267651 Association of Commonly Used Medications with Prevalence and Renal Recovery after Postoperative Acute Kidney Injury

Monday, October 29, 2012

Shahab Bozorgmehri, MD, MPH, CPH , Department of Epidemiology, University of Florida, Gainesville, FL
Meghan Brennan, MS , Department of Anesthesiology, University of Florida, Gainesville, FL
Tezcan Ozrazgat Baslanti, PhD , Department of Anesthesiology, University of Florida, Gainesville, FL
Charles E. Hobson, MD, MHA , Department of Surgery, University of Florida, Gainesville, FL
Azra Bihorac, MD, MS, FASN , Department of Anesthesiology, University of Florida, Gainesville, FL
Background: Acute kidney injury (AKI) is a common clinical condition in postoperative patients associated with a significantly increased risk of morbidity and mortality. We studied the association between the use of common postoperative medications and the prevalence of AKI as well as the recovery of renal function after the AKI episodes in postoperative patients. Methods: We conducted a retrospective, single center study of 54,768 adult surgical patients admitted to a tertiary academic center from 2000-2010 for ≥2 days. AKI was defined using consensus RIFLE classification. Renal outcome was classified as complete, partial and no renal recovery according to consensus. Results: AKI occurred in 21,361 (39%) patients, with RIFLE classes R, I and F, accounting for 21.3%, 10.3% and 7.4% respectively. Multivariate logistic regression showed that beta-blockers (OR 1.38, 95%CI 1.33-1.44), diuretics (OR 1.72,95% CI 1.65-1.80), aminoglycosides (OR 1.28,95% CI 1.20-1.36), vancomycin (OR 1.60, 95%CI 1.53-1.67), amphotericin B (OR 4.46, 95%CI 3.31-6.01), and antivirals (OR 1.24,95%CI 1.11-1.39) were significantly associated with higher risk for AKI, while ACE-inhibitors (OR 0.88, 95%CI 0.84-0.92), aspirin (OR 0.74,95%CI 0.70-0.77), NSAIDs (OR 0.91, 95%CI 0.81-0.96) and statins (OR 0.79, 95%CI 0.75-0.84) were associated with lower risk. Moreover, use of amphotericin B (OR 1.71, 95%CI 1.31-2.24), diuretics (OR 1.53, 95%CI 1.35-1.74), and beta-blockers (OR 1.18, 95%CI 1.04-1.35) was associated with increased risk for partial or no renal recovery after AKI episode. Conclusion: Our findings demonstrate that several commonly used postoperative medications may be associated not only with increased risk for AKI but also decrease the likelihood of renal recovery after AKI episode.

Learning Areas:
Epidemiology
Public health or related research

Learning Objectives:
Describe the prevalence of postoperative acute kidney injury (AKI) during hospitalization. Access the relationship between common postoperative medications and prevalence of AKI. Evaluate the association between the use of common postoperative medications and the recovery of renal function after the AKI episodes in postoperative patients.

Keywords: Epidemiology, Medicine

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been the sub-investigator of this study under supervision of Dr.Azra Bihorac,the principle investigator.I also performed the analysis and wrote parts of this abstract.I am a PhD student in epidemiology and my research interests are epidemiology of acute and chronic diseases including kidney diseases and cancer.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.