Related Experiment Video

Updated: Jul 31, 2025

5/6 Nephrectomy Using Sharp Bipolectomy Via Midline Laparotomy in Rats
05:34

5/6 Nephrectomy Using Sharp Bipolectomy Via Midline Laparotomy in Rats

Published on: April 4, 2025

730

Chronic Kidney Disease Predicts Greater 5-Year Mortality Following Major Limb Amputation

Luke T Pitsenbarger1, Maria N Som1, Natalie T Chao1

  • 1Vascular Division, Department of Surgery, University of Maryland School of Medicine, Baltimore, MD, USA.

The American Surgeon
|May 3, 2023
PubMed

Insights

Chronic kidney disease (CKD) increases mortality risk after major lower extremity amputation (MLEA), even in earlier stages. Early CKD identification and treatment are crucial for improving patient survival outcomes.

Area of Science:

  • Nephrology
  • Vascular Surgery
  • Epidemiology

Background:

  • Severe chronic kidney disease (CKD) is linked to higher mortality post-major lower extremity amputation (MLEA).
  • The impact of earlier CKD stages on post-MLEA outcomes remains less understood.
  • CKD is a significant comorbidity affecting surgical patient prognosis.

Purpose of the Study:

  • To investigate the association between all stages of CKD and mortality after MLEA.
  • To determine if earlier CKD stages predict adverse outcomes comparable to severe CKD.
  • To highlight the importance of preoperative CKD assessment in MLEA patients.

Main Methods:

  • Retrospective chart review of 398 patients undergoing MLEA between 2015-2021.
  • Stratification of patients based on glomerular filtration rate (GFR) to define CKD stages.
  • Statistical analysis including Chi-Square and Kaplan-Meier survival analysis to compare mortality rates.

Main Results:

  • Preoperative CKD diagnosis correlated with increased comorbidities and higher 1- and 5-year mortality.
  • Patients with any stage of CKD had significantly worse 5-year survival (62%) compared to those without CKD (81%; P < .001).
  • Both moderate (HR 2.37, P = .02) and severe CKD (HR 2.09, P = .005) independently predicted increased 5-year mortality.

Conclusions:

  • CKD, including moderate and severe stages, is an independent predictor of mortality following major lower extremity amputation.
  • Early identification and management of CKD preoperatively may improve survival rates in this vulnerable patient population.
  • Findings underscore the need for proactive nephrological care in patients undergoing major limb surgery.

Keywords:
chronic kidney diseasemajor limb amputationmortalityrenalvascular surgery

More Related Videos

A Murine Model of Hemodialysis Access-Related Hand Dysfunction08:39

A Murine Model of Hemodialysis Access-Related Hand Dysfunction

Published on: May 31, 2022

1.7K
Assessment of Vascular Function in Patients With Chronic Kidney Disease08:50

Assessment of Vascular Function in Patients With Chronic Kidney Disease

Published on: June 16, 2014

16.3K

Related Concept Videos

Chronic Kidney Disease I: Introduction01:25

Chronic Kidney Disease I: Introduction

Chronic Kidney Disease (CKD) arises when the kidneys progressively lose their ability to function, ultimately leading to end-stage renal disease. At this advanced stage, the kidneys can no longer filter waste or maintain essential body functions, requiring renal replacement therapy (RRT) through dialysis or a kidney transplant for survival.Early-stage chronic kidney disease and detection challengesIn CKD's early stages, symptoms often remain absent because healthy nephrons compensate for...
49
Chronic Kidney Disease III: Interprofessional Care01:28

Chronic Kidney Disease III: Interprofessional Care

Chronic kidney disease (CKD) requires collaborative and comprehensive management. CKD progresses through stages and can lead to end-stage kidney disease (ESKD) if untreated. Interprofessional collaboration and patient education are crucial, enabling patients to manage their health and improve their quality of life.Diagnostic approach for chronic kidney diseaseThe diagnosis of CKD primarily focuses on the glomerular filtration rate (GFR), which assesses kidney function by measuring how well...
56
Chronic Kidney Disease II: Clinical Manifestations01:24

Chronic Kidney Disease II: Clinical Manifestations

Chronic Kidney Disease (CKD) progressively impairs multiple body systems due to the accumulation of uremic toxins, which disrupt cellular functions across various organs.Neurologic symptomsNeurologic symptoms often arise early in CKD, as uremic toxin buildup drives changes in cognitive and motor functions. Patients frequently experience fatigue, headache, confusion, difficulty concentrating, and, in severe cases, seizures. Peripheral neuropathy commonly manifests as burning sensations in the...
47
Acute Kidney Injury II: Pathophysiology01:29

Acute Kidney Injury II: Pathophysiology

Acute kidney injury (AKI) causes are categorized into three primary categories based on the location of the injury: prerenal, intrarenal (or intrinsic), and postrenal causes. This classification guides clinical management and illustrates how different pathways can impair kidney function.Etiology and Pathophysiology of Acute Kidney Injury1. Prerenal causesEtiology: Prerenal Acute Kidney Injury, the most common type, occurs when reduced blood flow to the kidneys decreases filtration capacity...
37
Acute Kidney Injury III: Clinical Manifestations01:29

Acute Kidney Injury III: Clinical Manifestations

Acute Kidney Injury (AKI) progresses through distinct clinical phases: the oliguric, diuretic, and recovery phases, each marked by unique manifestations and challenges.Oliguric Phase:The oliguric phase is the initial stage of AKI, typically lasting 10 to 14 days. This phase is marked by a significant reduction in urine output, usually less than 400 mL per day, indicating decreased kidney function. Fluid retention is a prominent feature, leading to symptoms such as edema, hypertension, and...
46
Acute Kidney Injury IV: Diagnostic Studies and Prevention01:30

Acute Kidney Injury IV: Diagnostic Studies and Prevention

Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...
42