Key result
Reduced GFR linked to ~161% higher perioperative mortality.
Why the study?
Chronic kidney disease increases perioperative risk and complicates anaesthetic management, but evidence from sub-Saharan Africa on surgical outcomes across CKD stages is limited.
Does reduced renal function (GFR < 60 mL/min/1.73 m2) increase perioperative morbidity and mortality in adult CKD patients undergoing urgent or elective surgery?
Cross-Sectional (n=418)
No
Does reduced renal function (GFR < 60 mL/min/1.73 m2) increase perioperative morbidity and mortality in adult CKD patients undergoing urgent or elective surgery?
Reduced renal function (GFR < 60 mL/min/1.73 m2) independently predicts increased perioperative mortality in patients undergoing surgery, highlighting the need for improved risk stratification.
Answers are grounded in this paper and cite their sources.
Calls for heightened perioperative vigilance in sub-Saharan CKD patients with GFR <60; leaves open anaesthetic optimization pending prospective validation.
Background Chronic kidney disease (CKD) increases perioperative risk through metabolic, cardiovascular, and hematologic disturbances that complicate anaesthetic management. Evidence from sub-Saharan Africa on surgical outcomes across CKD stages is limited. Objective To describe anaesthetic practices and assess perioperative morbidity and mortality in CKD patients undergoing surgery at Monkole Hospital, Kinshasa. Methods This retrospective cross-sectional study included adult CKD patients who underwent urgent or elective surgery between February 2018 and December 2024. Renal function was classified using the CKD-EPI 2021 equation into GFR categories G1–G5. Outcomes included intraoperative incidents, perioperative complications, transfusion requirements, opioid use, and in-hospital mortality. Multivariate logistic regression identified predictors of adverse outcomes, comparing patients with GFR < 60 and ≥60 mL/min/1.73 m 2 . Results Among 418 patients, 48.1% were G3, 24.6% G2, and 15.3% G1. Complications and mortality rose with declining renal function. Patients with GFR < 60 mL/min/1.73 m 2 had higher mortality than those with GFR ≥ 60 (11.2% vs. 5.4%). After adjustment, GFR < 60 remained independently associated with mortality (OR 2.61, 95% CI 1.01–6.71). Conclusion Reduced renal function independently predicted increased perioperative mortality, highlighting the need for improved risk stratification in CKD patients.
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Isamba et al. (2026) conducted a cross-sectional in Chronic kidney disease (CKD) undergoing surgery (n=418). GFR < 60 mL/min/1.73 m2 vs. GFR ≥ 60 mL/min/1.73 m2 was evaluated on In-hospital mortality (OR 2.61, 95% CI 1.01-6.71, p=0.047). Reduced renal function (GFR < 60 mL/min/1.73 m2) independently predicted increased perioperative mortality compared to GFR ≥ 60 (11.2% vs. 5.4%, OR 2.61).
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