Tuesday, 3 July 2012

Dialysis demand increases after elective surgery

Elective surgery - surgery which can be scheduled in advance as it does not involve a medical emergency.

The number of patients needing dialysis after major elective surgery has tripled since 1995, a Canadian study reported here suggests.

Researchers reviewed data on 552,672 patients in Ontario who had elective major surgery in the province between 1995 to 2009. Out of this group, 2,231 received acute dialysis within 14 days after surgery. This represents an increase from 0.2 percent in 1995 to 0.6 percent in 2009. An extra 0.4 percent might not seem much, but it's 1487 more people!

According to kidney specialist Dr. Amit Garg of London Health Sciences Centre, when someone develops the complication and is sick enough after surgery to need dialysis, 40 per cent will unfortunately have died at 90 days. So it's a very high risk of death in patients who develop this complication. And in those who survive 90 days, one fourth are now left with permanent kidney failure needing ongoing maintenance dialysis and those outcomes haven't changed in the last 15 years.

Older, sicker patients may be higher risk of acute kidney injury, the researchers said, with people who already had weak kidneys, or high blood pressure or diabetes before the surgery at highest risk.