Chronic kidney disease and postoperative mortality: A systematic review and meta-analysis

A. Mathew, P. J. Devereaux, A. O'Hare, M. Tonelli, Heather Thiessen Philbrook, I. F.P. Nevis, A. V. Iansavichus, A. X. Garg

Research output: Contribution to journalReview article

Abstract

Whether renal dysfunction is an important factor in postoperative risk assessment has been difficult to prove. In an attempt to provide more compelling evidence, we conducted a systematic review comparing the risk of death and cardiac events in patients with and without chronic kidney disease who underwent elective noncardiac surgery. From electronic databases, web search engines, and bibliographies, 31 cohort studies were selected, evaluating postoperative outcomes in patients with chronic kidney disease. These patients had higher risks of postoperative death and cardiovascular events compared to those with preserved renal function. The pooled incidence of postoperative death was significantly less in those with preserved renal function than in those patients with chronic kidney disease. Meta-regression showed a graded relationship between disease severity and postoperative death. In adjusted analysis, chronic kidney disease had a similar strength of association with postoperative death as diabetes, stroke, and coronary disease. Our review identifies chronic kidney disease as an independent risk factor for postoperative death and cardiovascular events after elective, noncardiac surgery.

Original languageEnglish (US)
Pages (from-to)1069-1081
Number of pages13
JournalKidney International
Volume73
Issue number9
DOIs
StatePublished - Jan 1 2008
Externally publishedYes

Fingerprint

Chronic Renal Insufficiency
Meta-Analysis
Mortality
Kidney
Search Engine
Bibliography
Coronary Disease
Cohort Studies
Stroke
Databases
Incidence

Keywords

  • Chronic kidney disease
  • Meta-analysis
  • Postoperative risk

ASJC Scopus subject areas

  • Nephrology

Cite this

Mathew, A., Devereaux, P. J., O'Hare, A., Tonelli, M., Thiessen Philbrook, H., Nevis, I. F. P., ... Garg, A. X. (2008). Chronic kidney disease and postoperative mortality: A systematic review and meta-analysis. Kidney International, 73(9), 1069-1081. https://doi.org/10.1038/ki.2008.29

Chronic kidney disease and postoperative mortality : A systematic review and meta-analysis. / Mathew, A.; Devereaux, P. J.; O'Hare, A.; Tonelli, M.; Thiessen Philbrook, Heather; Nevis, I. F.P.; Iansavichus, A. V.; Garg, A. X.

In: Kidney International, Vol. 73, No. 9, 01.01.2008, p. 1069-1081.

Research output: Contribution to journalReview article

Mathew, A, Devereaux, PJ, O'Hare, A, Tonelli, M, Thiessen Philbrook, H, Nevis, IFP, Iansavichus, AV & Garg, AX 2008, 'Chronic kidney disease and postoperative mortality: A systematic review and meta-analysis', Kidney International, vol. 73, no. 9, pp. 1069-1081. https://doi.org/10.1038/ki.2008.29
Mathew, A. ; Devereaux, P. J. ; O'Hare, A. ; Tonelli, M. ; Thiessen Philbrook, Heather ; Nevis, I. F.P. ; Iansavichus, A. V. ; Garg, A. X. / Chronic kidney disease and postoperative mortality : A systematic review and meta-analysis. In: Kidney International. 2008 ; Vol. 73, No. 9. pp. 1069-1081.
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