SAN DIEGO—Patients who undergo gastrointestinal (GI) surgery are at relatively low risk of acute kidney injury (AKI) compared with those who have cardiac or vascular surgery, but it is associated with increased short- and long-term mortality according to study findings presented at Kidney Week.
Additionally, the study found that the rate of AKI is substantially higher after major and open operations and in patients with pre-existing kidney disease.
Þórir E. Long, MD, of the University of Iceland in Reykjavik, and colleagues examined the incidence of AKI among 10,022 patients who underwent 11,552 GI operations from 2007–2014 at a major hospital. Patients’ median age at the time of surgery was 52 years and 59.5% of patients were female. AKI developed after 246 surgeries (2.1%), with AKI stage 1, 2, and 3 diagnosed in 157 (1.4%), 57 (0.5%), and 32 (0.3%) cases, respectively.
The incidence of AKI was higher after major, open, and acute operations (5.3%, 4.9%, and 3.0%, respectively) compared with minor, laparoscopic, and non-acute operations (1.1%, 0.5%, and 1.8%, respectively).
Compared with propensity score matched controls without AKI, AKI patients had significantly worse survival rates at 30 days (82.4% vs. 94.7%) and 12 months (69.9% vs. 82.6%).
In multivariable analysis, older age, male sex, open surgery, re-operation, hypertension, an estimated glomerular filtration rate below 60 mL/min/1.73 m2, and higher ASA score were associated with post-operative AKI.