There has been a three-fold increase in the number of patients receiving acute dialysis because of injury after cardiac and vascular surgeries since 1995, states a new study in CMAJ (Canadian Medical Association Journal).
Acute kidney injury is a serious complication after surgery and can lead to death or result in compromised quality of life for people who do survive.
Researchers conducted a large study of 552 672 patients in Ontario who had elective major surgery at 118 hospitals between 1995 and 2009 to understand trends in acute dialysis. They found that of the 552 672 patients, 2231 received acute dialysis within 14 days after surgery. Almost half of the dialysis patients — 937 people — died within three months after the surgery. Of the people who survived, 27% (352 of 1294) required long-term dialysis. The incidence of acute dialysis increased from 0.2% to 0.6% over the 15-year study period.
"This study shows an important increase in the complication of severe acute kidney injury treated with dialysis after cardiac and vascular surgeries," writes Dr. Amit Garg, Western University, Lawson Health Research Institute, London, Ontario and the Institute for Clinical Evaluative Sciences (ICES), Toronto, with coauthors. "Outcomes for patients treated with acute dialysis after surgery remain poor."
"Our results should prompt renewed efforts to develop and test interventions to prevent severe acute kidney injury and to attenuate the high burden of death and end-stage renal disease after such injury has occurred," concludes Dr. Nausheen Siddiqui, University of Toronto, with coauthors.
The study was conducted by researchers from the Lawson Health Research Institute, Western University, London, Ont.; the Institute for Clinical Evaluative Sciences and the University of Toronto, Toronto, Ont.; McMaster University, Hamilton, Ont.; and Yale University, School of Medicine, New Haven, Connecticut.
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