ACUTE POSTOPERATIVE RENAL DAMAGE
Keywords:
acute postoperative renal damage, hemorrhage, renal replacement therapyAbstract
Purpose. Establish risk factors for acute postoperative renal damage (APRD). Material and methods. A retrospective, observational, cohort study of APRD, in order to determine the frequency and severity after resection of abdominal aortic aneurysm in 165 patients, hernia repair — 74 patients, peritonitis — 68 patients, pancreatic necrosis — 107 patients. Postoperative acute renal injury was diagnosed on the basis of RIFLE scale. Results and discussion. Among 414 patients in the preoperative period, the risk “R” of renal damage development was detected in 18.5% of patients, at the postoperative period and APRD at the system “I” (damage) occured almost 2 times as often as it was expected. Besides, a more severe degree “F” formed at stage “I” almost in 50% of patients. The connection between the blood loss and the level of urea and plasma creatinine plasma, allotransfusion and urea level, plasma creatinine as well as between intravascular hemolysis and the level of urea and creatinine, the relationship between volume and hemodilution level of urea and blood plasma creatinine. The obtained data were the basis for the change of intraoperative intensive therapy management, including term of renal replacement therapy. The most important factor, both the development and outcome of APRD are signs of surgery and its complications. Conclusions. It was determined the risk of APRD before operation based on RIFLE, SAPS, ASA scale. There was established “operational” risk factors for acute postoperative renal damage. Development of postoperative complications is an important factor of the APRD outcome.
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