Factors Affecting Perioperative Period Renal Function in Nephrectomies

Abstract

Patients who have had a nephrectomy usually have a history of renal dysfunction or are at risk for kidney failure due to tissue loss during surgery. In this study, our aim was to evaluate the factors affecting acute renal function in nephrectomy surgeries under general anesthesia. Demographic data of patients, case type, surgery type, duration of anesthesia, intraoperative lactate level, and postoperative complications of patients who underwent nephrectomy in our clinic were reviewed. Renal function was compared with urea, creatinine and estimated glomerular filtration rate (eGFR) levels in the preoperative (2 days before surgery) and postoperative period (day 2). The mean age of the patient was 58.2 ± 13.02 years, duration of anesthesia 166.24 ± 53.01/min, pre-operative eGFR 84.71 (67.69-90.0) mL/min/1.73 m2, and postoperative eGFR 65.09 (47.91-87.44) mL/min/1.73 m2 were respectively. When the pre- and postoperative renal functions of the patients were compared, the statistically significant results were those of urea (p: 0.01), creatinine (p:0.01), and GFR (p:0.01). The factors affecting GFR decrease were age (p:0.01) and case type (p:0.01). Increase in lactate levels in the postoperative period compared to the preoperative levels was statistically significant (p: 0.01). The increase in lactate levels was associated with complications (p: 0.001), case type (p:0.01) and surgery type (p: 0.01). Conclusions: The incidence of acute renal failure is increasing in nephrectomy surgeries, especially in radical ones. Age and case type are also the most important parameters to be consider.