Incidence of Post-operative Acute Kidney Injury among Selected Major Surgeries at University Hospital Kotelawala Defence University Sri Lanka: A Pilot Study.

Abstract

Background: Postoperative acute kidney injury (AKI) is a common complication of major surgeries, potentially progressing to chronic kidney disease and contributing to both short and long-term morbidity and mortality. Objective: To identify the incidence of AKI among those who underwent major surgeries at University Hospital Kotelawala Defense University (UHKDU), in terms of serum creatinine together with other risk factors

Methods: Extendable pilot study was conducted including 30 patients who underwent major surgeries at UHKDU. The selected major surgeries were Oncological (esophageal, gastrointestinal), non-cardiac, cardiac, abdominal, and gynecological surgeries. Post-operative AKI was defined as an increase in serum creatinine of >0.3 mg/dL within 48 hours according to the Kidney Disease Improving Global Outcomes guidelines. Pre-operative and post-operative serum creatinine levels were measured using a fully automated Biochemical analyzer (ABOTT Architect plus C-4000 Analyzer by Creatinine Jaffe method). Demographic, pre-operative, intra operative, and post-operative patient information were also recorded. Results: Mean±SD age and BMI of the patients were 55±18 years and 23.4±6.1 kg/m2, respectively. The majority (66.6%) of the patients were female. Mean±SD serum creatinine values of the patients before and after surgeries were 0.90±0.41 mg/dL and 0.93±0.49 mg/dL, respectively. Out of 30 patients, 47.0%, 17.0%, 17.0%, 13.0%, and 7.0% underwent abdominal, urological, oncological, neurological, and orthopedic surgeries, respectively. Overall incidence of post-operative AKI was 17% (n=5) consisting of patients who underwent three abdominal, one neurological and one urological surgery. All AKI patients were from open surgical procedures, with a high incidence in older age and female patients. Conclusions: As AKI is one of the factors that may affect their morbidity and mortality, close monitoring of patients after surgeries is crucial. Further research should be conducted to identify early biomarkers more reliable than serum creatinine for early diagnosis.