Acute kidney injury in peripheral arterial surgery patients: a cohort study

The aim of the study was to evaluate the prevalence of acute kidney injury (AKI) in a cohort of surgically treated patients with peripheral artery disease (PAD) and its association with the short-term and long-term outcome.

We conducted a retrospective cohort study on all the consecutive PAD inpatients in 2008. Data on the patients' demographic characteristics, medical history, treatment, outcome and laboratory tests measurements were retrieved from the medical records.

We analyzed 166 patients (71.6% males, mean age 63.2 years ± SD 10.7 years) and found an AKI prevalence of 12.7%. The AKI patients' group had more chronic kidney disease (CKD) (23.8% vs. 6.2%, p = 0.005), diabetes mellitus (DM) (61.9% vs. 33.1%, p = 0.011) and a higher length of hospital stay (19.48 vs. 15.42 days, p = 0.047). At one year, the mortality was 33.3% in the AKI group compared to 1.3% in non-AKI group, with a strong association between AKI and death (OR = 35.7; 95%CI = 6.7 to 189) and AKI and major cardiovascular events (OR = 29.1; 95% CI = 6.8 to 123.4). There was no significant difference in terms of age, cardiovascular disease and medication between the two groups.

AKI was associated with a poorer one-year outcome after the surgery of PAD patients. In our study, the presence of previous chronic kidney disease and type 2 diabetes increased the incidence of acute kidney injury after surgery.