Acutely kidney injury in the postoperative period of elective colorectal surgery: assessment of the age influence

Abstract

Background: The increase in life expectancy and the development of comorbidities bring a higher rate of complications and mortality in the postoperative period of surgical procedures in general. Among these associations, elective colorectal surgery and acute kidney injury are notable. Aims: To analyze risk factors associated with acute kidney injury in the postoperative period of elective colorectal surgeries in patients over 65 years of age. Additionally, to outline the epidemiological, clinical-surgical, and laboratory profile of the study population. Methods: A clinical, observational, longitudinal, prospective, and analytical study with a quantitative approach involving 30 patients from January 2023 to April 2024. Data analysis included pre, intra, and post-operative periods, with renal function assessment on the 3rd and 5th days after surgery. Results: The overall mean age was 70.4 years, 53.3% were female, 46.6% were smokers or former smokers, 63.3% had systemic arterial hypertension, and 23.3% had diabetes mellitus. Ten patients developed acute kidney injury in the postoperative period. The use of angiotensin-converting enzyme inhibitors and postoperative diuresis were significantly associated variables (p=0.039 and 0.034, respectively). The diuresis cutoff value to foretell non-progression to acute kidney injury was 0.5 mL/kg/h, with an accuracy of 88%, sensitivity of 100%, specificity of 77.78%, positive predictive value of 86.67%, and negative predictive value of 100%. Conclusions: In elderly patients undergoing elective colorectal surgery for oncological treatment, the incidence of acute kidney injury was high.