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

Abstract

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.