Risk factors for acute kidney injury after major abdominal surgery in the elderly aged 75 years and above

Abstract

Objectives The study aimed to investigate the incidence and risk factors of acute kidney injury (AKI) in elderly patients (aged ≥ 75 years) undergoing major nonvascular abdominal surgery. Methods The study was a retrospective study that evaluated the incidence of AKI in patients within 48 h after major abdominal surgeries. Patients' preoperative characteristics and intraoperative management, including the use of nephrotoxic medications, were evaluated for associations with AKI using a logistic regression model. Results A total of 573 patients were included in our analysis. A total of 33 patients (5.76%) developed AKI, and 30 (90.91%), 2 (6.06%) and 1 (3.03%) reached the AKI stages 1, 2 and 3, respectively. Older age (adjusted OR, aOR 1.112, 95% confidence interval, CI 1.020–1.212), serum albumin (aOR 0.900, 95% CI 0.829–0.977), baseline eGFR (aOR 3.401, 95% CI 1.479–7.820), the intraoperative occurrence of hypotension (aOR 3.509, 95% CI 1.553–7.929), and the use of hydroxyethyl starch in combination with nonsteroidal anti-inflammatory drugs (aOR 3.596, 95% CI 1.559–8.292) or furosemide (aOR 5.724, 95% CI 1.476–22.199) were independent risk factors for postoperative AKI. Conclusions Several risk factors, including intraoperative combined administration of HES and furosemide, are independent factors for AKI during abdominal surgeries. Anesthesiologists and surgeons should take precautions in treating at-risk patients.

Intraoperative Hypotension and Its Association with Postoperative Acute Kidney Injury in Patients Undergoing Pancreaticoduodenectomy: A 5-Year, Single-Center, Retrospective Cohort Study

“…Indeed, according to Futier et al, maintaining SBP within 10% of a patient’s resting BP resulted in decrease of postoperative organ dysfunction by around 25% compared to a more liberal approach [ 32 ]. Our study also confirms that older age is associated with postoperative adverse events, which consistent with other reports [ 34 , 35 ].…”

Association of intraoperative hypotension and severe postoperative complications during non-cardiac surgery in adult patients: A systematic review and meta-analysis

“…A total of 72 studies published between 1998 and 2022 were included in the systematic review and meta-analysis [ 7 , [19] , [20] , [21] , [22] , [23] , [24] , [25] , [26] , [27] , [28] , [29] , [30] , [31] , [32] , [33] , [34] , [35] , [36] , [37] , [38] , [39] , [40] , [41] , [42] , [43] , [44] , [45] , [46] , [47] , [48] , [49] , [50] , [51] , [52] , [53] , [54] , [55] , [56] , [57] , [58] , [59] , [60] , [61] , [62] , [63] , [64] , [65] , [66] , [67] , [68] , [69] , [70] , [71] , [72] , [73] , [74] , [75] , [76] , [77] , [78] , [79] , [80] , [81] , [82] , [83] ,…”

“…Twenty-eight studies [ 19 , 20 , [22] , [23] , [24] , [25] , [26] , 28 , 30 , 33 , 41 , 51 , 54 , 59 , 63 , 67 , 68 , 70 , [73] , [74] , [75] , [76] , [77] , [78] , [79] , [80] , 85 , 88 ] investigated the effect of IOH on AKI and included 160,836 participants and 10,497 AKI (6.52%). Low-quality evidence showed that IOH was associated with a higher risk of postoperative AKI (OR, 2.69; 95% CI, 2.15–3.37; P < .001; I 2 = 88%) within 7 days after non-cardiac surgery than non-IOH ( Fig.…”

Machine Learning for Predicting Risk and Prognosis of Acute Kidney Disease in Critically Ill Elderly Patients During Hospitalization: Internet-Based and Interpretable Model Study

“…In previous studies, age has been found to be a critical factor in the development of AKI [ 49 ]. Further, a retrospective study of Chinese multicenter patients with AKI revealed that age is an independent predictor of AKD progression in the logistic regression model but is not considered a risk factor for death [ 9 ].…”