Surgery can be a lifesaving measure for patients suffering from a number of diseases. Sometimes, though, surgery can lead to serious complications, including kidney damage.

The amount of patients who need dialysis after major elective surgery (e.g. heart surgery) has grown three-fold in the last couple decades.

This finding highlights the need for a better way to prevent kidney damage after these major elective surgeries.

Dialysis is a process that replaces the functions normally carried out by your kidneys. In both hemodialysis and peritoneal dialysis, the blood is filtered to rid the body of harmful wastes.

According to a recent study by Amit Garg, MD, of The University of Western Ontario, and colleagues, patients treated with acute dialysis after surgery continue to have poor outcomes.

"Our results should prompt renewed efforts to develop and test interventions to prevent severe acute kidney injury and to lessen the high burden of death and end-stage renal disease after acute kidney injury has occurred," says Dr. Garg.

These findings suggest that more needs to be done to prevent acute kidney injury, a severely harmful complication of major elective surgeries. When kidney damage cannot be prevented, more must be done to prevent total kidney failure and death caused by kidney damage.

Dr. Garg and colleagues studied more than 552,000 patients who underwent major elective surgeries such as heart and blood vessel surgery.

After surgery, 2,231 patients received acute dialysis. Of these, 937 died within three months of surgery. Of the surviving 1,294 dialysis patients, 352 needed long-term dialysis.

In 1995, about 0.2 percent of patients received acute dialysis after surgery. By 2009, that amount increased three times to 0.6 percent.

"The use of acute dialysis after [heart] and [blood vessel] surgery has increased substantially since 1995," says Nausheen F. Siddiqui, MD, also of Western University and lead author of the study.

Dr. Siddiqui concludes that there is a need for more research on ways to prevent and treat kidney injury after surgery.

The study is published in CMAJ.

Acute kidney failure occurs in about three to seven percent of the 37 million yearly admissions to United States hospitals, or about 1 to 2.6 million people. Acute kidney failure is a rapid loss of the ability of the kidneys to filter the blood and maintain the body's fluid and electrolyte balance.

It usually occurs in three settings: Loss of blood flow to the kidneys (blood loss, low blood pressure from heart failure, hardening of the renal arteries and blood clots), damage to the kidney tissue (from medications, infections, poisons), and obstruction of urine flow (enlarged prostate, urinary stones, bladder cancers, obstruction of the urethra). It is a medical emergency that can result in chronic kidney failure or death if left untreated.

Symptoms can be sudden, and are dependent on the type of kidney failure occurring. Usually, some combination of headache, fatigue, nausea, and loss of appetite is common. Irregular heartbeat, blood in the urine, seizures, swelling of the feet, and pain in the flanks may also occur.

Diagnosis is made by testing the blood chemistry, and sometimes ultrasound and CT scan. Treatment is aimed at eliminating the underlying cause of kidney failure, for example, in fluid loss, restoring fluids and electrolytes; in injury, removing the offending drug; in blockage, removing the blockage.

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