Perioperative medicine & outcomes
Association of perioperative fluid balance and acute kidney injury in patients undergoing elective colorectal surgery: A pre-planned secondary analysis of a multicentre prospective observational study
Authors' conclusion
In this secondary analysis, we found that higher positive perioperative fluid balance during the first 24 h was associated with an increased risk of postoperative acute kidney injury in patients undergoing elective colorectal surgery.
Study context
- Population
- Patients undergoing elective primary colorectal surgery with planned overnight stay, 80 hospitals in Spain; eGFR <30 ml min −1 and urgent/emergency surgery excluded
- Participants
- 1,139 patients · 80 hospitals
- Comparison
- Quartiles of perioperative fluid balance
- Primary endpoint
- Occurrence of AKI (mild, moderate, or severe)
- Follow-up
- 30 days following surgery
Methodological detailspredefined secondary sub-study, multicentre
- Predefined secondary sub-study
- Multicentre
Primary result
As reported in the abstract
Postoperative AKI
Each group vs Q1Adjusted relative risk (95% CI)
Q3
4.10(1.60–10.51)
Q4
4.81(1.91–12.11)
- Acute kidney injury (AKI) incidence, all patients
- 73 (6.4%)
- RR for AKI higher with higher positive perioperative fluid balance (Poisson model adjusted for sex, ASA grade, Enhanced Recovery After Surgery (ERAS) adherence, intraoperative bleeding)
- quadratic nonlinear P < 0.01
Original publication
Association of perioperative fluid balance and acute kidney injury in patients undergoing elective colorectal surgery: A pre-planned secondary analysis of a multicentre prospective observational study. Eur J Anaesthesiol. Published 6 January 2026. doi:10.
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