Clinical trial NCT06857630: Preoperative Hemoglobin and Acute Kidney Injury in Emergency Surgery
Official title: The Association Between Preoperative Hemoglobin and Acute Kidney Injury in Emergency Surgery: A Prospective Observational Study
Study type: OBSERVATIONAL
Overall status: RECRUITING
Conditions: Emergency Surgery
Acute Kidney Injury
Hemoglobin
Keywords: Acute kidney injury
Emergency surgery
Risk factor
Hemoglobin
Lead sponsor: Samsun University
Sponsor class: OTHER
First posted: 2025-03-04
Enrollment: 420
Sex: ALL
Minimum age (years): 18
Maximum age (years): 80
Standard ages: ADULT
OLDER_ADULT
Observational model: COHORT
Time perspective: PROSPECTIVE
Sampling method: PROBABILITY_SAMPLE
Study population: Patients undergoing emergency non-cardiac surgery

Brief summary: Optimization of hemoglobin levels for organ perfusion is essential, especially in critically ill patients. Although anemia is associated with severe organ failure, especially in coronary artery disease, the effects of blood transfusion or various interventions to increase hemoglobin levels on outcomes continue to be debated. The effects of hemoglobin levels in emergency surgery patients on the development of postoperative AKI have been investigated in a small number of studies in the literature, and clear results have not yet been reported. This study was designed to evaluate the effect of hemoglobin levels on the development of AKI after adjustment for known predictive factors.

Detailed description: Acute kidney injury (AKI) is a common complication in patients undergoing major surgery and is associated with both short-term morbidity and mortality and long-term adverse outcomes including the development of Chronic Kidney Failure. Optimization of hemoglobin levels for organ perfusion is essential, especially in critically ill patients. Although anemia is associated with severe organ failure, especially in coronary artery disease, the effects of various interventions such as blood transfusion or increasing hemoglobin levels on outcomes continue to be debated. This prospective observational study was planned to evaluate the effect of hemoglobin levels before emergency surgery on the development of postoperative AKI.

Emergency operated patients will be divided into two groups as Group AKI and Group non-AKI according to the development of postoperative renal failure. Postoperative AKI diagnosis and severity will be evaluated according to serum creatinine and/or urine output according to KDIGO (Kidney Disease: Improving Global Outcomes criteria).

Demographic characteristics of the patients, preoperative complete blood count, blood biochemistry characteristics, hemodynamic variables, fluid replacement, blood and blood product replacements, surgical characteristics, development and severity of AKI in the postoperative period will be recorded and the effect of hemoglobin level on the development of AKI will be evaluated.

Eligibility criteria: Inclusion Criteria:

* Patients undergoing emergency non-cardiac surgery

Exclusion Criteria:

* Known renal failure
* Need for reoperation within 48 hours postoperatively
* Exit status within 48 hours postoperatively
* Known hematological disease
* Known kidney transplantation
* Urgent surgery planned due to urinary system related diseases
* Patients who did not accept to participate in the study

Primary outcomes:
measure: Acute renal failure.
timeFrame: 72 hours
Secondary outcomes:
measure: Hospital days
timeFrame: 1 month
Other outcomes:
Locations:
city: Samsun
country: Turkey
facility: Özgür Kömürcü
Study officials:
affiliation: Samsun University
name: özgür kömürcü, 1
role: STUDY_DIRECTOR
References:
citation: Meersch M, Schmidt C, Zarbock A. Perioperative Acute Kidney Injury: An Under-Recognized Problem. Anesth Analg. 2017 Oct;125(4):1223-1232. doi: 10.1213/ANE.0000000000002369.
citation: Grams ME, Sang Y, Coresh J, Ballew S, Matsushita K, Molnar MZ, Szabo Z, Kalantar-Zadeh K, Kovesdy CP. Acute Kidney Injury After Major Surgery: A Retrospective Analysis of Veterans Health Administration Data. Am J Kidney Dis. 2016 Jun;67(6):872-80. doi: 10.1053/j.ajkd.2015.07.022. Epub 2015 Sep 1.
citation: Cabezuelo JB, Ramirez P, Rios A, Acosta F, Torres D, Sansano T, Pons JA, Bru M, Montoya M, Bueno FS, Robles R, Parrilla P. Risk factors of acute renal failure after liver transplantation. Kidney Int. 2006 Mar;69(6):1073-80. doi: 10.1038/sj.ki.5000216.