Purpose:We conducted a retrospective cohort study to determine incidences of transient and persistent acute kidney injury (AKI) after major abdominal surgery and their impacts on long-term outcome.
Materials and Methods:We enrolled 3,751 patients undergoing major abdominal surgery.Postoperative AKI was classified as transient or persistent based on the return of serum creatinine to the non-AKI range within 7 days post-surgery. Primary outcome was mortality within 1 year. We used multivariable Cox proportional hazard regression analysis to assess independent associations between AKI type and mortality.Results: Most patients with AKI were classified as transient (84%). Compared to patients without AKI, both patients with transient and persistent AKI demonstrated elevated 1-year mortality rates [adjusted hazard ratio (95% confidence interval): 2.01 (1.34-2.93); P = 0.001, and 6.20 (3.00-11.43); P < 0.001, respectively] and greater risk of chronic kidney disease progression at 1 year [adjusted odds ratio (95% confidence interval): 3.87 (2.12-7.08) and 23.70 (9.64-58.22), respectively; both P < 0.001].
Conclusions:Although most AKI cases after major abdominal surgery recover completely within 7 days, even these patients with transient AKI are at higher risk for 1-year mortality and chronic kidney disease progression compared to patients without AKI.
Authors' Contributions Toshiyuki Mizota: This author conceptualized and designed the study, collected and analyzed the dataset, and drafted the manuscript. Li Dong: This author helped design the study, analyzed and interpreted data, and critically revised and approved the manuscript. Chikashi Takeda: This author helped design the study, analyzed and interpreted data, and critically revised and approved the manuscript. Atsuko Shiraki: This author analyzed and interpreted data and critically revised and approved the manuscript. Shino Matsukawa: This author analyzed and interpreted data and critically revised and approved the manuscript.
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