The effect of acute kidney injury after revascularization on the development of chronic kidney disease and mortality in patients with chronic limb ischemia
Objective This study examined the effect of perioperative acute kidney injury (AKI) on long-term kidney dysfunction and death after lower extremity revascularization. Perioperative AKI is commonly seen in the form of mild rises of serum creatinine after major cardiovascular surgeries. Its effect on...
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| Veröffentlicht in: | Journal of vascular surgery 2015-03, Vol.61 (3), p.720-727 |
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| creator | Arora, Pradeep, MBBS Davari-Farid, Sina, MD Pourafkari, Leili, MD Gupta, Anu, MBBS Dosluoglu, Hasan H., MD Nader, Nader D., MD, PhD |
| description | Objective This study examined the effect of perioperative acute kidney injury (AKI) on long-term kidney dysfunction and death after lower extremity revascularization. Perioperative AKI is commonly seen in the form of mild rises of serum creatinine after major cardiovascular surgeries. Its effect on long-term survival and development of chronic kidney disease (CKD) is well established in cardiac surgery patients. However, there are no data on the effect of AKI on long-term outcomes after revascularization for lower limb ischemia. Methods We retrospectively reviewed the patients with peripheral arterial occlusive diseases who underwent endovascular or surgical revascularization of the lower extremities from 2001 through 2010. All demographic and clinical information have been maintained prospectively by the surgeon and followed up by the research team. Perioperative AKI was defined as rises of ≥0.3 mg/dL in serum creatinine from the values measured preoperatively. The primary end points were development of CKD (estimated glomerular filtration rate |
| doi_str_mv | 10.1016/j.jvs.2014.10.020 |
| format | Article |
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Perioperative AKI is commonly seen in the form of mild rises of serum creatinine after major cardiovascular surgeries. Its effect on long-term survival and development of chronic kidney disease (CKD) is well established in cardiac surgery patients. However, there are no data on the effect of AKI on long-term outcomes after revascularization for lower limb ischemia. Methods We retrospectively reviewed the patients with peripheral arterial occlusive diseases who underwent endovascular or surgical revascularization of the lower extremities from 2001 through 2010. All demographic and clinical information have been maintained prospectively by the surgeon and followed up by the research team. Perioperative AKI was defined as rises of ≥0.3 mg/dL in serum creatinine from the values measured preoperatively. The primary end points were development of CKD (estimated glomerular filtration rate <60 mL/min) and all-cause mortality. Univariate and multivariate analyses were performed to examine relevant associations. Results Within the study period, 717 patients underwent 875 procedures. Mean follow-up was 42 ± 14 months. AKI developed in 86 patients after the index procedure. Overall prevalence of CKD diagnosed postoperatively was 14.9%. Overall mortality reported within the follow-up period was 55.9%. Perioperative AKI was a significant predictor of CKD (area under the curve, 0.84 ± 0.13) and all cause mortality (area under the curve, 0.82 ± 0.12). Conclusions Perioperative AKI is associated with an increased occurrence of CKD and a higher mortality rate after revascularization procedures of the lower extremities.</description><identifier>ISSN: 0741-5214</identifier><identifier>EISSN: 1097-6809</identifier><identifier>DOI: 10.1016/j.jvs.2014.10.020</identifier><identifier>PMID: 25499712</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Acute Kidney Injury - diagnosis ; Acute Kidney Injury - etiology ; Acute Kidney Injury - mortality ; Aged ; Aged, 80 and over ; Biomarkers - blood ; Chi-Square Distribution ; Chronic Disease ; Creatinine - blood ; Endovascular Procedures - adverse effects ; Endovascular Procedures - mortality ; Female ; Glomerular Filtration Rate ; Humans ; Ischemia - diagnosis ; Ischemia - mortality ; Ischemia - therapy ; Kaplan-Meier Estimate ; Logistic Models ; Lower Extremity - blood supply ; Male ; Middle Aged ; Multivariate Analysis ; Odds Ratio ; Peripheral Arterial Disease - diagnosis ; Peripheral Arterial Disease - mortality ; Peripheral Arterial Disease - therapy ; Proportional Hazards Models ; Renal Insufficiency, Chronic - diagnosis ; Renal Insufficiency, Chronic - etiology ; Renal Insufficiency, Chronic - mortality ; Retrospective Studies ; Risk Assessment ; Risk Factors ; Surgery ; Time Factors ; Treatment Outcome ; Vascular Surgical Procedures - adverse effects ; Vascular Surgical Procedures - mortality</subject><ispartof>Journal of vascular surgery, 2015-03, Vol.61 (3), p.720-727</ispartof><rights>2015</rights><rights>Published by Elsevier Inc.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c451t-74b9e9753cd0c385830c01cf5d72271497fe475901e2f6f39ad30109a7e9063</citedby><cites>FETCH-LOGICAL-c451t-74b9e9753cd0c385830c01cf5d72271497fe475901e2f6f39ad30109a7e9063</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.jvs.2014.10.020$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>315,781,785,3551,27926,27927,45997</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25499712$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Arora, Pradeep, MBBS</creatorcontrib><creatorcontrib>Davari-Farid, Sina, MD</creatorcontrib><creatorcontrib>Pourafkari, Leili, MD</creatorcontrib><creatorcontrib>Gupta, Anu, MBBS</creatorcontrib><creatorcontrib>Dosluoglu, Hasan H., MD</creatorcontrib><creatorcontrib>Nader, Nader D., MD, PhD</creatorcontrib><title>The effect of acute kidney injury after revascularization on the development of chronic kidney disease and mortality in patients with chronic limb ischemia</title><title>Journal of vascular surgery</title><addtitle>J Vasc Surg</addtitle><description>Objective This study examined the effect of perioperative acute kidney injury (AKI) on long-term kidney dysfunction and death after lower extremity revascularization. Perioperative AKI is commonly seen in the form of mild rises of serum creatinine after major cardiovascular surgeries. Its effect on long-term survival and development of chronic kidney disease (CKD) is well established in cardiac surgery patients. However, there are no data on the effect of AKI on long-term outcomes after revascularization for lower limb ischemia. Methods We retrospectively reviewed the patients with peripheral arterial occlusive diseases who underwent endovascular or surgical revascularization of the lower extremities from 2001 through 2010. All demographic and clinical information have been maintained prospectively by the surgeon and followed up by the research team. Perioperative AKI was defined as rises of ≥0.3 mg/dL in serum creatinine from the values measured preoperatively. The primary end points were development of CKD (estimated glomerular filtration rate <60 mL/min) and all-cause mortality. Univariate and multivariate analyses were performed to examine relevant associations. Results Within the study period, 717 patients underwent 875 procedures. Mean follow-up was 42 ± 14 months. AKI developed in 86 patients after the index procedure. Overall prevalence of CKD diagnosed postoperatively was 14.9%. Overall mortality reported within the follow-up period was 55.9%. Perioperative AKI was a significant predictor of CKD (area under the curve, 0.84 ± 0.13) and all cause mortality (area under the curve, 0.82 ± 0.12). Conclusions Perioperative AKI is associated with an increased occurrence of CKD and a higher mortality rate after revascularization procedures of the lower extremities.</description><subject>Acute Kidney Injury - diagnosis</subject><subject>Acute Kidney Injury - etiology</subject><subject>Acute Kidney Injury - mortality</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Biomarkers - blood</subject><subject>Chi-Square Distribution</subject><subject>Chronic Disease</subject><subject>Creatinine - blood</subject><subject>Endovascular Procedures - adverse effects</subject><subject>Endovascular Procedures - mortality</subject><subject>Female</subject><subject>Glomerular Filtration Rate</subject><subject>Humans</subject><subject>Ischemia - diagnosis</subject><subject>Ischemia - mortality</subject><subject>Ischemia - therapy</subject><subject>Kaplan-Meier Estimate</subject><subject>Logistic Models</subject><subject>Lower Extremity - blood supply</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Multivariate Analysis</subject><subject>Odds Ratio</subject><subject>Peripheral Arterial Disease - diagnosis</subject><subject>Peripheral Arterial Disease - mortality</subject><subject>Peripheral Arterial Disease - therapy</subject><subject>Proportional Hazards Models</subject><subject>Renal Insufficiency, Chronic - diagnosis</subject><subject>Renal Insufficiency, Chronic - etiology</subject><subject>Renal Insufficiency, Chronic - mortality</subject><subject>Retrospective Studies</subject><subject>Risk Assessment</subject><subject>Risk Factors</subject><subject>Surgery</subject><subject>Time Factors</subject><subject>Treatment Outcome</subject><subject>Vascular Surgical Procedures - adverse effects</subject><subject>Vascular Surgical Procedures - mortality</subject><issn>0741-5214</issn><issn>1097-6809</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9ks2KFDEUhYMoTjv6AG4kSzfV3qR-UkEQZPAPBlzM7EM6uaFTU1Vpk1RL-yq-rCl7ZhYuhEBIOOcjOecS8prBlgHr3g3b4Zi2HFhTzlvg8IRsGEhRdT3Ip2QDomFVy1lzQV6kNAAw1vbiObngbSOlYHxDft_ukaJzaDINjmqzZKR33s54on4elnii2mWMNOJRJ7OMOvpfOvsw07JyMVs84hgOE85_CWYfw-zNA8P6hDoh1bOlU4hZjz6vZHookGJJ9KfP-0fX6Kcd9cnscfL6JXnm9Jjw1f1-SW4-f7q9-lpdf__y7erjdWWaluVKNDuJUrS1sWDqvu1rMMCMa63gXLBGCoeNaCUw5K5ztdS2hhKTFiihqy_J2zP1EMOPBVNWU3kAjqOeMSxJsU7UIAq-LVJ2lpoYUoro1CH6SceTYqDWRtSgSiNqbWS9Ko0Uz5t7_LKb0D46HioogvdnAZYvHj1GlUxJxqD1sbSibPD_xX_4x21GX5LU4x2eMA1hiXPJTjGVuAJ1s47EOhGsASaB9_UfVRCzcw</recordid><startdate>20150301</startdate><enddate>20150301</enddate><creator>Arora, Pradeep, MBBS</creator><creator>Davari-Farid, Sina, MD</creator><creator>Pourafkari, Leili, MD</creator><creator>Gupta, Anu, MBBS</creator><creator>Dosluoglu, Hasan H., MD</creator><creator>Nader, Nader D., MD, PhD</creator><general>Elsevier Inc</general><scope>6I.</scope><scope>AAFTH</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20150301</creationdate><title>The effect of acute kidney injury after revascularization on the development of chronic kidney disease and mortality in patients with chronic limb ischemia</title><author>Arora, Pradeep, MBBS ; Davari-Farid, Sina, MD ; Pourafkari, Leili, MD ; Gupta, Anu, MBBS ; Dosluoglu, Hasan H., MD ; Nader, Nader D., MD, PhD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c451t-74b9e9753cd0c385830c01cf5d72271497fe475901e2f6f39ad30109a7e9063</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Acute Kidney Injury - diagnosis</topic><topic>Acute Kidney Injury - etiology</topic><topic>Acute Kidney Injury - mortality</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Biomarkers - blood</topic><topic>Chi-Square Distribution</topic><topic>Chronic Disease</topic><topic>Creatinine - blood</topic><topic>Endovascular Procedures - adverse effects</topic><topic>Endovascular Procedures - mortality</topic><topic>Female</topic><topic>Glomerular Filtration Rate</topic><topic>Humans</topic><topic>Ischemia - diagnosis</topic><topic>Ischemia - mortality</topic><topic>Ischemia - therapy</topic><topic>Kaplan-Meier Estimate</topic><topic>Logistic Models</topic><topic>Lower Extremity - blood supply</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Multivariate Analysis</topic><topic>Odds Ratio</topic><topic>Peripheral Arterial Disease - diagnosis</topic><topic>Peripheral Arterial Disease - mortality</topic><topic>Peripheral Arterial Disease - therapy</topic><topic>Proportional Hazards Models</topic><topic>Renal Insufficiency, Chronic - diagnosis</topic><topic>Renal Insufficiency, Chronic - etiology</topic><topic>Renal Insufficiency, Chronic - mortality</topic><topic>Retrospective Studies</topic><topic>Risk Assessment</topic><topic>Risk Factors</topic><topic>Surgery</topic><topic>Time Factors</topic><topic>Treatment Outcome</topic><topic>Vascular Surgical Procedures - adverse effects</topic><topic>Vascular Surgical Procedures - mortality</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Arora, Pradeep, MBBS</creatorcontrib><creatorcontrib>Davari-Farid, Sina, MD</creatorcontrib><creatorcontrib>Pourafkari, Leili, MD</creatorcontrib><creatorcontrib>Gupta, Anu, MBBS</creatorcontrib><creatorcontrib>Dosluoglu, Hasan H., MD</creatorcontrib><creatorcontrib>Nader, Nader D., MD, PhD</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of vascular surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Arora, Pradeep, MBBS</au><au>Davari-Farid, Sina, MD</au><au>Pourafkari, Leili, MD</au><au>Gupta, Anu, MBBS</au><au>Dosluoglu, Hasan H., MD</au><au>Nader, Nader D., MD, PhD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The effect of acute kidney injury after revascularization on the development of chronic kidney disease and mortality in patients with chronic limb ischemia</atitle><jtitle>Journal of vascular surgery</jtitle><addtitle>J Vasc Surg</addtitle><date>2015-03-01</date><risdate>2015</risdate><volume>61</volume><issue>3</issue><spage>720</spage><epage>727</epage><pages>720-727</pages><issn>0741-5214</issn><eissn>1097-6809</eissn><abstract>Objective This study examined the effect of perioperative acute kidney injury (AKI) on long-term kidney dysfunction and death after lower extremity revascularization. Perioperative AKI is commonly seen in the form of mild rises of serum creatinine after major cardiovascular surgeries. Its effect on long-term survival and development of chronic kidney disease (CKD) is well established in cardiac surgery patients. However, there are no data on the effect of AKI on long-term outcomes after revascularization for lower limb ischemia. Methods We retrospectively reviewed the patients with peripheral arterial occlusive diseases who underwent endovascular or surgical revascularization of the lower extremities from 2001 through 2010. All demographic and clinical information have been maintained prospectively by the surgeon and followed up by the research team. Perioperative AKI was defined as rises of ≥0.3 mg/dL in serum creatinine from the values measured preoperatively. The primary end points were development of CKD (estimated glomerular filtration rate <60 mL/min) and all-cause mortality. Univariate and multivariate analyses were performed to examine relevant associations. Results Within the study period, 717 patients underwent 875 procedures. Mean follow-up was 42 ± 14 months. AKI developed in 86 patients after the index procedure. Overall prevalence of CKD diagnosed postoperatively was 14.9%. Overall mortality reported within the follow-up period was 55.9%. Perioperative AKI was a significant predictor of CKD (area under the curve, 0.84 ± 0.13) and all cause mortality (area under the curve, 0.82 ± 0.12). Conclusions Perioperative AKI is associated with an increased occurrence of CKD and a higher mortality rate after revascularization procedures of the lower extremities.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>25499712</pmid><doi>10.1016/j.jvs.2014.10.020</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Acute Kidney Injury - diagnosis Acute Kidney Injury - etiology Acute Kidney Injury - mortality Aged Aged, 80 and over Biomarkers - blood Chi-Square Distribution Chronic Disease Creatinine - blood Endovascular Procedures - adverse effects Endovascular Procedures - mortality Female Glomerular Filtration Rate Humans Ischemia - diagnosis Ischemia - mortality Ischemia - therapy Kaplan-Meier Estimate Logistic Models Lower Extremity - blood supply Male Middle Aged Multivariate Analysis Odds Ratio Peripheral Arterial Disease - diagnosis Peripheral Arterial Disease - mortality Peripheral Arterial Disease - therapy Proportional Hazards Models Renal Insufficiency, Chronic - diagnosis Renal Insufficiency, Chronic - etiology Renal Insufficiency, Chronic - mortality Retrospective Studies Risk Assessment Risk Factors Surgery Time Factors Treatment Outcome Vascular Surgical Procedures - adverse effects Vascular Surgical Procedures - mortality |
| title | The effect of acute kidney injury after revascularization on the development of chronic kidney disease and mortality in patients with chronic limb ischemia |
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