Abstract: SA-PO0297
Epidemiology and Risk Factors of Acute Kidney Disease After Major Noncardiac Surgery: A Multicenter Retrospective Cohort Study
Session Information
- AKI: Epidemiology and Risk Factors
October 24, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Acute Kidney Injury
- 101 AKI: Epidemiology, Risk Factors, and Prevention
Authors
- Cho, Semin, Chung-Ang University Gwangmyeong Hospital, Gwangmyeong-si, Gyeonggi-do, Korea (the Republic of)
- Lee, Hajeong, Seoul National University Hospital, Jongno-gu, Seoul, Korea (the Republic of)
Background
Acute kidney disease (AKD) is defined as the presence of functional or structural criteria with a duration ≤3 months, serving as a critical transitional phase between acute kidney injury (AKI) and chronic kidney disease (CKD). This study aimed to investigate the epidemiology and risk factors of AKD following major non-cardiac surgery.
Methods
We conducted a retrospective cohort study across seven tertiary centers in South Korea. Among patients who underwent non-cardiac major surgery between 2014 and 2020, AKI and AKD was defined according to the KDIGO criteria. Logistic regression models were constructed to identify independent predictors of AKD.
Results
Among 245,807 patients, overall AKD incidence was 11.2%. The incidence rate was 21.7% in patients with pre-existing CKD and 10.5% in those without. Among patients who did not develop AKI, 5.3% were subsequently identified as having AKD. High AKD rates occurred in liver (12.3%) and colorectal (10.2%) resections, with liver cases largely attributed to a 9.5% AKI rate. Hysterectomy (8.6%) and thyroidectomy (8.4%) showed high AKD rates despite low AKI (3.2%, 0.7%), reflecting frequent AKD without early AKI. In multivariable analysis, independent predictors of AKD without AKI were anemia, hypoalbuminemia, hyponatremia, diabetes mellitus, RAAS blocker use, and proteinuria ≥3+.
Conclusion
AKD was identified in 11.2% of patients undergoing major non-cardiac surgery. Notably, 5.3% of the total cohort developed AKI despite the absence of early postoperative AKI. These findings emphasize the necessity of extended kidney function surveillance beyond the immediate postoperative period.
Incidence of postoperative AKD stratified by baseline CKD and postoperative AKI
Incidence of postoperative AKD and AKI by departments and surgical sites
Funding
- Government Support – Non-U.S.