Objective:

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.

Sources:

• The Lancet Study
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