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Preoperative assessment in chronic kidney disease

Thomas Hanna, Jacob A Akoh
Renal hyperparathyroidism (RHPT) is a common complication of renal failure and it is associated with significant morbidity and mortality. The aim of this study was to determine the patient characteristics which might predict persistent or recurrent hyperparathyroidism after surgery and to assess the long-term effect of unsuccessful surgery. This is a retrospective study of all chronic kidney disease patients who required a total parathyroidectomy (TP) because of failed medical management from January 1999 to December 2014...
September 2016: Saudi Journal of Kidney Diseases and Transplantation
Aleksandra Nowicka, Thomas Selvaraj
STUDY OBJECTIVE: The aim of this study was to establish the incidence of acute kidney injury (AKI) in patients undergoing elective hip and knee arthroplasty. DESIGN: This was a retrospective cohort study. SETTING: The study was conducted in a district general hospital in the United Kingdom. PATIENTS: All patients undergoing elective hip and knee arthroplasty over a period of 6 months were included in the study. MEASUREMENT: Preoperative and postoperative serum creatinine concentration was recorded in all patients...
November 2016: Journal of Clinical Anesthesia
Jason H Greenberg, Michael Zappitelli, Prasad Devarajan, Heather R Thiessen-Philbrook, Catherine Krawczeski, Simon Li, Amit X Garg, Steve Coca, Chirag R Parikh
Importance: Acute kidney injury (AKI) after pediatric cardiac surgery is associated with high short-term morbidity and mortality; however, the long-term kidney outcomes are unclear. Objective: To assess long-term kidney outcomes after pediatric cardiac surgery and to determine if perioperative AKI is associated with worse long-term kidney outcomes. Design, Setting, and Participants: This prospective multicenter cohort study recruited children between ages 1 month to 18 years who underwent cardiopulmonary bypass for cardiac surgery and survived hospitalization from 3 North American pediatric centers between July 2007 and December 2009...
September 12, 2016: JAMA Pediatrics
Maria Carmen Mir, Ithaar Derweesh, Francesco Porpiglia, Homayoun Zargar, Alexander Mottrie, Riccardo Autorino
BACKGROUND: Partial nephrectomy (PN) is the reference standard of management for a cT1a renal mass. However, its role in the management of larger tumors (cT1b and cT2) is still under scrutiny. OBJECTIVE: To conduct a meta-analysis assessing functional, oncologic, and perioperative outcomes of PN and radical nephrectomy (RN) in the specific case of larger renal tumors (≥cT1b). The primary endpoint was an overall analysis of cT1b and cT2 masses. The secondary endpoint was a sensitivity analysis for cT2 only...
September 7, 2016: European Urology
Fatima Z Husain, Daniel C Rosen, David J Paulucci, John P Sfakianos, Ronney Abaza, Ketan K Badani
OBJECTIVE: To assess the association between the R.E.N.A.L. Nephrometry score, the amount of non-neoplastic parenchymal volume (NNPV) removed, and the renal function decline in patients undergoing robotic partial nephrectomy (RPN). PATIENTS AND METHODS: The Multi-institutional Mount Sinai Kidney Cancer Database was used to identify 1235 patients who underwent RPN between January 2008 and February 2016, of whom 366 had complete data, including NNPV removed. Mann-Whitney U tests and univariable linear regression models were used to assess the relationships between R...
October 2016: Journal of Endourology
Bo Zhang, Cheng Shen, Jie Jin, Yi Song, Zheng Zhao, Xiaochun Zhang, Gang Wang, Yu Fan, Yue Mi, Shuai Hu, Yun Cui, Liqun Zhou, Zhisong He, Wei Yu, Wenke Han
PURPOSE: Pretreatment serum pseudocholinesterase (PChE) has been reported to be a prognostic predictor in several cancers. However, the prognostic significance of serum PChE level in patients with upper tract urothelial carcinoma (UTUC) remains unknown. METHODS: A total of 180 patients who underwent radical nephroureterectomy (RNU) for UTUC were included in this retrospective analysis. The associations of pretreatment serum PChE levels with clinicopathological characteristics and clinical outcomes were assessed...
August 23, 2016: International Urology and Nephrology
Nirmish Singla, Ryan Hutchinson, Ahmed Haddad, Arthur Sagalowsky, Yair Lotan, Vitaly Margulis
INTRODUCTION: To compare renal function changes after radical nephroureterectomy (RNU) in patients with upper tract urothelial carcinoma (UTUC) based on the presence of preoperative hydronephrosis. MATERIALS AND METHODS: Clinicopathologic data of 208 patients with UTUC treated surgically from 1998 to 2013 were compiled. Patients with bilateral disease, less than 1 month follow up, missing hydronephrosis data, or who underwent nephron-sparing approaches were excluded...
August 2016: Canadian Journal of Urology
Jean-Michel Hougardy, Perrine Revercez, Aline Pourcelet, Bachar El Oumeiri, Judith Racapé, Alain Le Moine, Frédéric Vanden Eynden, Daniel De Backer
BACKGROUND: Cardiac surgery-associated acute kidney injury (CSA-AKI) is a common complication and is associated with the poorest outcomes. Therefore, early prediction of CSA-AKI remains a major issue. Severity scores such as the STS score could estimate the risk of AKI preoperatively. The main objective of this study was to evaluate the risk factors of on-pump CSA-AKI and to assess the performance of the STS score in order to predict CSA-AKI. PATIENTS: We identified 252 patients with on-pump cardiac surgery, and the STS score was defined retrospectively...
June 2, 2016: Acta Chirurgica Belgica
Andrew S Barbas, Yanhong Li, Murtuza Zair, Julie A Van, Olusegun Famure, Martin J Dib, Jerome M Laurence, S Joseph Kim, Anand Ghanekar
Living kidney donor evaluation commonly includes nuclear renography to assess split kidney function and computed tomography (CT) scan to evaluate anatomy. To streamline donor workup and minimize exposure to radioisotopes, we sought to assess the feasibility of using proportional kidney volume from CT volumetry in lieu of nuclear renography. We examined the correlation between techniques and assessed their ability to predict residual postoperative kidney function following live donor nephrectomy. In a cohort of 224 live kidney donors, we compared proportional kidney volume derived by CT volumetry with split kidney function derived from nuclear renography and found only modest correlation (left kidney R(2) =26...
September 2016: Clinical Transplantation
Rafael De la Garza Ramos, Amit Jain, Jonathan Nakhla, Rani Nasser, Varun Puvanesarajah, Hamid Hassanzadeh, Reza Yassari, Daniel M Sciubba
OBJECTIVE: To investigate the postoperative morbidity and mortality rate of patients with chronic kidney disease (CKD) and end-stage renal disease (ESRD) undergoing elective anterior cervical fusion (ACF). METHODS: The Nationwide Inpatient Sample database from 2002 to 2011 was used to identify adult patients who underwent elective ACF for degenerative spine disease. Major complication rates and in-hospital mortality was compared between three groups - no kidney disease, CKD, and ESRD (dialysis-dependent)...
June 29, 2016: World Neurosurgery
Himanshu J Patel, Donald S Likosky, Andrew L Pruitt, Edward T Murphy, Patricia F Theurer, Richard L Prager
BACKGROUND: As transcatheter aortic valve replacement (TAVR) therapy transitions from inoperable or high-risk patients to those considered moderate risk, a contemporary evaluation of AVR in this latter group is warranted. METHODS: Using the Michigan Cardiothoracic Surgical Quality Collaborative Database, we analyzed outcomes and identified predictors of a composite end point (30-day death, stroke, and dialysis) for 2,979 patients (2007 to 2015) undergoing AVR (n = 1,196) or AVR and coronary artery bypass grafting (n = 1,783) with a preoperative The Society of Thoracic Surgeons predicted risk of mortality (PROM) of 4% to 8% (mean, 5...
June 18, 2016: Annals of Thoracic Surgery
Takuya Ogami, Yuya Matsue, Ryo Kawasumi, Hiroaki Tanabe
PURPOSE: Chronic kidney disease (CKD) and anemia are independent preoperative risk factors for coronary artery bypass graft (CABG) surgery. We evaluated the implications of the coexistence of these two factors and their associated prognosis for CABG surgery. METHODS: We analyzed, retrospectively, consecutive patients who underwent elective CABG surgery between 2004 and 2014. The patients were classified into four groups depending on the presence or absence of preoperative CKD and anemia...
June 20, 2016: Surgery Today
Patrícia Barreto, Paulo Almeida, Norton de Matos, José Alexandre Queirós, Joaquim Pinheiro, Fernanda Silva, Telmo Carvalho, Rui Almeida, António Cabrita
PURPOSE: Hemodialysis (HD) is the main treatment modality in stage 5 chronic kidney disease, and vascular access planning is a crucial step in the path to dialysis treatment. Beyond detailed patient history and physical examination, duplex ultrasound (DU) evaluation is essential in preoperative vascular mapping. METHODS: A retrospective descriptive nonrandomized study was performed and included 108 end-stage kidney disease patients referred from eight HD centers to be assessed for creation of an arteriovenous (AV) access (AV fistula or AV graft)...
July 12, 2016: Journal of Vascular Access
Hao Chen, He Yang, Pu Jia, Li Bao, Hai Tang
BACKGROUND: Kyphoplasty is a popular treatment option for osteoporotic vertebral compression fractures (OVCFs). However, there is still a lack of comprehensive clinical evidence demonstrating whether kyphoplasty is suitable for treatment of OVCFs complicated by chronic kidney disease (CKD). The purpose of this study was to evaluate the effectiveness and safety of kyphoplasty in the treatment of OVCFs in CKD. METHODS: Twelve OVCF patients with CKD who received kyphoplasty were retrospectively reviewed...
September 2016: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
Yang Gi Ryu, Dong Kyu Lee, Man-Jong Baek, Heezoo Kim
BACKGROUND: The intraoperative assessment of autogenous arteriovenous fistulas (AVF) is crucial for achieving an optimal surgical outcome; however, it is not easy to predict the adequacy of surgically created AVF. We used the transit-time flow measurement (TTFM) method to assess the anastomotic quality of AVF and to identify the cutoff value for predicting prognosis of established AVF. METHODS: Retrospective study, a total of 187 patients were included in this study...
August 2016: Annals of Vascular Surgery
Kenneth Tran, Andres Fajardo, Brant W Ullery, Christopher Goltz, Jason T Lee
OBJECTIVE: Limited data exist regarding the effect of fenestrated endovascular aneurysm repair (fEVAR) on renal function. We performed a comprehensive analysis of acute and chronic renal function changes in patients after fEVAR. METHODS: This study included patients undergoing fEVAR at two institutions between September 2012 and March 2015. Glomerular filtration rate was estimated using the Modification of Diet in Renal Disease formula with serum creatinine levels obtained during the study period...
May 27, 2016: Journal of Vascular Surgery
Hironobu Sakaura, Toshitada Miwa, Yusuke Kuroda, Tetsuo Ohwada
OBJECTIVE The authors recently reported that the presence of chronic kidney disease (CKD) and/or extended abdominal aortic calcification was associated with significantly worse clinical outcomes after posterior lumbar interbody fusion. CKD is one of the highest risk factors for systemic atherosclerosis. Therefore, impaired blood flow due to atherosclerosis could exacerbate degeneration of the cervical spine and neural tissue. However, there has been no report of a study evaluating the deleterious effects of CKD and atherosclerosis on the outcomes after decompression surgery for cervical compression myelopathy...
May 27, 2016: Journal of Neurosurgery. Spine
Alexander Nelson, James Otto, John Whittle, Robert C M Stephens, Daniel S Martin, John R Prowle, Gareth L Ackland
OBJECTIVE: Reduced exercise capacity is well documented in end-stage chronic kidney disease (CKD), preceded by changes in cardiac morphology in CKD stage 3. However, it is unknown whether subclinical cardiopulmonary dysfunction occurs in CKD stage 3 independently of heart failure. METHODS: Prospective observational cross-sectional study of exercise capacity assessed by cardiopulmonary exercise testing in 993 preoperative patients. Primary outcome was peak oxygen consumption (VO2peak)...
2016: Open Heart
Sung Min Kim, Youngjin Han, Hyunwook Kwon, Hee Sun Hong, Ji Yoon Choi, Hojong Park, Tae-Won Kwon, Yong-Pil Cho
PURPOSE: The aim of this study was to determine the possible predictors of primary arteriovenous fistula (AVF) failure and examine the impact of a preoperative evaluation on AVF outcomes. METHODS: A total of 539 patients who underwent assessment for a suitable site for AVF creation by physical examination alone or additional duplex ultrasound were included in this study. Demographics, patient characteristics, and AVF outcomes were analyzed retrospectively. RESULTS: AVF creation was proposed in 469 patients (87...
April 2016: Annals of Surgical Treatment and Research
Timothy L Tan, Michael M Kheir, Dean D Tan, Edward J Filippone, Eric H Tischler, Antonia F Chen
BACKGROUND: Kidney disease is associated with increased complications in total joint arthroplasty (TJA). The purpose of this study was to determine the association of kidney disease severity as measured by the chronic kidney disease (CKD) staging system with complications after TJA. METHODS: A retrospective review of 12,308 primary TJAs (6361 hips and 5947 knees) from 2008 to 2013 was performed. The following preoperative variables were obtained from medical records: chemistry 7 panel, Elixhauser comorbidities, and demographic factors...
September 2016: Journal of Arthroplasty
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