Postoperative Acute Kidney Injury is Associated with Persistent Renal Dysfunction: A Multicenter Propensity Matched...

Area of Science:

• Nephrology
• Surgery
• Critical Care Medicine

Background:

• The long-term impact of postoperative acute kidney injury (pAKI) on renal function is not well-defined.
• Persistent reduction in renal function post-pAKI requires further investigation.

Purpose of the Study:

• To evaluate the long-term decline in renal function for patients who develop pAKI compared to those who do not.
• To assess the risk of a 40% decrease in glomerular filtration rate (GFR) up to 36 months post-surgery.

Main Methods:

• A multi-center retrospective study involving 95,208 adult surgical patients.
• Propensity score matching was employed to compare patients with and without pAKI.
• Kaplan-Meier analysis and a piecewise Cox model were used to analyze time to a 40% GFR decline.

Main Results:

• The incidence of pAKI ranged from 9.9% to 13.7% across the participating institutions.
• pAKI was significantly associated with an increased hazard of a 40% GFR decline.
• Hazard ratios for a 40% GFR decline ranged from 13.35 (0-6 months) to 4.32 (24-36 months) post-pAKI.

Conclusions:

• Postoperative acute kidney injury substantially increases the risk of a significant long-term decline in kidney function.
• The elevated risk of GFR decline persists for up to 36 months following the initial surgery.
• Findings underscore the importance of monitoring renal function in patients following pAKI.