D.4. On postoperative day 2, the patient's creatinine approaches 2.5 mg/dL. What is the incidence of postoperative acute kidney injury and renal failure requiring chronic hemodialysis?
Answer:
Postoperative renal dysfunction is a common postoperative complication, occurring in as many as 33% of patients and necessitating dialysis in as many as 8% of patients. Risk factors associated with postoperative renal failure include age older than 50 years, preexisting renal dysfunction, administration of greater than 5 units of either pRBCs or salvaged washed autologous blood, and aortic cross-clamp time of greater than 100 minutes. Postoperative renal dysfunction of any degree is associated with increased perioperative mortality.
References
- Chatterjee S, Casar JG, LeMaire SA, Preventza O, Coselli JS. Perioperative care after thoracoabdominal aortic aneurysm repair: The Baylor College of Medicine experience. Part 2: Postoperative management. J Thorac Cardiovasc Surg. 2021;161:699-705.
- Khan FM, Naik A, Hameed I, et al. Ann Thorac Surg. 2020;110:1941-1949.