Perioperative medicine & outcomes

Association of intraoperative hypotension and cumulative norepinephrine dose with postoperative acute kidney injury in patients having noncardiac surgery: a retrospective cohort analysis

Br J AnaesthPublished Retrospective cohort study

An erratum to this article was published (Br J Anaesth, Jun 2025 ↗)

Authors' conclusion

Both intraoperative hypotension and cumulative intraoperative norepinephrine dose were independently associated with postoperative AKI in patients undergoing noncardiac surgery.

Study context

Population
Adult male and female patients who had noncardiac surgery
Participants
38,338 participants
Exposure
AKI vs No AKI
Outcome
AKI
Follow-up
Within the first 7 postoperative days
Methodological detailsadjusted multivariable logistic regression
  • Adjusted multivariable logistic regression

Main finding

As reported in the abstract

Association of intraoperative hypotension and cumulative norepinephrine dose with AKI
Independently associated with AKI
Estimate (95% CI)P value
Area under a MAP of 65 mm Hg
OR 1.55 per mm Hg∗day(1.17–2.02)
P = 0.002
Cumulative intraoperative norepinephrine dose
OR 1.02 per μg kg-1(1.01–1.02)
P < 0.001

Each row per its own increment, as printed

Observational data: associations, not effects.

Further findings

Area under a MAP of 65 mm Hg

P < 0.001

Cumulative intraoperative norepinephrine dose

P < 0.001

Original publication

Association of intraoperative hypotension and cumulative norepinephrine dose with postoperative acute kidney injury in patients having noncardiac surgery: a retrospective cohort analysis. Br J Anaesth. Published 12 December 2024. doi:10.1016/j.bja.2024.11.005

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