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Health See other Health Articles Title: Dialysis demand jumps after elective surgeries The number of patients needing dialysis after major elective surgery has tripled since 1995, a Canadian study suggests. Severe acute kidney injury needing dialysis is a serious complication that is on the rise, harming survival and quality of life, researchers say in Monday's issue of the Canadian Medical Association Journal. A man forms his hand in the shape of a heart over scars from heart surgery. More elective heart surgery patients are showing acute kidney complications.A man forms his hand in the shape of a heart over scars from heart surgery. More elective heart surgery patients are showing acute kidney complications. (Charles Rex Arbogast/Associated Press) For the study, researchers reviewed data on 552, 672 patients in Ontario who had elective major surgery in the province between 1995 to 2009 to understand trends in dialysis. Of these patients, 2, 231 received acute dialysis within 14 days after surgery. The incidence increased from 0.2 percent in 1995 to 0.6 percent in 2009. The surgeries included heart bypasses that didn't require emergency treatment, as well as other elective procedures like treating ballooning of the aorta — the major blood vessel supplying the legs — which may not cause symptoms but risks rupturing. "We see the rates are going up but when someone develops this complication what is their prognosis?" asked kidney specialist Dr. Amit Garg of London Health Sciences Centre, one of the lead authors of the study. "So unfortunately, when someone develops the complication and is sick enough after surgery to need dialysis, 40 per cent will unfortunately have died at 90 days. So it's a very high risk of death in patients who develop this complication. And in those who survive 90 days, one fourth are now left with permanent kidney failure needing ongoing maintenance dialysis and those outcomes haven't changed in the last 15 years." For survivors who need dialysis long term, it can mean having to go for treatment three times a week. Garg said the the paper aims to raise awareness of an important issue. Older patients and weak kidneys "It's serving as a call to action for us to work on testing strategies to prevent this from occurring and when it does occur, preventing people from having bad outcomes," he said. Potential treatments being tested could include drugs and surgery, as well as changes to health services. It's reasonable to assume that older, sicker patients may be higher risk of acute kidney injury, the researchers noted. In particular, people who already had weak kidneys before the surgery were at highest risk, said Garg, who is also a professor of medicine and epidemiology at Western University, a scientist at ICES and a nephrologist at Lawson Health Research Institute. Those with high blood pressure or diabetes were also at greater risk of suffering the kidney complication. To conduct the study, Garg's team used three linked databases on hospital admissions and discharges, which included information on diagnoses and procedures performed as well a physician billing database and vital statistics. "Worldwide, that means each year there's about a million people who require acute dialysis after major surgery," Garg said. The researchers weren't able to tell if the thresholds for starting dialysis changed over the course of the study and the team did not have access to the patients' lab test results. If someone had more than one admission to hospital during the study period then only the first one was analyzed to avoid selecting surgeries besides the first, elective one. The other study authors were from Western, Toronto's Institute for Clinical Evaluative Sciences, University of Toronto, McMaster University in Hamilton and Yale University in New Haven, Conn. The research was funded by the Lawson Health Research Institute. With files from CBC's Amina Zafar Poster Comment: GeckoX: t's probably related to the strong drugs they are given before, during, and after surgery. A lot of the pharmceutical cardio-protectives like beta blockers do rapid damage to the liver and kidneys at higher doses, which is what they tend to use for heart surgeries. It amazes me that all of the cases of dialysis following heart surgery do not trigger immediate investigations into certain health practices and procedures by the College of Physicians. If this was in the natural health field the government would be arresting people, shutting down businesses, and banning health products left, right and centre; but when it's MDs tens of thousands of people die every year and these drugs still fill the market. Who is really benefiting from this? So many people should not be dying from secondary complications over procedures intended to improve their lives! Acrolein: Of course they need dialysis the drugs used before and after the surgery can damage the kidneys especially after heart surgery. Beta blockers just about killed me,this compound works on the central nervous system and if I had been on it for more than a few days god knows what would have been the result. Thirty minutes after I took the medication my blood pressure dropped as well as my heart rate which was barely legible! When I started flushing it appeared to me that I was in serious trouble. I am positive this medication is a metobolic toxin because of its chemical structure is the same or similar molecular structure to cyclophoshamide, trade name Cytoxan a chemotherapy drug which not only apparently creates reactive carbonyl molecules of acrolein in the liver it is also synthesized from these same reactive carbonyls! Acrolein is known to damage the mitochondria in both the liver and kidneys and is the major inducer of hemorrhagic cystitis in the bladder. I will have to say probably also one of the major inducers of swollen and cancerous prostrates as well. Check out cyclophosphamide in Medicinenet.com and its metabolites and also the toxicity of beta blockers and you should be able to see the connection as both will cause oxidation of lipids = Acrolein! Also anesthesiology can cause damage to the kidneys! I am concerned anesthesiology is dangerous at any level to both the liver and the kidneys as some people can detoxify these compounds but many of us can not! Its not just beta blockers and chemotherapy drugs that damage the mitochondria, most NSAIDS like Tylenol that are given post op cause the same phenomenon. It appears the physicians want to repair your cardio system so you can live long enough to develop cancer from the pharmacology.Rating-8Agree with comment (12 people agree)Disagree with comment (20 people disagree)ReplyPolicyReport abuse (1) Think Twice: My mother was one of these statistics.At 84 she had a single bypass and valve replacement and came out needing dialysis. The dialysis required someone to drive her to a city an hour away summer and winter, sometimes in dreadful drving consitions. She died 2 years later of kidney failure. The irony is that she never experienced any symptoms of the heart condition. It was discovered during a routine physical. The surgery was never presented to her as a choice. Her medical professionals simply put her on the list and the system sucked her in.Later, we learned that, had she known she had a choice she would have declined the surgery. She might not have lived those two years but her quality of life would have been better. My mother came from a generation and circumstance where people did what they were told. The lesson I took from her final years was that we always have a choice.+73 Post Comment Private Reply Ignore Thread
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