ASN's Mission

To create a world without kidney diseases, the ASN Alliance for Kidney Health elevates care by educating and informing, driving breakthroughs and innovation, and advocating for policies that create transformative changes in kidney medicine throughout the world.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005

email@asn-online.org

202-640-4660

The Latest on Twitter

Kidney Week

Abstract: FR-PO092

The Incidence and Risk Factor of Post-Operative Acute Kidney Disease After Non-Cardiac Surgery

Session Information

Category: Acute Kidney Injury

  • 101 AKI: Epidemiology‚ Risk Factors‚ and Prevention

Authors

  • Kwon, Soie, Seoul National University Hospital, Jongno-gu, Seoul, Korea (the Republic of)
  • Yang, Sunah, Seoul National University Hospital, Jongno-gu, Seoul, Korea (the Republic of)
  • Nam, Geumnae, Seoul National University Hospital, Jongno-gu, Seoul, Korea (the Republic of)
  • Park, Sehoon, Seoul National University Hospital, Jongno-gu, Seoul, Korea (the Republic of)
  • Park, Jina, Seoul National University Hospital, Jongno-gu, Seoul, Korea (the Republic of)
  • Ryu, Jiwon, Seoul National University Bundang Hospital, Seongnam, Korea (the Republic of)
  • Lee, Jeonghwan, Seoul National University Seoul Metropolitan Government Boramae Medical Center, Dongjak-gu, Seoul, Korea (the Republic of)
  • Baek, Chung Hee, Asan Medical Center, Songpa-gu, Seoul, Korea (the Republic of)
  • Kim, Ji Eun, Korea University Guro Hospital, Seoul, Korea (the Republic of)
  • Park, Ji In, Kangwon National University Hospital, Chuncheon, Kangwon, Korea (the Republic of)
  • Hwang, Jin Ho, Chung Ang University Hospital, Seoul, Korea (the Republic of)
  • Kim, Dong Ki, Seoul National University Hospital, Jongno-gu, Seoul, Korea (the Republic of)
  • Oh, Kook-Hwan, Seoul National University Hospital, Jongno-gu, Seoul, Korea (the Republic of)
  • Joo, Kwon Wook, Seoul National University Hospital, Jongno-gu, Seoul, Korea (the Republic of)
  • Kim, Yon Su, Seoul National University Hospital, Jongno-gu, Seoul, Korea (the Republic of)
  • Lee, Hajeong, Seoul National University Hospital, Jongno-gu, Seoul, Korea (the Republic of)
Background

The importance of acute kidney disease (AKD), the condition of which acute kidney disease (AKI) has not recovered, is being emphasized because it increases the risk of progression to chronic kidney disease (CKD). Although, there was a lack of large-scale cohort study on AKD after non-cardiac surgery.

Methods

We performed a retrospective cohort study from three tertiary referral center in South Korea. Among patients who underwent non-cardiac surgery over than 1 hour from 2014 to 2020, AKI was defined as whether the KDIGO AKI criteria were satisfied within 7 days after surgery. AKD was defined as a case of not recovering to less than 1.5 times from baseline creatinine within 7 days after peak creatinine after surgery in AKI group. The information of death event and initiation of renal replacement therapy were collected at 90 days after surgery.
Logistic regression was used to investigate the risk factors that AKI progressed to AKD. In multivariate logistic regression, only variables with p-value less than 0.2 in univariate analysis were considered.

Results

A total of 178,565 patients were enrolled and 11,047 (6.2%) cases of AKI events were occurred. In whole population, 442(0.2%) patients newly started RRT and 2,157 patients dead (1.2%). 594 (8.2%) patients were progress to AKD and patients who progressed AKD had more risk of all-cause mortality and ESRD progression. (Figure 1)
In multivariate logistic regression, surgery from urology (Odd ratio [OR] 2.13, 95% confidence interval [CI] 1.62-2.80, p=<0.001 Table 1) and neurosurgery (OR 2.05, CI 1.16-4.62, p=0.014) department and leukocytosis (OR 1.04, CI 1.00-1.07, p=0.024) were associated with increased risk of progression to AKD. Patients who diagnose with malignancy before surgery (OR 0.62, CI 0.43-0.88, p=0.008) had lower risk of progression to AKD in the present study cohort.

Conclusion

Considering high mortality and poor renal outcome of AKD patients, physicians need pay attention to the occurrence of post-operative AKD after non-cardiac surgery.

Funding

  • Government Support – Non-U.S.