Incidence, risk factors, and outcomes of perioperative acute kidney injury in noncardiac and nonvascular surgery.
BACKGROUND
The aim of this study was to determine the incidence rate, identify the risk factors, and describe the clinical outcome of perioperative acute kidney injury (AKI) in patients undergoing noncardiac, nonvascular surgery (NCS).


METHODS
A total of 1,200 adult consecutive patients undergoing NCS were prospectively evaluated. Patients with pre-existing renal dysfunction were excluded. The primary outcome of this study was perioperative AKI defined by the RIFLE (risk, injury, failure, loss of function, and end-stage kidney disease) criteria.


RESULTS
Eighty-one patients (6.7%) met the AKI criteria. Multivariate analysis identified age, diabetes, revised cardiac risk index, and American Society of Anesthesiologists physical status as independent predictors of AKI. Patients with AKI had more cardiovascular (33.3% vs 11.3%, P < .001) complications and a higher in-hospital mortality rate (6.1% vs 0.9%, P = .003) compared with patients without AKI.


CONCLUSIONS
Several preoperative predictors are found to be associated with AKI after NCS. Perioperative AKI is an independent risk factor for outcome after NCS.
Medipol University, Faculty of Medicine, Department of Cardiology, Istanbul, Turkey. Electronic address: murbit2@yahoo.com.
Murat
M
Biteker
Department of Family Medicine, Haydarpaşa Numune Education and Research Hospital, Istanbul, Turkey.
Akın
A
Dayan
Department of Cardiology, Dr. Siyami Ersek Cardiovascular and Thoracic Surgery Research and Training Hospital, Istanbul, Turkey.
Ahmet İlker
Aİ
Tekkeşin
Department of Cardiology, Bagcılar Education and Research Hospital, Istanbul, Turkey.
Mehmet M
MM
Can
Department of Internal Medicine, Haydarpaşa Numune Education and Research Hospital, Istanbul, Turkey.
İbrahim
İ
Taycı
Department of Cardiology, Van Erciş State Hospital, Van, Turkey.
Erkan
E
İlhan
Department of Nephrology, Haydarpaşa Numune Education and Research Hospital, Istanbul, Turkey.
Gülizar
G
Şahin
D058186:Acute Kidney Injury / Q000453:epidemiology* / Q000209:etiology*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D018570:Risk Assessment; D012307:Risk Factors; D013514:Surgical Procedures, Operative / Q000009:adverse effects*; D016896:Treatment Outcome; D014421:Turkey / Q000453:epidemiology
Noncardiac surgery; Outcome; Perioperative acute kidney injury