• Kianoush Kashani, Jon H Steuernagle, Abbasali Akhoundi, Anas Alsara, Andrew C Hanson, and Daryl J Kor.
• Divisions of Nephrology and Hypertension; Division of Pulmonary and Critical Care, Department of Medicine. Electronic address: kashani.kianoush@mayo.edu.
• J. Cardiothorac. Vasc. Anesth. 2015 Dec 1; 29 (6): 1588-95.

ObjectivesTo develop a risk-prediction model for acute kidney injury (AKI) in patients undergoing vascular surgery.DesignA retrospective cohort study.SettingA tertiary referral center.ParticipantsParticipants included 845 adult patients who underwent vascular surgery between January 3, 2003, and May 29, 2008.InterventionsNone.Measurements And Main ResultsThe median age of patients was 72 years (interquartile range 65-80 years), and 653 patients (77%) were male. AKI developed in 258 (30.5%) patients. Patients with AKI had lower estimated glomerular filtration rates (60±21 v 72±21, p<0.001), were older (73 [68-78] years v 71 [65-80] years, p = 0.01), had a higher prevalence of hypertension (81% v 73%, p = 0.02), and were more likely to undergo emergency surgery (5% v 2%, p = 0.02). Patients with AKI also received more diuretics (p<0.001) and β-blockers (p = 0.003) prior to surgery. The multivariate AKI risk-prediction model with preoperative variables (estimated glomerular filtration rate, previous vascular interventions, use of preoperative diuretics and β-blockers, and emergency surgery) showed an area under the receiver operating characteristic curve of 0.67 (95% confidence interval, 0.628-0.710); a model with additional intraoperative variables (procedure duration, fluid balance, and plasma and platelet transfusion) had an area under the receiver operating characteristic curve of 0.72 (95% confidence interval, 0.685-0.760).ConclusionsAs AKI is a very common complication after vascular surgery, a risk-prediction model was derived to assess the likelihood of postoperative AKI. If validated in an independent cohort, this model may be used to facilitate targeted interventions in vascular surgery patients at high risk for AKI.Copyright © 2015 Elsevier Inc. All rights reserved.

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