LONDON, Ontario—The rate of acute dialysis after elective major surgery tripled in Ontario between 1995 and 2009, new findings suggest. The increase was primarily among patients undergoing cardiac and vascular surgery, reported Renal & Urology News.
The investigators, led by Amit Garg, MD, PhD, of the London Health Sciences Centre in London, Ontario, said they believe the cause may be an increase in proportion of individuals with preoperative chronic kidney disease who undergo major surgery. They are now testing interventions aimed at reducing the post-operative rates of acute kidney injury (AKI), particularly among patients with compromised kidney function before the surgery.
“One of our trials, which are all funded by the CIHR [Canadian Institutes of Health Research], is looking at the spice turmeric for the prevention of AKI in the elective abdominal aortic aneurysm repair setting, where there are high rates of AKI,” Garg said.
Garg and his colleagues used data on hospital admissions from the Canadian Institute for Health Information's discharge-abstract database, information on inpatient and outpatient services from the Ontario Health Insurance Plan, and vital statistics on all permanent Ontario residents from the Registered Persons Database.
They analyzed data from 552,672 adults admitted to hospital for an overnight stay for elective major surgery between Jan. 1, 1995 and Dec. 31, 2009.
“We wanted to restrict our analysis to people who had major surgery,” Garg said. “Day surgery procedures are much less invasive, and the complication rate there, particularly for acute kidney injury—whether it requires dialysis or not—has not been an important medical concern.”