The following is a summary of “Glomerular hyperfiltration is an independent predictor of postoperative outcomes: A NSQIP multi-specialty surgical cohort analysis,” published in the July 2023 issue of Nephrology by Riveros et al.
Although the high estimated glomerular filtration rate (eGFR) has been linked to higher overall mortality, its impact on postoperative outcomes is less well-known. Researchers started a retrospective study investigating the link between high eGFR and 30-day postoperative outcomes in a multi-specialty surgical cohort.
They used the National Surgical Quality Improvement Program database to choose adults for whom eGFR could be determined using the 2021 Chronic Kidney Disease Epidemiology Collaboration equation. These individuals were then categorized based on sex-specific eGFR distributions within age quintiles, resulting in low (<5th percentile), normal (5–95th percentile), and high eGFR (>95th percentile) groups. Primary outcome as 30-day major adverse events (death, reoperation, cardiac arrest, myocardial infarction, stroke). Secondary outcomes with 30-day infectious complications, VTE, transfusion-requiring bleeding, extended hospital stays, and unplanned readmissions. Adjusted for demographics, comorbidities, and surgical factors, logistic regression models assessed the link between extreme eGFR values and outcomes.
The results showed 1,668,447 patients, 84,115 (5.07%) had a high eGFR. Having a high eGFR was not linked to major adverse outcomes (OR 1.00 [95% CI: 0.97, 1.03]); nevertheless, it did correlate with reoperation (OR 1.04 [95% CI: 1.00, 1.08]), infectious complications (OR 1.14 [95% CI: 1.11, 1.16]), venous thromboembolism (VTE) (OR 1.15 [95% CI: 1.09, 1.22]), and extended length of hospital stay (OR 1.19 [95% CI: 1.16, 1.21]).
The results showed high kidney function may increase the risk of adverse postoperative outcomes.