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Efficacy of Estimated Glomerular Filtration Rate in Prediction of the Early Complication After Peripheral Artery Reconstruction

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Kazimierczak A., Cnotliwy M., Gutowski P.
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issue 11
512-517
EN
Glomerular Filtration Rate impairment is an important risk factor of complication after operation. The recognition of Chronic Kidney Disease prior to surgery assists in reducing postoperative complications. This is especially important for arteriosclerotic patients with kidney function impairment, which quite often persist unrecognized. Estimation of the eGFR identify patients with CKD and assist in the planning and modification of treatment.The aim of the study was evaluation of the number of patients with impaired kidney function (eGFR 15-60 ml/min/1.73 m2) from those referred for artery reconstruction. The analysis of early complications related to the impaired GFR.Material and methods. Prospective not-randomized trial of a group of 828 patients who had undergone surgical or endovascular procedures. On admission eGFR was assessed according to the Cockroft-Gault formula. Comparison in frequency and type of early complication was performed between two groups (eGFR ≤ 60 ml/min/1.73 m2 - 536 patients and eGFR 15-60 ml/min/1.73 m2 - 292 patients).Results. Impaired Kidney Function with eGFR in the range between 15- 60 ml/min/1,73 m2, was recognized in 35% of patients. In the impaired eGFR group gastrointestinal bleeding (p<0.0005), acute renal insufficiency (p<0.0005), pneumonia (p<0.05), diabetes decompensation (p<0.005) and myocardial infarct occurred more often (p<0.05) compared to the normal kidney group. Only a few general and local complications were noticed after the aortic arch arteries operations and endovascular procedures. No statistically insignificant differences were observed between both groups.Conclusions. Glomerular Filtration Rate assessment prior to surgery is useful in predicting severe complications after vascular surgery and should be performed on a regular basis.
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