Impacts of air pollution on postoperative renal injuries: evidence from a multicenter cohort study of 112, 643 patients

作者：Xinchi Li, Qilian Tan, Huili Jiang, Ruijian Huang, Siyu Kong, Xuan Yin, Cheng Qian, Ke Ding, Jie Sun, Xuesheng Liu, Lihai Chen, Yali Ge, Jifang Zhou · 发表于：Annals of Medicine · 年份：2026 · DOI：10.1080/07853890.2026.2654944 · 研究领域：Air Quality and Health Impacts、Ureteral procedures and complications、Abdominal Surgery and Complications

PURPOSE: Air pollution is an emerging risk factor for adverse surgical outcomes, but its impact on postoperative kidney health is unclear. This study aimed to examine the association between exposure to multiple air pollutants and the risk of acute kidney injury (AKI) after surgery. METHODS: We conducted a retrospective cohort study among inpatients who underwent surgery under anesthesia at three academic medical centers from 2015 to 2023. The Air Quality Health Index (AQHI) was used to comprehensively quantify and score multiple ambient air pollutants. In this study, short-term exposure was defined as the 30-day average prior to surgery, with long-term exposure defined as the 2-year average. The main endpoint was the occurrence of AKI within 7 days after surgery, stage 2 or 3 acute kidney injury (AKI 2+), and acute kidney disease (AKD). RESULTS: This study included 112, 643 surgical patients (with an average age of 54 years, 48.4% of whom were male), among whom 95.3% underwent non-cardiac surgeries and 80.8% had non-emergency surgeries. In the quartile-based analysis of long-term AQHI exposure, higher AQHI levels were associated with increased odds of renal injury AKI (aOR(adjusted Odds Ratio) 1.24; 95% CI, 1.14-1.34), AKI 2+ (aOR 1.29; 95% CI, 1.19-1.53), and AKD (aOR 1.18; 95% CI, 0.97-1.43). However, in the short-term exposure analysis, associations were attenuated but remained significant. AKI (aOR 1.24; 95% CI, 1.14-1.34), AKI 2+ (aOR 1.28; 95% CI, 1.12-1.45), and AKD (...