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.
