Gennadiy G. Khubulava, Andrey B. Sazonov, Oleg A. Nagibovich, Kirill V. Kitachov, Roman O. Nagibovich, Konstantin Y. Petrov, Ruslan A. Ahadov

Medical Military Academy St.Petersburg, St.Petersburg, Russia

Date, time and location: 2018.05.25 13:30, Congress Hall, 2F–B

Abstract

Objective: To find operative intervention indicators which are forming surgery risk factor acute kidney injury (AKI) after aortoiliac reconstruction and to predict individual AKI stage in postoperative period. 

Methods: We performed medical record of 457 patients with different forms of aortoiliac occlusive diseases, which had surgical intervention between January 2007, through December 2016. For diagnose AKI we used KDIGO (Kidney Disease Improve Global Outcomes) criteria. All patients were dividing into two groups: group 1 (n=81) without AKI, and group 2 (n=376) with AKI. We used adescriptive statistics, correlation and regression statistical analysis. 

Results: In patient which have had surgical intervention the real AKI rate was 91% (95% CI 87,3%-94,5%) in contrast with recorded cases of AKI 51,4% (95% CI 47,6%-54,2%). Patient with AKI had higher (p<0,001) blood loss level in operation time and "creatininum peak" on the 4th day after surgical procedure. The regression model of maximum creatininemia level and AKI stage during 7 days after aortoiliac reconstruction was shown. 

Conclusion: Surgical procedure as a major risk factor with other factors are increasing a developing of AKI from patients undergoing aortoiliac reconstructions. The proprieties (speed, volume and duration) of intraoperative blood loss are a second major factor. The regression model, based on standard indicators (blood creatinin level before the surgical intervention, infusion therapy volume, aorta clamping time), will help to set a AKI stage during the first seven days after reconstruction. The phenomenon of the 4th day peak of creatinin level hasn't described yet. Medical staff have diagnosed AKI only in half of cases.