Article Abstract

Risk factors for acute renal failure in nephrectomized patients treated in a university hospital

Authors: João Paulo Pretti Fantin, Ronaldo de Carvalho Neiva, Marcio Gatti, Pedro Ferraz de Arruda, José Germano Ferraz de Arruda, Thiago Antoniassi, Luís Cesar Fava Spessoto, José Carlos Mesquita, Lilian Castiglioni, Fernando Nestor Fácio Júnior


Background: New surgical techniques for nephrectomy mainly related to early diagnosis made possible by advances in imaging studies have been developed in recent decades. However, postoperative renal dysfunction is a constant concern because of the major problems faced by healthcare services and by the patients themselves. To assess risk factors for developing acute renal failure (ARF) in patients submitted to nephrectomy in a university hospital.
Methods: Seventy-seven patients submitted to nephrectomy for benign and malignant diseases in a university hospital were evaluated in respect to preoperative and postoperative creatinine clearance. Demographic (gender, age), clinical (cancer, diabetes, high blood pressure, chronic kidney disease) and surgical (anesthesia time, open or laparoscopic surgery) variables were also analyzed.
Results: Of the 77 patients, 72 met the inclusion criteria. Of these, ten (13.8%) had a diagnosis of chronic renal failure (CRF), 30 (48%) had stage I ARF and one (16.1%) had stage II ARF. The anesthesia time, type of surgery (open or laparoscopy), total or partial nephrectomy, the side of the procedure, hypertension, diabetes, CRF, renal cancer, preoperative and postoperative creatinine concentrations were analyzed. Only the difference between preoperative and postoperative creatinine clearance was clinically significant (P<0.001).
Conclusions: An altered preoperative renal function is a risk factor for the development of ARF in nephrectomized patients.