Incidence and Long term impact of postoperative Acute Kidney Injury in patients undergoing major abdominal surgery (IMPACT PO-AKI)

Postoperative acute kidney injury (PO-AKI) is a common complication of major surgery  that is strongly associated with short-term surgical complications and long-term adverse outcomes,  including increased risk of chronic kidney disease  cardiovascular events and death.POAKI is best defined as AKI occurring within 7 days of an operative intervention using  the Kidney Disease Improving Global Outcomes (KDIGO) definition of AKI. Prevention of PO-AKI is  largely based on identification of high baseline risk, monitoring and reduction of nephrotoxic insults,  whereas treatment involves the application of a bundle of interventions to avoid secondary kidney  injury and mitigate the severity of AKI.

Acute Kidney injury (AKI) is described as an abrupt and reversible decline in the glomerular filtration  rate (GFR) which results in an elevation of serum blood urea nitrogen (BUN), creatinine and other  metabolic waste products that are normally excreted by the kidney. In 2012, Kidney Disease  Improving Global Outcomes (KDIGO) described the KDIGO AKI diagnostic criteria and categorized AKI  into stages 1–3, determined by changes in serum creatinine and/or urine output.

The risk of developing AKI following emergency  major abdominal surgery is 17percent. The risk of renal injury is particularly high in patients treated with cisplatin-containing HIPEC regimens . Incidence of AKI in  patients undergoing laparoscopic pancreas surgeries was 11percent . Incidence of PO-AKI in TMH patients undergoing major abdominal cancer surgery was 10percent. Colloids have been associated with acute kidney injury. Recently, there has been a change in departmental fluid policy i.e. no use of colloids in the perioperative period, therefore we planned this prospective observational study was to study the incidence of PO-AKI.