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• W2051280623 abstract "In Brief Objective: To investigate the association between obesity and perioperative acute kidney injury (AKI), controlling for preoperative kidney dysfunction. Background: More than 30% of patients older than 60 years are obese and, therefore, at risk for kidney disease. Postoperative AKI is a significant problem. Methods: We performed a matched case-control study of patients enrolled in the Obesity and Surgical Outcomes Study, using data of Medicare claims enriched with detailed chart review. Each AKI patient was matched with a non-AKI control similar in procedure type, age, sex, race, emergency status, transfer status, baseline estimated glomerular filtration rate, admission APACHE score, and the risk of death score with fine balance on hospitals. Results: We identified 514 AKI cases and 694 control patients. Of the cases, 180 (35%) followed orthopedic procedures and 334 (65%) followed colon or thoracic surgery. After matching, obese patients undergoing a surgical procedure demonstrated a 65% increase in odds of AKI within 30 days from admission (odds ratio = 1.65, P < 0.005) when compared with the nonobese patients. After adjustment for potential confounders, the odds of postoperative AKI remained elevated in the elderly obese (odds ratio = 1.68, P = 0.01.) Conclusions: Obesity is an independent risk factor for postoperative AKI in patients older than 65 years. Efforts to optimize kidney function preoperatively should be employed in this at-risk population along with keen monitoring and maintenance of intraoperative hemodynamics. When subtle reductions in urine output or a rising creatinine are observed postoperatively, timely clinical investigation is warranted to maximize renal recovery. In a matched case-control study of Medicare patients, obesity was found to be an independent risk factor for postoperative acute kidney injury. This finding remained after controlling for patient comorbidities and postoperative complications associated with acute kidney injury." @default.
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• W2051280623 date "2013-08-01" @default.
• W2051280623 modified "2023-10-03" @default.
• W2051280623 title "Acute Kidney Injury, Renal Function, and the Elderly Obese Surgical Patient" @default.
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• W2051280623 doi "https://doi.org/10.1097/sla.0b013e31829654f3" @default.
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