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Purpose The incidence, patient features, risk factors and outcomes of surgery-associated postoperative acute kidney injury (PO-AKI) across different countries and health care systems is unclear. Methods We conducted an international prospective, observational, multi-center study in 30 countries in patients undergoing major surgery (> 2-h duration and postoperative intensive care unit (ICU) or high dependency unit admission). The primary endpoint was the occurrence of PO-AKI within 72 h of surgery defined by the Kidney Disease: Improving Global Outcomes (KDIGO) criteria. Secondary endpoints included PO-AKI severity and duration, use of renal replacement therapy (RRT), mortality, and ICU and hospital length of stay. Results We studied 10,568 patients and 1945 (18.4%) developed PO-AKI (1236 (63.5%) KDIGO stage 1500 (25.7%) KDIGO stage 2209 (10.7%) KDIGO stage 3). In 33.8% PO-AKI was persistent, and 170/1945 (8.7%) of patients with PO-AKI received RRT in the ICU. Patients with PO-AKI had greater ICU (6.3% vs. 0.7%) and hospital (8.6% vs. 1.4%) mortality, and longer ICU (median 2 (Q1-Q3, 1–3) days vs. 3 (Q1-Q3, 1–6) days) and hospital length of stay (median 14 (Q1-Q3, 9–24) days vs. 10 (Q1-Q3, 7–17) days). Risk factors for PO-AKI included older age, comorbidities (hypertension, diabetes, chronic kidney disease), type, duration and urgency of surgery as well as intraoperative vasopressors, and aminoglycosides administration. Conclusion In a comprehensive multinational study, approximately one in five patients develop PO-AKI after major surgery. Increasing severity of PO-AKI is associated with a progressive increase in adverse outcomes. Our findings indicate that PO-AKI represents a significant burden for health care worldwide. Supplementary Information The online version contains supplementary material available at 10.1007/s00134-023-07169-7.

Chronic kidney disease is one of the most common chronic diseases globally. Many studies have shown it is strongly associated with increased social and psychological problems such as depression and anxiety which are considered as common psychiatric disorders that occur in patients with chronic kidney disease. We investigated the prevalence of depression, anxiety and perception of quality of life in a sample of chronic kidney disease patients at the Jordan University Hospital. We aimed to see any association of the mental health in these patients; mainly depression and anxiety with their quality of life and correlation to socio-demographics or laboratory and metabolic profile of this population. 103 chronic kidney disease patients were interviewed using a questionnaire in the Nephrology outpatient clinics of the Jordan University Hospital, the questionnaire included four sections, the first sections handled socio-demographic data. Also, it contains a brief Clinical and laboratory parameter of our patients. The second part consisted of the 9-item Patient Health Questionnaire (PHQ-9) that used to measure the severity of depression. The third part included the 7-item Generalized Anxiety Disorder (GAD-7) to evaluate the severity of anxiety, the fourth part assessed participants quality of life (QOL) using The World Health Organization Quality of Life, Short Form (WHOQOL-BREF) questionnaire. More than half of the participants have depression and anxiety with a percentage of 58.3% and 50.5%, respectively. There was a negative moderate to strong correlation between depression score and quality of life domains scores (p < 0.001).Only marital status had a significant relationship with depression (p < 0.001).Weak positive correlation between Glomerular Filtration Rate and anxiety score (p = 0.04),with significant positive correlation between lipid profile and anxiety score. There was a negative correlation between anxiety score and quality of life domains scores. Females had higher anxiety score than males (p = 0.27). Patients who do not work had a lower physical functioning score compared to others (p value = 0.024).Patients with higher serum Hemoglobin had higher physical and psychological scores. Anxiety, Depression are common among our chronic kidney disease patients, more interventions are needed to improve the mental health of our patients and their quality of life perception. This kind of study allows us to gain a deeper understanding regarding the effects of chronic kidney disease on psychosocial well-being of those patients, and helps health care providers to put depression, anxiety and Quality of life into consideration when treating patients.

Background Despite the growing concern worldwide regarding the quality of life (QoL) and mental well-being among chronic kidney disease (CKD), a few research has been done to address this issue. The study aims to measure depression, anxiety, and QoL prevalence among Jordanian patients with End Stage Renal Disease (ESRD) on hemodialysis and how all of these variables are correlated. Methods This is a cross-sectional, interview-based study on patients at the Jordan University Hospital (JUH) dialysis unit. Sociodemographic factors were collected, and the prevalence of depression, anxiety disorder, and QOL was assessed using the Patient Health Questionnaire 9 (PHQ9), the Generalized Anxiety Disorder 7-item (GAD7), and the WHOQOL-BREF, respectively. Results In a study of 66 patients, 92.4% had depression, and 83.3% had generalised anxiety disorder. Females had significantly higher depression scores than males (mean = 6.2 ± 3.77 vs 2.9 ± 2.8, p < 0.001), and single patients had significantly higher anxiety scores than married patients (mean = 6.1 ± 6 vs 2.9 ± 3.5, p = 0.03). Age was positively correlated with depression scores (rs= 0.269, p = 0.03), and QOL domains showed an indirect correlation with GAD7 and PHQ9 scores. Males had higher physical functioning scores than females (mean = 64.82 vs 58.87, p = 0.016), and patients who studied in universities had higher physical functioning scores than those with only school education (mean of College/University = 78.81 vs mean of School Education = 66.46, p = 0.046). Patients taking <5 medications had higher scores in the environmental domain (p = 0.025). Conclusion The high prevalence of depression, GAD, and low QOL in ESRD patients on dialysis highlights the need for caregivers to provide psychological support and counselling for these patients and their families. This can promote psychological health and prevent the onset of psychological disorders.

Background High neutrophil–lymphocyte ratio (NLR) is associated with poor survival in lung cancer. This study evaluates whether NLR is associated with baseline brain metastasis in stage IV non-small cell lung cancer (NSCLC). Methods Medical records of stage IV NSCLC patients treated at King Hussein Cancer Center (Amman-Jordan) between 2006 and 2016 were reviewed. Patients with baseline brain imaging and complete blood count (CBC) were included. Receiver operating characteristic (ROC) curve was used to identify the optimal cutoff value for the association between NLR and baseline brain metastasis. Association between age, gender, location of the primary tumor, histology, and NLR was assessed using univariate and multivariate logistic regression analyses. Results A total of 722 stage IV NSCLC patients who had baseline brain imaging were included. Median age was 59 years. Baseline brain metastasis was present in 280 patients (39.3%). Nine patients had inconclusive findings about brain metastasis. The ROC curve value of 4.3 was the best fitting cutoff value for NLR association with baseline brain metastasis. NLR ≥ 4.3 was present in 340 patients (48%). The multivariate analyses showed that high baseline NLR (≥ 4.3) was significantly associated with higher odds of baseline brain metastasis (odds ratio [OR]: 1.6, 95% confidence interval [CI]: 1.2–2.2; p = 0.0042). Adenocarcinoma histology was also associated with baseline brain metastasis (OR: 0.4, 95% CI: 0.25–0.6; p = 0.001). Conclusion High NLR is associated with baseline brain metastasis in advanced-stage NSCLC. In the era of immunotherapy and targeted therapies, whether high NLR predicts response of brain metastasis to treatment is unknown.