Synapse
⌘+K
Synapse
PulseExploreClubsResearchersJournals
Instagram
HomeClubsExplore
July 17, 2025Journal of Clinical Monitoring and ComputingOpen Access

Association of intraoperative hypotension and acute kidney injury in noncardiac surgery patients: a post hoc secondary analysis of the EU HYPROTECT registry

View Full Paper
Ask AI
Bookmark
Share

Why the study?

Previous studies linked intraoperative hypotension to AKI, but whether this independent association persists when clinicians actively strive to avoid profound hypotension remained to be confirmed.

Is intraoperative hypotension associated with acute kidney injury in patients undergoing major noncardiac surgery?

Population

697 noncardiac surgery patients with predictive blood pressure monitoring

Comparison

Duration and severity of intraoperative hypotension (area under MAP 65 mmHg)

Design

Multicentre registry post hoc secondary analysis

Follow-up

First 3 days after surgery

Authors

JRJulian RungeCGCarla D. GrundmannRDRobin Denz

Discussion

Loading...

Member takes

Overview

Intraoperative hypotension associated with early AKI after noncardiac surgery; hypothesis-generating for BP management trials.

Structured PICO

Is intraoperative hypotension associated with acute kidney injury in patients undergoing major noncardiac surgery?

P
Population
697 adults undergoing elective major noncardiac surgery under general anesthesia expected to last at least 120 min, monitored with Acumen Hypotension Prediction Index software. Mean age 62.7, 51.5% male, multinational (5 European countries). Excluded: emergency surgery, nephrectomy, liver/kidney transplant, atrial fibrillation, sepsis, ASA class V or VI, and pre-existing renal replacement therapy.
I
Intervention
Intraoperative hypotension (exposure quantified as the area under a mean arterial pressure [MAP] of 65 mmHg)
O
Outcome
Acute kidney injury (AKI) within the first 3 days after surgery (defined by KDIGO criteria using serum creatinine)hard clinical

In patients undergoing major noncardiac surgery with predictive blood pressure monitoring, intraoperative hypotension remains independently associated with an increased risk of acute kidney injury within 3 days postoperatively.

Limitations

  • Diagnosed AKI based on clinically available serum creatinine values but did not consider urine output
  • Highly skewed distribution of hypotension with limited variability rendering robust subgroup or regression analyses statistically inappropriate
  • Post hoc nature
  • Cannot conclude causality

Cite This Study

Runge et al. (2025) studied this question.

synapsesocial.com/papers/6a7e45d2196d67da7483e2c5https://doi.org/10.1007/s10877-025-01329-4
View Full Paper
Ask AI
Bookmark
Share

Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Hypotension Prediction Index and Incidence of Perioperative Hypotension: A Single-Center Propensity-Score-Matched Analysis2023 · 14 citations
  2. 2Epidemiology of surgery associated acute kidney injury (EPIS-AKI): a prospective international observational multi-center clinical study2023 · 169 citations
  3. 3Automated Ambulatory Blood Pressure Measurements and Intraoperative Hypotension in Patients Having Noncardiac Surgery with General Anesthesia2019 · 99 citations
  4. 4The SLUScore: A Novel Method for Detecting Hazardous Hypotension in Adult Patients Undergoing Noncardiac Surgical Procedures2017 · 85 citations
  5. 5Long-Term Risk of Mortality and Acute Kidney Injury During Hospitalization After Major Surgery2009 · 530 citations