Acute kidney injury after colorectal surgery with an enhanced recovery pathway
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LETTER TO THE EDITOR
Acute kidney injury after colorectal surgery with an enhanced recovery pathway Kai Su1 · Fu‑Shan Xue1 · Zhao‑Jing Xue1 · Lei Wan1 Received: 25 August 2020 / Accepted: 25 September 2020 © Springer Nature Singapore Pte Ltd. 2020
Dear Editor, In the recent article by Zorrilla-Vaca et al. [1] examining the risk factors of postoperative acute kidney injury (AKI) in patients undergoing colorectal surgery with an enhanced recovery pathway, we noted that several methodological issues were not addressed well. We invite the authors to elaborate on these. First, in the two previous multicenter prospective cohort studies used as data sources in this study [2, 3], only serum creatinine was provided for preoperative assessment of kidney function. However, this study used the incidence of chronic kidney disease to define preoperative kidney function impairment. As the diagnostic criteria of chronic kidney disease were not provided in the Methods section, it was unclear whether patients with occult or mild chronic kidney disease (stages 1 and 2) were included in the study. The available literature identifies occult or mild chronic kidney disease as an independent risk factor for postoperative AKI [4]. Second, this study performed the multivariable analysis to identify the risk factors independently associated with postoperative AKI. In the statistical analysis, the authors performed univariable comparisons for primary outcome (AKI) and only variables that reached statistical significance, defined as a P
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