LAUSR

who underwent nephrectomy between 2010 e 2018. Intraoperative anesthetic parameters evaluated included duration of hypotension (mean arterial pressure (MAP) <55mmHg), tachycardia (heart rate >100bpm), hypothermia (body temperature <35.5 C) and volatile anesthetic use. MAP at arrival to the post-anesthesia care unit, and total ketorolac dose within 48 hours of surgery were collected. Outcomes included acute kidney injury (AKI) and estimated glomerular filtration rate (eGFR) within 1 year after nephrectomy. The associations between the anesthetic parameters and outcomes were evaluated with multivariable logistic regression and longitudinal analyses, respectively, adjusted for known predictors of renal function after nephrectomy. RESULTS: The study cohort included 2111 (65%) males, and the median age was 60 years (IQR 52, 68). Prior to nephrectomy, 677 (21%) patients had stage 3 chronic kidney disease (CKD). Over two-thirds (69%) underwent partial nephrectomy. A quarter of the patients had AKI in the immediate postoperative period and 33% had stage 3 CKD 12 months after surgery. Most patients were not exposed to intraoperative hypotension [median duration 0 minutes (IQR 0, 2)]. We did not find evidence that intraoperative hypotension was associated with postoperative renal function. Prolonged hypothermia (per 10-min) was consistently associated with an increased rate of AKI (OR 1.02; 95% CI 1.00, 1.04; p[0.024), and a decrease in eGFR (change in eGFR -0.19; 95% CI -0.27, -0.12; p<0.0001). However, while statistically significant, these results have limited clinical significance, aside for a small number of patients exposed to very long hypothermia (Figure 1). CONCLUSIONS: Current practice is aimed at tightly maintaining blood pressure during surgery. Within this setting we did not find an association between intraoperative hypotension and renal function after nephrectomy.