ASSOCIATION OF PREOPERATIVE RISK-FACTORS WITH POSTOPERATIVE ACUTE-RENAL-FAILURE

We performed a systematic review of 28 studies that examined preoperat ive risk factors for postoperative renal failure. Included in the stud ies were 10,865 patients who underwent either vascular, cardiac, gener al, or biliary surgery. No two studies used the same criteria for acut e renal failure. Variability in definitions of renal failure, lack of consistent criteria for establishing risk factors, and nonuniformity i n the statistical methods employed result in a literature that is not adequate to support a comprehensive quantitative review. Of the 30 var iables considered in the studies, preoperative renal risk factors, suc h as increased serum creatinine, increased blood urea nitrogen, and pr eoperative renal dysfunction were repeatedly found to predict postoper ative renal dysfunction. The literature provides little quantitative i nformation concerning the degree of risk associated with other factors . Cardiac risk factors, such as left ventricular dysfunction, were rep orted to be predictive of postoperative renal failure more consistentl y than was advanced age.