To evaluate the effectiveness of a preventive care strategy based on specific Kidney Disease: Improving Global Outcomes recommendations in reducing moderate to severe acute kidney injury (AKI) following major surgery.
Approach:
Key Findings:
Moderate to severe AKI occurred in 14% of the intervention group vs. 22% in the control group, corresponding to a number needed to treat of 12.
Any-stage AKI occurred in 37% of the intervention group vs. 41% in the control group.
Persistent AKI lasting more than 48 hours was lower in the intervention group (39% vs. 45%).
No significant differences in mortality or major adverse kidney events at 90 days between groups.
Interpretation:
The preventive care strategy significantly decreased the occurrence of moderate to severe AKI within 72 hours of surgery in high-risk patients.
Limitations:
Implementation of the strategy was only 47% in patients, reflecting challenges in adherence.
The trial was open-label and may not be generalizable to all settings.
Patients with advanced chronic kidney disease were excluded.
The study was not powered to detect long-term outcome differences.
Conclusion:
The study reinforces the importance of supportive care in high-risk surgical populations to effectively reduce AKI risk.
Randomized trial finds a topical anti-inflammatory patch provided similar pain relief, function, and safety as oral therapy during the first 6 weeks after surgery.
