Intraoperative urinary output does not predict postoperative renal function in patients undergoing abdominal aortic revascularization.

Abstract

To determine whether intraoperative urinary output was predictive of postoperative renal function, mean urinary output and lowest hourly urinary output were measured in 137 patients during operation for aortic reconstruction. Pulmonary capillary wedge pressure was kept within normal limits. If urinary output was less than 0.125 ml X kg-1 X hr-1, patients were given crystalloid solution, mannitol, furosemide (Lasix), or nothing. For each patient, serum creatinine and blood urea nitrogen (BUN) levels were assayed on postoperative days 1, 3, and 7. There was no significant correlation between intraoperative mean urinary output or lowest hourly urinary output and change from preoperative to postoperative levels of creatinine or BUN. Twenty-one patients had postoperative renal insufficiency; of these, 17 had had renal disease before operation. In these patients as well; mean urinary output and the lowest hourly urinary output did not correlate with change in BUN or creatinine levels. The position of the aortic cross-clamp did not affect these correlations. Therefore, intraoperative urinary output was not predictive of postoperative renal insufficiency in patients undergoing aortic reconstruction.