Acute kidney injury after open ventral hernia repair: an analysis of the 2005-2012 ACS-NSQIP datasets.

PURPOSE: Acute kidney injury (AKI) is a serious postoperative complication, negatively impacting mortality rates, extending length of stay, and raising hospital costs. The purpose of this study was to examine AKI following open ventral hernia repair (OVHR) using a large, heterogeneous database to determine the incidence and identify risk factors for this complication. METHODS: Using the 2005-2012 ACS-NSQIP database, patients undergoing open ventral hernia repair were identified by CPT codes. Patients with acute kidney injury within 30 days of surgery were compared to controls by multivariate logistic regression across preoperative and intraoperative characteristics. RESULTS: Of 48,629 open ventral hernia repair patients identified in the dataset, AKI developed in 1.4% (681 patients). Multivariate logistic regression determined a number of factors associated with AKI. These include WHO Class III obesity (OR = 2.57, p < 0.001), history of cardiovascular disease (OR = 1.81, p < 0.001), diabetes (OR = 1.29, p = 0.028), hypoalbuminemia (OR = 1.42, p = 0.004), and chronic kidney disease (for a baseline GFR of 60-89 mL/min/1.73 m2, OR = 1.62, p = 0.001; for 30-59 mL/min/1.73 m2, OR = 2.25, p < 0.001; for 15-29 mL/min/1.73 m2, OR = 4.96, p < 0.001). Intraoperative factors include prolonged operative time (for ≥1 SD above the mean, OR = 1.68, p = 0.002; for ≥2SD above the mean, OR = 2.76, p < 0.001) and intraoperative transfusion (OR = 2.44, p < 0.001). CONCLUSIONS: Patients with a history of obesity, chronic kidney disease, cardiovascular history, diabetes, and hypoalbuminemia are at increased risk for AKI when undergoing OVHR. Intraoperative variables such as prolonged operative times and blood transfusions may also suggest increased risk. Preoperative identification of patients with these characteristics and perioperative hemodynamic stabilization are important first steps to minimize this complication.

Development of novel microsatellite markers for conservation genetic studies of Vulpes vulpes (Canidae) by using next-generation sequencing method.

The red fox, Vulpes vulpes (Canidae), is the most widely distributed terrestrial carnivore worldwide, but this species is classified as endangered in Korea. In this study, we developed 25 polymorphic microsatellite markers that included 3-13 (mean = 6.32) alleles per locus using 22 red fox individuals. The most polymorphic locus was FR(59)TG (13 alleles) and the least polymorphic loci were FR(70)TG and FR(182)AG (3 alleles each). No significant deviation from Hardy-Weinberg equilibrium (P < 0.05) was observed for the 25 markers. Observed (HO) and expected (HE) heterozygosity varied from 0.182 to 1.000 and from 0.175 to 0.929, respectively. These newly developed microsatellite markers will be useful for investigating the genetic diversity and population genetic structure of V. vulpes and will aid in developing conservation strategies for this species.