Mooney J.F.Ranasinghe I.Chow C.K.Perkovic V.Barzi F.Zoungas S.Holzmann M.J.Welten G.M.Biancari F.VIN-CENT WUTan T.C.Hillis G.S.Hillis G.S.2021-11-302021-11-3020130003-3022https://www.scopus.com/inward/record.uri?eid=2-s2.0-84875898881&doi=10.1097%2fALN.0b013e318287b72c&partnerID=40&md5=8c2138f2dbe17dc65e05511fa4c82743https://scholars.lib.ntu.edu.tw/handle/123456789/588514Background: Kidney dysfunction is a strong determinant of prognosis in many settings. Methods: A systematic review and meta-analysis was undertaken to explore the relationship between estimated glomerular filtration rate (eGFR) and adverse outcomes after surgery. Cohort studies reporting the relationship between eGFR and major outcomes, including all-cause mortality, major adverse cardiovascular events, and acute kidney injury after cardiac or noncardiac surgery, were included. Results: Forty-six studies were included, of which 44 focused exclusively on cardiac and vascular surgery. Within 30 days of surgery, eGFR less than 60 ml·min·1.73 m was associated with a threefold increased risk of death (multivariable adjusted relative risk [RR] 2.98; 95% confidence interval [CI] 1.95-4.96) and acute kidney injury (adjusted RR 3.13; 95% CI 2.22-4.41). An eGFR less than 60 ml·min·1.73 m was associated with an increased risk of all-cause mortality (adjusted RR 1.61; 95% CI 1.38-1.87) and major adverse cardiovascular events (adjusted RR 1.49; 95% CI 1.32-1.67) during long-term follow-up. There was a nonlinear association between eGFR and the risk of early mortality such that, compared with patients having an eGFR more than 90 ml·min·1.73 m the pooled RR for death at 30 days in those with an eGFR between 30 and 60 ml·min·1.73 m was 1.62 (95% CI 1.43-1.80), rising to 2.85 (95% CI 2.49-3.27) in patients with an eGFR less than 30 ml·min·1.73 m and 3.75 (95% CI 3.44-4.08) in those with an eGFR less than 15 ml·min·1.73 m. CONCLUSION[SDGs]SDG3acute kidney failure; adverse outcome; cardiovascular disease; confidence interval; death; estimated glomerulus filtration rate; follow up; glomerulus filtration rate; heart surgery; human; long term care; mortality; outcome assessment; preoperative evaluation; priority journal; prognosis; review; risk factor; systematic review; vascular surgery; Acute Kidney Injury; Cardiovascular Diseases; Cohort Studies; Creatinine; Female; Follow-Up Studies; Glomerular Filtration Rate; Humans; Male; Postoperative Complications; Preoperative Period; Prognosis; Prospective Studies; Retrospective Studies; Riskreview10.1097/ALN.0b013e318287b72c233772232-s2.0-84875898881