[How valuable for prognosis is the perioperative assessment of serum creatinine values with reference to postoperative renal complications in risk patients?].
Renal function is not considered to be as important as cardiovascular or respiratory function during the perioperative period. Nevertheless, recent studies demonstrate a significant correlation between preoperative levels of creatinine and postoperative disturbances of kidney function.


RESULTS
In a retrospective study 250 patients with the ASA physical status classification III and IV were investigated. All patients had a preoperative creatinine level greater than 1.0 mg/dl. For further investigations patients were divided into two groups; group I consisted of patients with preoperative creatinine level of 1.0-1.19 mg/dl; group II patients had preoperative creatinine levels greater than 1.2 mg/dl. Postoperatively these parameters were monitored on the 1st, 3rd and 5th days. A deterioration of renal function was seen postoperatively in all high risk patients (Tables 3, 4). Group II patients showed significant changes in kidney function on the 3rd and 5th postoperative days (p less than 0.005). During the study period the creatinine levels in this group did not return to normal values. In this group four patients suffered acute postoperative kidney failure, and two of these died.


CONCLUSIONS
In a recent study Hou et al. [5] could show that 5% of all patients suffer renal insufficiency during their hospital stay. Mortality for acquired renal failure is still 40-70%. The most important factor in the development of disturbances of kidney function is pre-existing kidney disease. The patients investigated in this study were high-risk patients. Cardiovascular complications during the perioperative phase are common, and hemodynamically mediated renal failure is the most frequent form of kidney failure.(ABSTRACT TRUNCATED AT 250 WORDS)
Kröll
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Universitäts-Klinik für Anaesthesiologie, Graz.
List
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WF
D058186:Acute Kidney Injury / Q000097:blood*; D000765:Anesthesia, Conduction; D000769:Anesthesia, Inhalation; D001794:Blood Pressure; D002318:Cardiovascular Diseases / Q000097:blood; D003404:Creatinine / Q000097:blood*; D006801:Humans; D007677:Kidney Function Tests; D011183:Postoperative Complications / Q000097:blood*; D011379:Prognosis; D012307:Risk Factors
D003404:Creatinine
Wie aussagekräftig ist die perioperative Verlaufskontrolle des Serum-Kreatininwertes im Hinblick auf postoperative renale Komplikationen beim Risikopatienten?