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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Bibliographic Details
Published in:Journal of vascular surgery 2015-03, Vol.61 (3), p.720-727
Main Authors: Arora, Pradeep, MBBS, Davari-Farid, Sina, MD, Pourafkari, Leili, MD, Gupta, Anu, MBBS, Dosluoglu, Hasan H., MD, Nader, Nader D., MD, PhD
Format: Article
Language:English
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
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Summary: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 
ISSN:0741-5214
1097-6809
DOI:10.1016/j.jvs.2014.10.020