Dialysis demand jumps after major elective surgeries

The number of patients receiving acute dialysis after cardiac and vascular surgery has increased three-fold since 1995 according to a study led by Dr. Amit Garg of the Departments of Medicine and Epidemiology & Biostatistics. The study is published in the CMAJ.

"Outcomes of patients treated with acute dialysis after surgery remain poor. Our results should prompt renewed efforts to develop and test interventions to prevent severe acute kidney injury (AKI) and to lessen the high burden of death and end-stage renal disease after acute kidney injury has occurred," says Dr. Amit Garg, one of the lead authors on the study. Dr. Garg is a Scientist at the Lawson Health Research Institute and ICES, a kidney specialist at the London Health Sciences Centre, and a Professor at Western's Schulich School of medicine & Dentistry.

The population-based study of Ontario patients between 1995 and 2009 found:

• 552,672 patients underwent major elective surgery and 2,231 received acute dialysis.
• AKI requiring dialysis is a devastating complication of major elective surgery. Among patients who received acute dialysis, 937 died within 90 days of surgery.
• Among the 1,294 patients who received acute dialysis and survived, 352 required chronic dialysis.
• The incidence of acute dialysis increased from 0.2 per cent in 1995 to 0.6 per cent in 2009.
• This increase was primarily seen following cardiac and vascular surgeries.