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

被引：130

作者：

Mathew, A. ^{[1
]}

Devereaux, P. J. ^{[2
,3
]}

O'Hare, A. ^{[4
,5
]}

Tonelli, M. ^{[6
]}

Thiessen-Philbrook, H. ^{[1
]}

Nevis, I. F. P. ^{[1
]}

Iansavichus, A. V. ^{[1
]}

Garg, A. X. ^{[1
,2
,7
]}

机构：

[1] Univ Western Ontario, Dept Med, Div Nephrol, London, ON, Canada

[2] McMaster Univ, Dept Clin Epidemiol & Biostat, Hamilton, ON, Canada

[3] McMaster Univ, Dept Med, Hamilton, ON, Canada

[4] Univ Calif San Francisco, San Francisco, CA 94143 USA

[5] VA Med Ctr San Francisco, Div Nephrol, Dept Med, San Francisco, CA USA

[6] Univ Alberta, Dept Med, Div Nephrol, Edmonton, AB, Canada

[7] Univ Western Ontario, Dept Epidemiol & Biostat, London, ON, Canada

来源：

KIDNEY INTERNATIONAL | 2008年 / 73卷 / 09期

关键词：

chronic kidney disease; postoperative risk; meta-analysis;

D O I：

10.1038/ki.2008.29

中图分类号：

R5 [内科学]; R69 [泌尿科学（泌尿生殖系疾病）];

学科分类号：

1002 ; 100201 ;

摘要：

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.

引用

页码：1069 / 1081

页数：13

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