The study showed that 50.6 percent of patients were 65 years and older in 2006-2009, compared with 39.5 percent in 1995-1997, according to a report published in the Canadian Medical Association Journal (2012;184:1237-1245). In addition, the researchers found an increase in the proportions of diseases associated with postoperative acute dialysis, such as diabetes and chronic kidney disease (CKD).
The incidence of post-operative acute dialysis increased steadily from 0.2 percent in 1995 to 0.6 percent in 2009. The increase occurred in all age groups, but primarily among those who underwent cardiac and vascular surgery. Garg's team noted that “in recent years, as many as one in 80 patients had their cardiac surgery complicated by acute dialysis, compared to one in 390 in 1995.”
In addition, the time to the start of acute dialysis post-operatively grew shorter: In 1995, the first dialysis treatment was done a median of five days after surgery, and in 2009 it was two days.
The type of dialysis used also changed over time. After 1998, the researchers observed a shift almost completely away from peritoneal dialysis and toward continuous renal replacement therapy.
Among the 2,231 patients who receive post-operative acute dialysis, 937 deaths occurred within 90 days of surgery. The study did not show a significant change over time in 90-day post-operative mortality among those who received acute dialysis.
