OBJECT: Earlier definitions of acute renal failure are not sensitive in identifying milder forms of acute kidney injury (AKI). The authors hypothesized that by applying the RIFLE criteria for acute renal failure (Risk of renal dysfunction, Injury to the kidney, Failure of kidney function, Loss of kidney function, and End-stage kidney disease) to thoracic and lumbar spine surgery, there would be a higher incidence of AKI. They also developed a model to predict the postoperative glomerular filtration rate (GFR). METHODS: A hospital data repository was used to identify patients undergoing thoracic and/or lumbar spine surgery over a 5-year period (2006-2011). The lowest GFR in the first week after surgery was used to identify and categorize kidney injury if present. Risk factors were identified and a model was developed to predict postoperative GFR based on the defined risk factors. RESULTS: A total of 726 patients were identified over the study period. The incidence of AKI was 3.9% (n = 28) based on the RIFLE classification with 23 patients in the risk category and 5 in the injury category. No patient was classified into the failure category or required renal replacement therapy. The baseline GFR in the non-AKI and AKI groups was 80 and 79.8 ml/min, respectively. After univariate analysis, only hypertension was associated with postoperative AKI (p = 0.02). A model was developed to predict the postoperative GFR. This model accounted for 64.4% of the variation in the postoperative GFRs (r(2) = 0.644). CONCLUSIONS: The incidence of AKI in spine surgery is higher than previously reported, with all of the patients classified into either the risk or injury RIFLE categories. Because these categories have previously been shown to be associated with poor long-term outcomes, early recognition, management, and follow-up of these patients is important.
OBJECT: Earlier definitions of acute renal failure are not sensitive in identifying milder forms of acute kidney injury (AKI). The authors hypothesized that by applying the RIFLE criteria for acute renal failure (Risk of renal dysfunction, Injury to the kidney, Failure of kidney function, Loss of kidney function, and End-stage kidney disease) to thoracic and lumbar spine surgery, there would be a higher incidence of AKI. They also developed a model to predict the postoperative glomerular filtration rate (GFR). METHODS: A hospital data repository was used to identify patients undergoing thoracic and/or lumbar spine surgery over a 5-year period (2006-2011). The lowest GFR in the first week after surgery was used to identify and categorize kidney injury if present. Risk factors were identified and a model was developed to predict postoperative GFR based on the defined risk factors. RESULTS: A total of 726 patients were identified over the study period. The incidence of AKI was 3.9% (n = 28) based on the RIFLE classification with 23 patients in the risk category and 5 in the injury category. No patient was classified into the failure category or required renal replacement therapy. The baseline GFR in the non-AKI and AKI groups was 80 and 79.8 ml/min, respectively. After univariate analysis, only hypertension was associated with postoperative AKI (p = 0.02). A model was developed to predict the postoperative GFR. This model accounted for 64.4% of the variation in the postoperative GFRs (r(2) = 0.644). CONCLUSIONS: The incidence of AKI in spine surgery is higher than previously reported, with all of the patients classified into either the risk or injury RIFLE categories. Because these categories have previously been shown to be associated with poor long-term outcomes, early recognition, management, and follow-up of these patients is important.
Authors: Raymond K Hsu; Charles E McCulloch; Michael Heung; Rajiv Saran; Vahakn B Shahinian; Meda E Pavkov; Nilka Ríos Burrows; Neil R Powe; Chi-yuan Hsu Journal: Clin J Am Soc Nephrol Date: 2015-12-18 Impact factor: 8.237
Authors: Michael R Mathis; Bhiken I Naik; Robert E Freundlich; Amy M Shanks; Michael Heung; Minjae Kim; Michael L Burns; Douglas A Colquhoun; Govind Rangrass; Allison Janda; Milo C Engoren; Leif Saager; Kevin K Tremper; Sachin Kheterpal; Michael F Aziz; Traci Coffman; Marcel E Durieux; Warren J Levy; Robert B Schonberger; Roy Soto; Janet Wilczak; Mitchell F Berman; Joshua Berris; Daniel A Biggs; Peter Coles; Robert M Craft; Kenneth C Cummings; Terri A Ellis; Peter M Fleishut; Daniel L Helsten; Leslie C Jameson; Wilton A van Klei; Fabian Kooij; John LaGorio; Steven Lins; Scott A Miller; Susan Molina; Bala Nair; William C Paganelli; William Peterson; Simon Tom; Jonathan P Wanderer; Christopher Wedeven Journal: Anesthesiology Date: 2020-03 Impact factor: 7.892
Authors: Rafael De la Garza Ramos; C Rory Goodwin; Amit Jain; Daniel Martinez-Ramirez; Isaac O Karikari; Daniel M Sciubba Journal: J Spine Surg Date: 2017-12
Authors: João Paulo Pretti Fantin; Ronaldo de Carvalho Neiva; Marcio Gatti; Pedro Ferraz de Arruda; José Germano Ferraz de Arruda; Thiago Antoniassi; Luís Cesar Fava Spessoto; José Carlos Mesquita; Lilian Castiglioni; Fernando-Nestor Fácio-Júnior Journal: Transl Androl Urol Date: 2017-04