Perioperative medicine & outcomes
Incidence and trajectories of subclinical and KDIGO-defined postoperative acute kidney injury in patients undergoing major abdominal surgery
Authors' conclusion
Subclinical postoperative kidney injury not fulfilling the KDIGO criteria occurred in every 10th patient, and one in 14 suffered from PO-AKI after major abdominal surgery. A majority of PO-AKD cases was preceded by sPO-AKI and PO-AKI. Early kidney injuries were associated with longer-term adverse outcomes including MAKE30, 30-day mortality, and CKD.
Study context
- Population
- Patients undergoing major abdominal surgery, two hospitals in Sweden
- Participants
- 588 patients · 2 hospitals
- Outcome
- Incidence and trajectories of postoperative subclinical AKI (sPO-AKI; 25-49% increase in serum creatinine within 7 days), PO-AKI, PO-AKD and CKD (ADQI-POQI criteria)
Methodological detailspre-planned nested cohort sub study of the Myocardial Injury in Noncardiac Surgery in Sweden (MINSS) study, two hospitals
- Pre-planned nested cohort sub study of the MINSS study
- Two hospitals
Main finding
As reported in the abstract
sPO-AKI
59
10.2%
PO-AKI
41
7.1%
PO-AKD
29
6.2%
Chronic kidney disease (CKD)
6
1.2%
Observational data: associations, not effects.
Further findings
Trajectories to PO-AKD and CKD
- Similar proportions of patients with sPO-AKI and PO-AKI developed PO-AKD
- All patients with CKD had pre-existing PO-AKD
Association of combined sPO-AKI and PO-AKI with 30-day mortality
- Cramer's V
- 0.1
- P
- P = 0.037
Association of PO-AKD with major adverse kidney events (MAKE30) and 30-day mortality
- Cramer's V
- 0.4
- P
- P < 0.001
Original publication
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