Evaluation of Risk Factors for Peste des Petits Ruminants Virus in Sheep and Goats at the Wildlife-Livestock Interface in Punjab Province, Pakistan

Peste des petits ruminants virus (PPRV) is causing infectious disease with high morbidity and mortality rate in domestic and wild small ruminants of Pakistan with valuable economical losses. The present study was carried out to investigate risk factors of PPRV in domestic small ruminants which were present in the vicinity of wildlife parks. A total of 265 sera samples (27 wild ruminants and 238 domesticated small ruminants) from apparently healthy animals from two different wildlife parks were collected and analysed for PPRV antibodies. Also, 20 nasal swabs from domestic small ruminants showing respiratory signs were collected to check for presence of PPRV antigen. Competitive ELISA revealed highest proportions of anti-PPRV antibodies in domestic small ruminants around the Wildlife Park at Lahore (35%) as compared to Faisalabad (13%), with no existence of PPRV antibodies in tested serum of wild ruminants at these parks. Higher seropositivity was observed in females (25.6%) than in males (5.1%) and in goats (34.5%) compared to sheep (11.2%). The results of N-gene based RT-PCR highlight the absence of PPRV due to lack of current PPR outbreak in the region during study period. Even though grazing was not a significant risk factor, there is still a possibility of wildlife-livestock interactions for feed and water reservoirs, resulting in spillover of PPR to wildlife. Keeping in view the high seropositivity and risk of PPR, vaccination should be adopted to avoid circulation of PPRV among wild and domestic small ruminants (sheep and goats).

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Epidemiological characterization and risk factors associated with lentiviral infection of small ruminants at animal fairs in the semiarid Sertão region of Pernambuco, Brazilian semiarid

Semina Ciências Agrárias ◽

10.5433/1679-0359.2017v38n4p1875 ◽

2017 ◽

Vol 38 (4) ◽

pp. 1875

Author(s):

José Romero Alexandre Alves ◽

Clécio Henrique Limeira ◽

Geilson Manoel de Souza Lima ◽

Raymundo Rizaldo Pinheiro ◽

Francisco Selmo Fernandes Alves ◽

...

Keyword(s):

Risk Factors ◽

Traffic Control ◽

Disease Transmission ◽

Significant Risk ◽

Small Ruminants ◽

Significant Risk Factor ◽

Disease Diagnosis ◽

Serum Samples ◽

Western Blots ◽

Factors Associated

Animal agglomerations at commercial events such as trade fairs represent an important facilitator in infectious disease transmission. Thus, it is crucial to understand the epidemiology of infectious diseases in small ruminants. The objective of this study was to examine lentiviral presence in goats and sheep traded at the animal fair of Tabira city (Sertão region of Pernambuco) and identify possible risk factors associated with infection. We collected serum samples from 233 crossbred goats and 119 crossbred sheep, belonging to 12 breeders, at the Tabira livestock fair from November 2014 to June 2015. An epidemiological questionnaire was used to analyze the risk factors. Agar gel immunodiffusion (AGID) and western blotting (WB) were performed to diagnose small ruminant lentivirus (SRLV) infection. In the AGID test, we used maedi-visna virus (MVV) antigens for sheep and caprine arthritis/encephalitis virus (strain Cork) (CAEV-Co) antigen for goats. The WB analysis used CAEV-Co antigen for both species. Variables from the questionnaire were analyzed with univariate and multivariate statistics. One seropositive goat but no sheep was identified via AGID. According to the WB results, 15/233 goats (6.44%; CI95% = 3.94 - 10.35%) and 8/119 sheep (6.72%; CI95% = 3.45 - 12.71%) were seropositive, totaling 23/352 reactive animals (6.53%; CI95% = 4.39 - 9.61%) from 12 herds. Annual vermifugation of the animals was a significant risk factor (odds ratio = 5.9; CI95% = 1.7-19.8; p = 0.04) for disease in goats, but no variables associated with infection risks were identified in sheep. We concluded that SRLV was present in goats and sheep at the animal fair. Western blots were more sensitive than AGID for SRLV diagnosis. Practices aiming to improve sanitary management may reduce the risk of infection in goats. All studied herds included animals identified as seropositive for SRLV. Therefore, we recommend adopting measures that increase disease diagnosis while intensifying traffic control and surveillance of animal agglomerations.

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Comparison of nucleotide sequences of recent and previous lineages of peste-des-petits-ruminants viruses of sheep and goats in Nigeria

Onderstepoort Journal of Veterinary Research ◽

10.4102/ojvr.v83i1.1163 ◽

2016 ◽

Vol 83 (1) ◽

Cited By ~ 3

Author(s):

Samuel Mantip ◽

Melvyn Quan ◽

David Shamaki ◽

Moritz Van Vuuren

Keyword(s):

Phylogenetic Analysis ◽

Small Ruminants ◽

Viral Disease ◽

N Gene ◽

Peste Des Petits Ruminants ◽

East African ◽

Tissue Samples ◽

Sheep And Goats ◽

Ecological Zones ◽

Agro Ecological Zones

Peste-des-petits-ruminants virus (PPRV) is a highly contagious, fatal and economically important viral disease of small ruminants that is still endemic and militates against the production of sheep and goats in endemic areas of the world. The aim of this study was to describe the viral strains within the country. This was carried out by collecting tissue and swab samples from sheep and goats in various agro-ecological zones of Nigeria. The phylogeny of archived PPRV strains or isolates and those circulating and causing recent outbreaks was determined by sequencing of the nucleoprotein (N)-gene. Twenty tissue and swab samples from apparently healthy and sick sheep and goats were collected randomly from 18 states, namely 3 states in each of the 6 agro-ecological zones visited. A total of 360 samples were collected. A total of 35 samples of 360 (9.7%) tested positive by reverse transcriptase–polymerase chain reaction, of which 25 were from oculo-nasal swabs and 10 were from tissue samples. Neighbour-joining phylogenetic analysis using Phylogenetic Analysis Using Parsimony (PAUP) identified four different lineages, that is, lineages I, II, III and IV. Interestingly, the Nigerian strains described in this study grouped in two separate major lineages, that is, lineages II and IV. Strains from Sokoto, Oyo, Plateau and Ondo states grouped according to the historical distribution of PPRV together with the Nigerian 75/1 strain of lineage II, while other strains from Sokoto, Oyo, Plateau, Akwa-Ibom, Adamawa, Kaduna, Lagos, Bauchi, Niger and Kano states grouped together with the East African and Asian strains of lineage IV. This finding confirms that both lineage II and IV strains of PPRV are circulating in Nigeria. Previously, only strains of lineage II were found to be present in the country.

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Sero-epidemiology and associated risk factors of brucellosis among sheep and goat population in the south western Nepal: a comparative study

BMC Veterinary Research ◽

10.1186/s12917-021-02835-8 ◽

2021 ◽

Vol 17 (1) ◽

Author(s):

Tulsi Ram Gompo ◽

Rubina Shah ◽

Ishwari Tiwari ◽

Yam Bahadur Gurung

Keyword(s):

Risk Factors ◽

Significant Risk ◽

Small Ruminants ◽

Control Program ◽

Significant Risk Factor ◽

Serum Samples ◽

Cross Sectional ◽

Sheep Population ◽

Goat Population ◽

Associated Risk Factors

Abstract Background Brucellosis is a zoonotic disease caused by Brucella spp. In Nepal, the presence of brucellosis in small ruminants, namely sheep and goats, has impacted farmers’ livelihood and the food safety of consumers. A cross-sectional study was conducted in Rupandehi district of Nepal during January to March 2020 to investigate the seroepidemiology and associated risk factors of brucellosis in the sheep and goat population. Altogether, 19 sheep and 60 goat farms in the district were visited. Owners were interviewed to get information on animals, including their management and movement patterns. Three hundred fifty-seven samples (80 sheep and 277 goat samples) were collected proportionately based on farm sizes. Each serum sample was tested with Rose Bengal Test and ELISA to estimate the seropositivity of brucellosis. Logistic regression was carried out to calculate corresponding odds ratios of each variable associated with detection of brucellosis. Results At the farm level, 31.6% (6/19; 95% CI: 12, 54%) of sheep farms and 3.3% (2/60, 95% CI: 0.9, 11.4%) of goat farms were seropositive to brucellosis. Out of 80 sheep serum samples, 12 (15%; 95% CI: 8.79–24.41%) and out of 277 goat serum samples, three (1.1%; 95% CI: 0.37–3.14%) were seropositive to brucellosis. Age greater than 1.5 years (OR = 5.56, 95% CI: 1.39, 29.38; p = 0.02) and herd size of greater than 100 (OR = 4.74, 95% CI: 1.23, 20.32, p = 0.03) were identified as significant risk factors for seropositivity of brucellosis in the sheep population. While in the goat population, none of the variables was identified as a significant risk factor. Conclusion The study provides evidence that the older sheep and the sheep from the large herds were at higher risk of brucellosis. A control program should be put in place immediately in the sheep population because they may transmit infections to other livestock as they were regularly moved for grazing and selling purposes. Also, strict biosecurity measures should be implemented among pastoralists to prevent brucellosis transmission in them. We suggest further one health-based study to reveal the transmission dynamics of brucellosis between animals and humans.

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Sero-epidemiology and associated risk factors of brucellosis among sheep and goat population in the mid southern Nepal: A comparative study

10.21203/rs.3.rs-39025/v1 ◽

2020 ◽

Author(s):

Tulsi Ram Gompo ◽

Rubina Shah ◽

Ishwari Tiwari ◽

Yam Bahadur Gurung

Keyword(s):

Risk Factors ◽

Significant Risk ◽

Small Ruminants ◽

Bivariate Analysis ◽

Serum Samples ◽

Cross Sectional ◽

Sheep Population ◽

Sheep And Goats ◽

Goat Population ◽

Associated Risk Factors

Abstract Background Brucellosis is a zoonotic disease of animals and humans caused by the Brucella spps. In Nepal, the presence of brucellosis in small ruminants, e.g., sheep and goats, has impacted the farmers' livelihood and people's food safety. A cross-sectional study was conducted at Rupandehi districts of Nepal to the discover the seroepidemiology and associated risk factors of brucellosis in sheep and goat population. Altogether, 19 sheep and 60 goat farms located in the districts' local units were visited, and the owners were interviewed to get the information on animal characteristics, management, and movement patterns. Three hundred fifty-seven serum samples (80 sheep and 277 goat’s samples) were collected from selected herd based on the probability proportional to their sizes. Each serum sample was tested for Rose Bengal Plate Test (RBPT) and ELISA to estimate the seropositivity. Bivariate analysis followed by multivariable logistic regression was applied to calculate corresponding odds ratios of each variable associated with the brucellosis. Results Out of 80 sheep samples, 12 (15%; 95%CI: 8.79%-24.41%, P<0.001) and out of 277 goat samples 3 (1.1%; 0.37%-3.14%, P<0.001) were tested positive to brucellosis. Age of greater than 1.5 years (OR= 6.39, 95%CI: 1.23, 54.67, p= 0.04) was identified as the significant risk factor for brucellosis in sheep population. While in the goat population, none of the variables were identified as the significant risk factors in multivariable regression analysis. However, the goat from the frequent grazing herds had borderline significance (OR = 8.81, 95%CI: 0.44, 174.56, p<0.15). It might be because of the regular movement of sheep herds that get mixed up with the goat populations. Conclusion The study provides evidence that the burden of brucellosis in sheep is significantly higher than goats. The brucellosis control program in sheep should be applied immediately, as the contiguous herds of sheep and goats keep mixing while grazing and selling. Also, the strict biosecurity and biosafety measures should be implemented among the sheepherders to prevent infection of Brucella in them. We suggest further study on both small ruminants and the sheep owners to reveal the transmission dynamics through one health approach.

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Prevalence, Risk Factors for Exposure, and Socio-Economic Impact of Peste Des Petits Ruminants in Karenga District, Karamoja Region, Uganda

Pathogens ◽

10.3390/pathogens11010054 ◽

2022 ◽

Vol 11 (1) ◽

pp. 54

Author(s):

Claire Akwongo ◽

Melvyn Quan ◽

Charles Byaruhanga

Keyword(s):

Risk Factors ◽

Economic Impact ◽

Small Ruminant ◽

Small Ruminants ◽

Eastern Africa ◽

Enzyme Linked Immunosorbent Assay ◽

High Morbidity ◽

Peste Des Petits Ruminants ◽

Socio Economic Impact ◽

The Impact

Peste des petits ruminants (PPR), a disease caused by small ruminant morbillivirus (SRM), is highly contagious with high morbidity and mortality. Controlling PPR requires a proper understanding of the epidemiological dynamics and impact of the disease in a range of geographical areas and management systems. Karenga district, located in the pastoral region of Karamoja in northeastern Uganda, and in the vicinity of Kidepo Valley National Park, is characterised by free cross-border (South Sudan and Kenya) livestock trade, communal grazing, and transhumance. This study was conducted from November through December 2020 to determine the seroprevalence of anti-SRM antibodies, the risk factors associated with the occurrence, and the socio-economic impact of PPR in Karenga. A total of 22 kraals were randomly selected from all administrative units, and 684 small ruminants (sheep = 115, goats = 569) were selected for serum collection using systematic random sampling. Exposure to SRM was determined using a competitive enzyme-linked immunosorbent assay. The overall true seroprevalence of SRM antibodies was high, 51.4 (95% confidence interval [CI] 45–52.6). Multivariate logistic regression for risk factors showed that seroprevalence varied significantly by location (26.8% to 87.8%, odds ratio (OR) ≤ 14.5). The odds of exposure to SRM were higher in sheep (73.9%) than in goats (43.8%) (OR = 1.7, p = 0.08), and seropositivity was higher in animals greater than two years old (65.5%; OR = 11.1, p < 0.001), or those one to two years old (24.7%; OR = 1.6, p = 0.2), compared to small ruminants less than one year old (16.1%). Using participatory epidemiology approaches (semi-structured interviews, clinical examinations, pairwise ranking, proportional piling, impact matrix scoring) with 15 key informants and 22 focus groups of pastoralists, PPR was the second most important small ruminant disease: relative morbidity 14%, relative mortality 9%, and case fatality rate 78%, and impacted productivity mainly in terms of treatment costs, mortality, marketability, and conflicts. These findings provide evidence to support the implementation of disease surveillance and control strategies to mitigate the impact of PPR in Karamoja and other pastoral areas in eastern Africa.

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Sero-epidemiology and associated risk factors of brucellosis among sheep and goat population in the south western Nepal: A comparative study

10.21203/rs.3.rs-39025/v2 ◽

2020 ◽

Author(s):

Tulsi Ram Gompo ◽

Rubina Shah ◽

Ishwari Tiwari ◽

Yam Bahadur Gurung

Keyword(s):

Risk Factors ◽

Significant Risk ◽

Small Ruminants ◽

Control Program ◽

Significant Risk Factor ◽

Serum Samples ◽

Cross Sectional ◽

Sheep Population ◽

Goat Population ◽

Associated Risk Factors

Abstract BackgroundBrucellosis is a zoonotic disease of animals and humans caused by the Brucella spp. In Nepal, the presence of brucellosis in small ruminants, such as sheep and goats, has impacted farmers' livelihood and the food safety of the consumer. A cross-sectional study was conducted in the Rupandehi district of Nepal to investigate the seroepidemiology and associated risk factors of brucellosis in the sheep and goat population. Altogether, nineteen sheep and sixty goat farms located in the district were visited. The owners were interviewed to get information on animals, including their management and movement patterns. Three hundred fifty-seven samples (80 sheep and 277 goat samples) were collected proportionately based on the farm sizes. Each serum sample was tested with Rose Bengal Test and ELISA to estimate the seropositivity of brucellosis. Logistic regression was applied to calculate corresponding odds ratios of each variable associated with detection brucellosis. Results At the farm level, 31.6% (6/19; 95% CI: 12%, 54%) of sheep farms and 3.3% (2/60, 95% CI: 0.9%, 11.4 %) of the goat farms were seropositive to brucellosis. Out of 80 sheep serum samples, 12 (15%; 95% CI: 8.79%-24.41%) and out of 277 goat serum samples 3 (1.1%; 95% CI: 0.37%-3.14%) were seropositive to brucellosis. Age greater than 1.5 years (OR= 5.56, 95% CI: 1.39, 29.38, p = 0.02) and herd size of greater than a hundred (OR= 4.74, 95% CI: 1.23, 20.32, p = 0.03) were identified as significant risk factors for seropositivity of brucellosis in the sheep population. While in the goat population, none of the variables was identified as a significant risk factor. ConclusionThe study provides evidence that the older sheep and the sheep from the large herd sizes were at higher risk of detecting brucellosis. A control program should be applied immediately in the sheep population because they may transmit infections to other livestock as they were regularly moved for grazing and selling purposes. Also, strict biosecurity measures should be implemented among pastoralists to prevent brucellosis transmission in them. We suggest further one health-based study to reveal the transmission dynamics of brucellosis between animals and humans.

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Flock level seroprevalence of and risk factors for parainfluenza type 3 virus in small ruminants in northern Jordan

Current Research in Microbiology and Infection ◽

10.31559/crmi2020.1.1.4 ◽

2020 ◽

Vol 1 (1) ◽

pp. 22-29

Author(s):

Waleed Al-Momani ◽

Mahmoud N. Abo-Shehada

Keyword(s):

Risk Factors ◽

Management Practices ◽

Health Management ◽

Significant Risk ◽

Small Ruminants ◽

Elisa Test ◽

Farm Animals ◽

Sheep And Goats ◽

Type 3 ◽

Northern Jordan

Background. Infectious diseases of the respiratory tract of farm animals are caused by a combination of infectious agents and predisposing factors. Parainfluenza virus type 3 is usually nominated as one of the causes. Seroprevalence and animal risk factors for PI3 infections were investigated in northern Jordan. Methods. The study involved 104 small ruminant flocks (18 sheep, 27 goats, and 59 mixed flocks sampled in northern Jordan. Indirect ELISA was used to test 678 blood samples used in this study. Flocks were identified as infected if at least 1 animal has been detected as positive by the ELISA test. Information regarding production and health management practices was collected in a questionnaire. Statistical analysis was conducted using the Statistical Package for Social Sciences software SPSS 23 (SPSS Inc., Chicago, IL, USA). Results. Flock-level and individual-level seroprevalences were 97%, 37%, and 76%, 11% in sheep and goats respectively. Multivariable logistic regression applied for production and health management practices showed significant risk factors for: Climatic zone (OR= 0.3) was decreasing risk factor for the PI3 seropositivity. Young separated from dams (OR= 4), neonatal deaths (OR= 3), and milking manual (OR= 37.5) were increasing risk factors for the seropositivity of PI3. Conclusions. PI3 virus has a high prevalence in sheep than goats and two risk factors could increase the prevalence of PI3 in both sheep and goats.

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Staphylococcus aureus carriage in care homes: identification of risk factors, including the role of dementia

Epidemiology and Infection ◽

10.1017/s0950268810000233 ◽

2010 ◽

Vol 138 (5) ◽

pp. 686-696 ◽

Cited By ~ 24

Author(s):

G. LASSETER ◽

A. CHARLETT ◽

D. LEWIS ◽

I. DONALD ◽

R. HOWELL-JONES ◽

...

Keyword(s):

Risk Factors ◽

Multivariable Analysis ◽

Significant Risk ◽

Significant Risk Factor ◽

Care Homes ◽

Prevalence Survey ◽

Nasal Swabs ◽

Agar Media ◽

Associated Risk Factors

SUMMARYThe aim of this study was to investigate the prevalence and associated risk factors of methicillin-susceptible and methicillin-resistant Staphylocccus aureus (MSSA and MRSA) carriage in care homes, with particular focus on dementia. A point-prevalence survey of 748 residents in 51 care homes in Gloucestershire and Greater Bristol was undertaken. Dementia was assessed by the clock test or abbreviated mini-mental test. Nasal swabs were cultured for S. aureus on selective agar media. Multivariable analysis indicated that dementia was not a significant risk factor for MSSA (16·2%) or MRSA (7·8%); and that residents able to move around the home unassisted were at a lower risk of MRSA (P=0·04). MSSA carriage increased with increasing age (P=0·03) but MRSA carriage decreased with increasing age (P=0·05). Hospitalization in the last 6 months increased the risk of MSSA (P=0·04) and MRSA (P=0·10). We concluded that cross-infection through staff caring for more dependent residents may spread MRSA within care homes and from the recently hospitalized. Control of MSSA and MRSA in care homes requires focused infection control interventions.

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Sero-epidemiology and associated risk factors of brucellosis among sheep and goat population in the south western Nepal: A comparative study

10.21203/rs.3.rs-39025/v3 ◽

2021 ◽

Author(s):

Tulsi Ram Gompo ◽

Rubina Shah ◽

Ishwari Tiwari ◽

Yam Bahadur Gurung

Keyword(s):

Risk Factors ◽

Significant Risk ◽

Small Ruminants ◽

Control Program ◽

Significant Risk Factor ◽

Serum Samples ◽

Cross Sectional ◽

Sheep Population ◽

Goat Population ◽

Associated Risk Factors

Abstract BackgroundBrucellosis is a zoonotic disease caused by Brucella spp. In Nepal, the presence of brucellosis in small ruminants, namely sheep and goats, has impacted farmers' livelihood and the food safety of consumers. A cross-sectional study was conducted in Rupandehi district of Nepal during January to March 2020 to investigate the seroepidemiology and associated risk factors of brucellosis in the sheep and goat population. Altogether, 19 sheep and 60 goat farms in the district were visited. Owners were interviewed to get information on animals, including their management and movement patterns. Three hundred fifty-seven samples (80 sheep and 277 goat samples) were collected proportionately based on farm sizes. Each serum sample was tested with Rose Bengal Test and ELISA to estimate the seropositivity of brucellosis. Logistic regression was carried out to calculate corresponding odds ratios of each variable associated with detection of brucellosis.Results At the farm level, 31.6% (6/19; 95% CI: 12%, 54%) of sheep farms and 3.3% (2/60, 95% CI: 0.9%, 11.4 %) of goat farms were seropositive to brucellosis. Out of 80 sheep serum samples, 12 (15%; 95% CI: 8.79%-24.41%) and out of 277 goat serum samples, three (1.1%; 95% CI: 0.37%-3.14%) were seropositive to brucellosis. Age greater than 1.5 years (OR= 5.56, 95% CI: 1.39, 29.38; p = 0.02) and herd size of greater than 100 (OR= 4.74, 95% CI: 1.23, 20.32, p = 0.03) were identified as significant risk factors for seropositivity of brucellosis in the sheep population. While in the goat population, none of the variables was identified as a significant risk factor.ConclusionThe study provides evidence that the older sheep and the sheep from the large herds were at higher risk of brucellosis. A control program should be put in place immediately in the sheep population because they may transmit infections to other livestock as they were regularly moved for grazing and selling purposes. Also, strict biosecurity measures should be implemented among pastoralists to prevent brucellosis transmission in them. We suggest further one health-based study to reveal the transmission dynamics of brucellosis between animals and humans.

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Renal Failure after Coronary Bypass Surgery and the Associated Risk Factors

The Heart Surgery Forum ◽

10.1532/hsf.1216 ◽

2015 ◽

Vol 18 (1) ◽

pp. 006

Author(s):

Hasan Reyhanoglu ◽

Kaan Ozcan ◽

Murat Erturk ◽

Fatih İslamoglu ◽

İsa Durmaz

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Renal Failure ◽

Coronary Artery ◽

Coronary Artery Bypass ◽

Bypass Surgery ◽

Artery Bypass ◽

Significant Risk ◽

High Morbidity ◽

Factors Associated

Objective: We aimed to evaluate the risk factors associated with acute renal failure in patients who underwent coronary artery bypass surgery. Methods: One hundred and six patients who developed renal failure after coronary artery bypass grafting (CABG) constituted the study group (RF group), while 110 patients who did not develop renal failure served as a control group (C group). In addition, the RF group was divided into two subgroups: patients that were treated with conservative methods without the need for hemodialysis (NH group) and patients that required hemodialysis (HR group). Risk factors associated with renal failure were investigated. Results: Among the 106 patients that developed renal failure (RF), 80 patients were treated with conservative methods without any need for hemodialysis (NH group); while 26 patients required hemodialysis in the postoperative period (HR group). The multivariate analysis showed that diabetes mellitus and the postoperative use of positive inotropes and adrenaline were significant risk factors associated with development of renal failure. In addition, carotid stenosis and postoperative use of adrenaline were found to be significant risk factors associated with hemodialysis-dependent renal failure (P < .05). The mortality in the RF group was determined as 13.2%, while the mortality rate in patients who did not require hemodialysis and those who required hemodialysis was 6.2% and 34%, respectively. Conclusion: Renal failure requiring hemodialysis after CABG often results in high morbidity and mortality. Factors affecting microcirculation and atherosclerosis, like diabetes mellitus, carotid artery stenosis, and postoperative vasopressor use remain the major risk factors for the development of renal failure.

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