ◽  
Kidney Injury ◽  
Enhanced Recovery Pathway

Acute kidney injury after colorectal surgery with an enhanced recovery pathway

Surgery Today ◽  
2020 ◽  
Author(s):  
Kai Su ◽  
Fu-Shan Xue ◽  
Zhao-Jing Xue ◽  
Lei Wan
Keyword(s):  
Acute Kidney Injury ◽  
Colorectal Surgery ◽  
Enhanced Recovery ◽  
Kidney Injury ◽  
Enhanced Recovery Pathway

Caution: Increased Acute Kidney Injury in Enhanced Recovery after Surgery (ERAS) Protocols

2019 ◽  
Vol 85 (2) ◽  
pp. 156-161 ◽  
Author(s):  
Crystal P. Koerner ◽  
Alexandra G. Lopez-Aguiar ◽  
Mohammad Zaidi ◽  
Shelby Speegle ◽  
Glen Balch ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Colorectal Surgery ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Kidney Injury ◽  
Morbidity And Mortality ◽  
Elective Colorectal Surgery ◽  
Baseline Serum ◽  
Increased Risk ◽  
Postoperative Aki

Minimizing perioperative fluid administration is a key component of enhanced recovery after surgery protocols (ERAS). Acute kidney injury (AKI) is a major cause of morbidity and mortality in hospitalized patients. Our aim was to assess the association of ERAS with the incidence and severity of AKI in patients undergoing elective colorectal surgery. In this single-study retrospective review, patients undergoing colorectal surgery from 2013 to 2017 were included. Primary endpoint was postoperative AKI. Secondary outcomes were hospital length of stay (LOS) and 30-day readmission. Baseline demographics and procedure types were similar between both groups. AKI was higher in the ERAS versus non-ERAS group (23 vs 9%; P = 0.002). Factors associated with increased risk of AKI on univariate regression included presence of preoperative cardiovascular risk factors (hazard ratio (HR) 3.5; 95% CI 1.3–9.7; P < 0.01), more complex colorectal operations (HR 5.1; 95% CI 1.6–16.1; P < 0.01), and management with an ERAS pathway (HR 2.9; 95% CI 1.5–5.8; P < 0.01). On multi-variable analysis, ERAS remained a significant risk factor for developing AKI (HR 3.44; 95% CI 1.5–7.7; P < 0.01). ERAS patients had a shorter hospital LOS (3.9 vs 5.9 days, P < 00.1) compared with non-ERAS patients, with no difference in 30-day readmission rates (11.5 vs 10.7%; P = 0.98). Although the incidence of AKI is higher in patients treated with ERAS protocols, the majority represent minor elevations in baseline serum creatinine and did not affect the reduction in hospital LOS associated with ERAS. Given the potential association of AKI, however, with increased long-term morbidity and mortality, ERAS protocols should be optimized to prevent postoperative AKI.

Risk factors for acute kidney injury in an enhanced recovery pathway for colorectal surgery

Surgery Today ◽  
2020 ◽  
Author(s):  
Andrés Zorrilla-Vaca ◽  
Gabriel E. Mena ◽  
Javier Ripolles-Melchor ◽  
Juan Victor Lorente ◽  
Juan José M. Ramirez-Rodriguez ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Colorectal Surgery ◽  
Enhanced Recovery ◽  
Kidney Injury ◽  
Enhanced Recovery Pathway

Incidence of and risk factors for delayed acute kidney injury in patients undergoing colorectal surgery

2019 ◽  
Vol 218 (5) ◽  
pp. 907-912 ◽  
Author(s):  
Youn Kyung Kee ◽  
Hyoungnae Kim ◽  
Jong Hyun Jhee ◽  
Seung Hyeok Han ◽  
Tae-Hyun Yoo ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Colorectal Surgery ◽  
Kidney Injury

scholarly journals SP246POSTOPERATIVE ILEUS IS AN IMPORTANT RISK FACTOR OF ACUTE KIDNEY INJURY IN PATIENTS UNDERGOING COLORECTAL SURGERY

2015 ◽  
Vol 30 (suppl_3) ◽  
pp. iii460-iii460
Author(s):  
Wonyong Cho ◽  
Jun Yong Lee ◽  
Myung Gyu Kim ◽  
Sang-Kyung Jo
Keyword(s):  
Acute Kidney Injury ◽  
Risk Factor ◽  
Colorectal Surgery ◽  
Kidney Injury ◽  
Important Risk Factor
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