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Journal of Anesthesia

, Volume 32, Issue 5, pp 740–747 | Cite as

Chronic hyperglycemia with elevated glycated hemoglobin level and its association with postoperative acute kidney injury after a major laparoscopic abdominal surgery in diabetes patients

  • Tak Kyu Oh
  • Sunghee Han
  • Ah-Young Oh
  • Saeyeon Kim
  • Jung-Hee Ryu
Original Article

Abstract

Background

The relationship between preoperative hyperglycemia and postoperative acute kidney injury (AKI) occurrence in non-cardiac surgery including laparoscopic surgery remains unclear. This study aimed to assess the relationship between preoperative chronic hyperglycemia and postoperative AKI occurrence after a major laparoscopic abdominal surgery.

Methods

We retrospectively reviewed medical records of diabetic patients (≥ 20 years old) who underwent elective major laparoscopic abdominal surgery procedures between 2010 and 2016. Patients were divided into two groups based on a cut-off value of hemoglobin A1c (HbA1c) at 6%. Serum creatinine value was used for the diagnosis of AKI, and all assessments and diagnoses of postoperative AKI were performed on 0–3 postoperative days (POD) using the criteria of Kidney Disease: Improving Global Outcomes.

Results

In all, 1885 patients were included in the final analysis, and patients were divided into the following groups: < 6.0% group with 1257 patients (66.7%), and ≥ 6.0% group with 628 patients (33.3%). Sixty-nine patients (3.7%) were diagnosed with postoperative AKI within 3 POD. Multivariable logistic regression analysis showed no significant difference in the incidence rate of postoperative AKI between the HbA1c ≥ 6.0% group and the < 6.0% group (odds ratio 1.10, 95% confidence interval 0.57–2.15; P = 0.770). In addition, there was no significant interaction between preoperative HbA1c group and exposure to acute hyperglycemia (serum glucose > 200 mg/dL) for incidence of AKI on POD 0–3 (P = 0.181).

Conclusions

In diabetic patients, preoperative chronic hyperglycemia is not associated with postoperative AKI occurrence within 3 POD after a major laparoscopic abdominal surgery.

Keywords

Acute kidney injury Diabetes mellitus General surgery Laparoscopy 

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Copyright information

© Japanese Society of Anesthesiologists 2018

Authors and Affiliations

  • Tak Kyu Oh
    • 1
  • Sunghee Han
    • 1
    • 2
  • Ah-Young Oh
    • 1
    • 2
  • Saeyeon Kim
    • 1
  • Jung-Hee Ryu
    • 1
    • 2
  1. 1.Department of Anesthesiology and Pain MedicineSeoul National University Bundang HospitalSeongnam-siSouth Korea
  2. 2.Department of Anesthesiology and Pain MedicineSeoul National University College of MedicineSeoulSouth Korea

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