Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/33567
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dc.contributor.authorHahn, Robert G-
dc.contributor.authorWeinberg, Laurence-
dc.contributor.authorLi, Yuhong-
dc.contributor.authorBahlmann, Hans-
dc.contributor.authorBellomo, Rinaldo-
dc.contributor.authorWuethrich, Patrick Y-
dc.date2023-
dc.date.accessioned2023-08-23T07:20:04Z-
dc.date.available2023-08-23T07:20:04Z-
dc.date.issued2023-
dc.identifier.citationPloS One 2023; 18(8)en_US
dc.identifier.issn1932-6203-
dc.identifier.urihttps://ahro.austin.org.au/austinjspui/handle/1/33567-
dc.description.abstractElevations of plasma creatinine are common after major surgery, but their pathophysiology is poorly understood. To identify possible contributing mechanisms, we pooled data from eight prospective studies performed in four different countries to study circumstances during which elevation of plasma creatinine occurs. We included 642 patients undergoing mixed major surgeries, mostly open gastrointestinal. Plasma and urinary creatinine and a composite index for renal fluid conservation (Fluid Retention Index, FRI) were measured just before surgery and on the first postoperative morning. Urine flow was measured during the surgery. The results show that patients with a postoperative increase in plasma creatinine by >25% had a high urinary creatinine concentration (11.0±5.9 vs. 8.3±5.6 mmol/L; P< 0001) and higher FRI value (3.2±1.0 vs. 2.9±1.1; P< 0.04) already before surgery was initiated. Progressive increase of plasma creatinine was associated with a gradually lower urine flow and larger blood loss during the surgery (Kruskal-Wallis test, P< 0.001). The patients with an elevation > 25% also showed higher creatinine and a higher FRI value on the first postoperative morning (P< 0.001). Elevations to > 50% of baseline were associated with slightly lower mean arterial pressure (73 ± 10 vs. 80 ± 12 mmHg; P< 0.005). We conclude that elevation of plasma creatinine in the perioperative period was associated with low urine flow and greater blood loss during surgery and with concentrated urine both before and after the surgery. Renal water conservation-related mechanisms seem to contribute to the development of increased plasma creatinine after surgery.en_US
dc.language.isoeng-
dc.titleConcentrated urine, low urine flow, and postoperative elevation of plasma creatinine: A retrospective analysis of pooled data.en_US
dc.typeJournal Articleen_US
dc.identifier.journaltitlePloS Oneen_US
dc.identifier.affiliationKarolinska Institutet at Danderyds Hospital (KIDS), Stockholm, Sweden.en_US
dc.identifier.affiliationAnaesthesiaen_US
dc.identifier.affiliationDepartment of Anesthesiology, Shulan International Hospital, Shuren University, Hangzhou, 3100004, Zhejiang Province, PR of China.en_US
dc.identifier.affiliationDepartment of Anesthesiology and Intensive Care in Linköping, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.en_US
dc.identifier.affiliationIntensive Careen_US
dc.identifier.affiliationDepartment of Anesthesiology and Pain Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.en_US
dc.identifier.affiliationDepartment of Critical Care, The University of Melbourne, Melbourne, Australia.en_US
dc.identifier.doi10.1371/journal.pone.0290071en_US
dc.type.contentTexten_US
dc.identifier.orcid0000-0002-1528-3803en_US
dc.identifier.orcid0000-0002-2658-2518en_US
dc.identifier.orcid0000-0003-3704-6785en_US
dc.identifier.pubmedid37590224-
dc.description.volume18-
dc.description.issue8-
dc.description.startpagee0290071-
item.cerifentitytypePublications-
item.languageiso639-1en-
item.grantfulltextnone-
item.openairetypeJournal Article-
item.fulltextNo Fulltext-
item.openairecristypehttp://purl.org/coar/resource_type/c_18cf-
crisitem.author.deptAnaesthesia-
crisitem.author.deptIntensive Care-
crisitem.author.deptData Analytics Research and Evaluation (DARE) Centre-
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