Comparison of the Relationship between Preoperative Hemoglobin Level and Acute Renal Failure in Patients Undergoing Noncardiac Surgery

Document Type : Original Article (s)

Authors

1 Professor, Department of Anesthesiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

2 Student of Medicine, Student Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Background: Acute renal failure is one of the problems among hospitalized patients in different parts of the hospital, which, if not considered, will increase patient costs, length of hospitalization, and mortality rate; identification of factors affecting it will reduce these complications. Therefore, the aim of this study was to compare the relationship between preoperative hemoglobin level and acute renal failure in patients undergoing noncardiac surgery.Methods: This study was performed on 440 patients with noncardiac surgery. Patients were divided into four groups of 110 based on the level of hemoglobin and the need for blood transfusion. Then, the incidence of acute renal failure after the surgery and laboratory and demographic variables were determined and recorded in four groups. Chi-square and one-way ANOVA tests were used to compare studied variables.Findings: The lowest frequency of acute renal failure was found in the group of normal hemoglobin and no need for blood transfusion (3.6%); and the highest frequency was related to the group of abnormal hemoglobin and needing blood transfusion (54.5%) (P < 0.001). In addition, the group of abnormal hemoglobin and needing blood transfusion had the highest creatinine level (1.21 ± 0.29 mg/dl) at the second 24 hours after surgery (P < 0.001) and also had the lowest urinary output (3689.1 ± 452.7 cc) (P < 0.001).Conclusion: Our study revealed that patients with abnormal hemoglobin and needing blood transfusion have the highest risk for acute renal failure after the surgery. So that, the creatinine increased significantly in these patients and, on the other hand, urinary excretion reduced significantly.

Keywords

References

  1. Hahn K, Kanbay M, Lanaspa MA, Johnson RJ, Ejaz AA. Serum uric acid and acute kidney injury: A mini review. J Adv Res 2017; 8(5): 529-36.
  2. Sever MS, Erek E, Vanholder R, Koc M, Yavuz M, Aysuna N, et al. Lessons learned from the catastrophic Marmara earthquake: Factors influencing the final outcome of renal victims. Clin Nephrol 2004; 61(6): 413-21.
  3. Nash K, Hafeez A, Hou S. Hospital-acquired renal insufficiency. Am J Kidney Dis 2002; 39(5): 930-6.
  4. Connell A, Montgomery H, Morris S, Nightingale C, Stanley S, Emerson M, et al. Service evaluation of the implementation of a digitally-enabled care pathway for the recognition and management of acute kidney injury. F1000Res 2017; 6: 1033.
  5. Rodrigo E, Suberviola B, Santibanez M, Belmar L, Castellanos A, Heras M, et al. Association between recurrence of acute kidney injury and mortality in intensive care unit patients with severe sepsis. J Intensive Care 2017; 5: 28.
  6. Saillard C, Darmon M, Mokart D. Acute Kidney Injury in Patients with Cancer. N Engl J Med 2017; 377(5): 499.
  7. Massoudy P, Wagner S, Thielmann M, Herold U, Kottenberg-Assenmacher E, Marggraf G, et al. Coronary artery bypass surgery and acute kidney injury--impact of the off-pump technique. Nephrol Dial Transplant 2008; 23(9): 2853-60.
  8. Reeder BJ, Svistunenko DA, Cooper CE, Wilson MT. The radical and redox chemistry of myoglobin and hemoglobin: From in vitro studies to human pathology. Antioxid Redox Signal 2004; 6(6): 954-66.
  9. Moore KP, Holt SG, Patel RP, Svistunenko DA, Zackert W, Goodier D, et al. A causative role for redox cycling of myoglobin and its inhibition by alkalinization in the pathogenesis and treatment of rhabdomyolysis-induced renal failure. J Biol Chem 1998; 273(48): 31731-7.
  10. Holt S, Reeder B, Wilson M, Harvey S, Morrow JD, Roberts LJ, et al. Increased lipid peroxidation in patients with rhabdomyolysis. Lancet 1999; 353(9160): 1241.
  11. Christen S, Finckh B, Lykkesfeldt J, Gessler P, Frese-Schaper M, Nielsen P, et al. Oxidative stress precedes peak systemic inflammatory response in pediatric patients undergoing cardiopulmonary bypass operation. Free Radic Biol Med 2005; 38(10): 1323-32.
  12. Akbari H, Nikkhah A, Alizadeh A. Evaluation of acute renal failure and its associated factors in heart ‎surgery patients in Fatima Zahra Hospital, Sari, 2012. J Mazandaran Univ Med Sci 2014; 24(112): 97-102. [In Persian].
  13. Haase M, Bellomo R, Story D, Letis A, Klemz K, Matalanis G, et al. Effect of mean arterial pressure, haemoglobin and blood transfusion during cardiopulmonary bypass on post-operative acute kidney injury. Nephrol Dial Transplant 2012; 27(1): 153-60.
  14. Thakar CV, Yared JP, Worley S, Cotman K, Paganini EP. Renal dysfunction and serious infections after open-heart surgery. Kidney Int 2003; 64(1): 239-46.
  15. Desmet L, Lacroix J. Transfusion in pediatrics. Crit Care Clin 2004; 20(2): 299-311.
  16. Haase M, Bellomo R, Haase-Fielitz A. Novel biomarkers, oxidative stress, and the role of labile iron toxicity in cardiopulmonary bypass-associated acute kidney injury. J Am Coll Cardiol 2010; 55(19): 2024-33.
  17. Bailey M, McGuinness S, Haase M, Haase-Fielitz A, Parke R, Hodgson CL, et al. Sodium bicarbonate and renal function after cardiac surgery: A prospectively planned individual patient meta-analysis. Anesthesiology 2015; 122(2): 294-306.
Journal of Isfahan Medical School
Volume 35, Issue 443 - Serial Number 443
July and August 2017
Pages 1030-1037

Files

History

  • Receive Date: 23 July 2017
  • Revise Date: 02 November 2024
  • Accept Date: 06 April 2022

Share

How to cite

Statistics