Renal Insufficiency After Colectomy for Colon Cancer

BackgroundRenal insufficiency (RI) is highly prevalent among cancer patients and is linked to increased mortality. Comorbid conditions, drug-induced nephrotoxicity, and medication side effects, such as dehydration from vomiting, may affect kidney function. Hence, a better understanding of factors related to postoperative RI in patients undergoing colectomies for colon cancer can help identify strategies to enhance patient outcomes.MethodsWe analyzed the 2022 American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP)-Targeted Colectomy database to identify patients undergoing colectomies for colon cancer. We excluded those with preoperative renal failure, those who received a stoma, or those who experienced postoperative anastomotic leaks to ensure the validity of this study. A total of 535 patients were identified as having postoperative RI (Post-op RI Group), while 11,794 patients were identified as not having postoperative RI (Control Group).ResultsMultivariate logistic regression indicated that preoperative factors such as congestive heart failure (Odds Ratio (OR) = 3.3217; P < .001), hypertension (OR = 2.4416; P < .001), and chemotherapy within 90 days before surgery (OR = 1.7154; P < .001) were independently associated with increased odds of postoperative RI. Postoperative RI was independently associated with increased odds of mortality (OR = 5.3119; P < .001).ConclusionPostoperative RI is associated with morbidity in patients with colon cancer. Identification of patient characteristics, such as preoperative chemotherapy use and comorbidities, that may contribute to RI can be utilized in the management of patients. Closer preoperative monitoring of renal function and urine output, and fluid management in these patients may reduce the risk of kidney injury.