Perioperative renal function and surgical outcome

A large proportion of patients undergoing surgery have coexisting chronic kidney disease, placing them at greater risk of postoperative morbidity and mortality. The purpose of this review is to review the recent developments in how renal function is estimated, how this relates to surgical outcomes, and how this has been applied clinically.

Recent developments in defining chronic kidney disease have coincided with an increased recognition of the prognostic importance of even mild preoperative renal dysfunction and the incorporation of more refined estimates of renal function into one of the most widely used risk prediction scores for cardiac surgery. In addition, several novel markers appear to hold promise as better predictors of perioperative outcome in general and acute kidney injury in particular.

Improved accuracy in defining kidney disease will aid clinicians in identifying higher risk patients, and aid earlier diagnosis of acute kidney injury. Further research is required, specifically on the implications of kidney disease in noncardiac surgical patients, and how defining renal function before and after surgery can aid in preventive strategies.