[Incidence and risk factors of postoperative emergency treatment in dialysis patients after elective noncardiac surgery: a five-year retrospective study].
BACKGROUND
Chronic hemodialysis patients undergoing surgery require intensive care. The purpose of this study was to determine the incidence and risk factors of emergency treatment before the planned elective postoperative dialysis.


METHODS
One hundred and ten dialysis patients undergoing elective noncardiac surgery were retrospectively analyzed.


RESULTS
Emergency treatment was performed in 31 (28.1%) of the 110 patients, including one patient with emergency dialysis, because of hyperkalemia (n = 27) or metabolic acidosis (n = 4). Receiving operating characteristic curve analysis showed a cutoff value for serum potassium concentration < 4.0 mEq x l(-1) estimated by maximizing the Youden index. We could not find other perioperative data as significant risk factors for emergency treatment.


CONCLUSIONS
About 30 percent of dialysis patients aftet elective noncardiac surgery required emergency treatment. The highest risk was high serum potassium concentrations after induction of anesthesia Preoperative serum potassium concentrations should be kept below 4.0 mEq x l(-1) to avoid postoperative emergency treatment.
Kenji
K
Uehara
Sayako
S
Oya
Miki
M
Kameyama
Noriko
N
Terada
Masakazu
M
Yamaoka
Makoto
M
Takatori
Keiichi
K
Tada
D000368:Aged; D002122:Calcium Chloride / Q000008:administration & dosage; D003956:Dialysis; D017558:Elective Surgical Procedures; D004632:Emergency Medical Services / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D006947:Hyperkalemia / Q000453:epidemiology* / Q000517:prevention & control* / Q000628:therapy; D015994:Incidence; D007362:Intensive Care Units / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D019990:Perioperative Care; D011182:Postoperative Care / Q000706:statistics & numerical data*; D011183:Postoperative Complications / Q000453:epidemiology* / Q000517:prevention & control* / Q000628:therapy; D012189:Retrospective Studies; D012307:Risk Factors; D017693:Sodium Bicarbonate / Q000008:administration & dosage; D013514:Surgical Procedures, Operative; D013997:Time Factors
D017693:Sodium Bicarbonate; D002122:Calcium Chloride