Incidence, risk factors and outcome of postoperative acute kidney injury in China

作者：Yichun Cheng, Sheng Nie, Xingyang Zhao, Xin Xu, Hong Xu, Bi‐Cheng Liu, Jianping Weng, Chunbo Chen, Jialu Liu, Qiongqiong Yang, Hua Li, Yaozhong Kong, Guisen Li, Qijun Wan, Yan Zha, Ying Hu, Yongjun Shi, Yilun Zhou, Guobin Su, Ying Tang, Mengchun Gong, Fan Fan Hou, Shuwang Ge, Gang Xu · 发表于：Nephrology Dialysis Transplantation · 年份：2024 · DOI：10.1093/ndt/gfad260 · 被引用次数：29 · 研究领域：Acute Kidney Injury Research、Trauma, Hemostasis, Coagulopathy, Resuscitation、Chronic Kidney Disease and Diabetes

BACKGROUND: Postoperative acute kidney injury (AKI) is a common condition after surgery, however, the available data about nationwide epidemiology of postoperative AKI in China from large and high-quality studies are limited. This study aimed to determine the incidence, risk factors and outcomes of postoperative AKI among patients undergoing surgery in China. METHODS: This was a large, multicentre, retrospective study performed in 16 tertiary medical centres in China. Adult patients (≥18 years of age) who underwent surgical procedures from 1 January 2013 to 31 December 2019 were included. Postoperative AKI was defined by the Kidney Disease: Improving Global Outcomes creatinine criteria. The associations of AKI and in-hospital outcomes were investigated using logistic regression models adjusted for potential confounders. RESULTS: Among 520 707 patients included in our study, 25 830 (5.0%) patients developed postoperative AKI. The incidence of postoperative AKI varied by surgery type, which was highest in cardiac (34.6%), urologic (8.7%) and general (4.2%) surgeries. A total of 89.2% of postoperative AKI cases were detected in the first 2 postoperative days. However, only 584 (2.3%) patients with postoperative AKI were diagnosed with AKI on discharge. Risk factors for postoperative AKI included older age, male sex, lower baseline kidney function, pre-surgery hospital stay ≤3 days or >7 days, hypertension, diabetes mellitus and use of proton pump inhibitors or diuretics. The ris...