Incidence, risk factors, and outcomes of perioperative acute kidney injury in noncardiac and nonvascular surgery

Am J Surg. 2014 Jan;207(1):53-9. doi: 10.1016/j.amjsurg.2013.04.006. Epub 2013 Sep 17.


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.

Keywords: Noncardiac surgery; Outcome; Perioperative acute kidney injury.

MeSH terms

  • Acute Kidney Injury / epidemiology*
  • Acute Kidney Injury / etiology*
  • Adult
  • Aged
  • Aged, 80 and over
  • Analysis of Variance
  • Female
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Risk Assessment
  • Risk Factors
  • Surgical Procedures, Operative / adverse effects*
  • Treatment Outcome
  • Turkey / epidemiology