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Risk factors of perioperative acute kidney injury in elderly patients: a single-center retrospective study

  • Nephrology - Original Paper
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Abstract

Purpose

The elderly are vulnerable to perioperative acute kidney injury. The aim of this study was to determine the risk factors that associated with acute kidney injury among elderly patients.

Methods

Clinical data of elderly patients (> 65 years) who underwent noncardiac, nonrenal surgery between Dec 1 2009 and July 1 2016 were collected for this single-centered historical cohort study. Univariate and multivariate analyses were conducted to explore the risk factors that contribute to acute kidney injury, which was defined as a serum creatinine increase >0.3 mg/dL within 48 h or 1.5 times increase in serum creatinine within 7 days after surgery.

Results

7775 patients were eligible for the final analysis, among which 511 (6.57%) patients developed acute kidney injury. We observed 21 risk factors being associated with perioperative acute kidney injury, with the most important disposing factors being history of kidney disease (adjusted OR = 2.94, 95% CI 2.25–3.84), operation time > 180 min (aOR = 2.93, 95% CI 2.04–4.24), preoperative eGFR [15, 30) (aOR = 2.43, 95% CI 1.29–4.45), and protective factor being intraoperative use of sufentanil (aOR = 0.35, 95% CI 0.23–0.54).

Conclusion

This study determined risk factors for perioperative acute kidney injury among the elderly in the Second Xiangya Hospital and visualized the risk factors using nomogram and Excel calculator, which may provide some clues to further investigations. Overall, the prevalence of AKI among this large cohort is 6.57%.

Clinical trials registration

http://www.chictr.org.cn; ChiCTR1900027007; October 28, 2019.

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Funding

This study was supported by National Key Research and Development Program of China (Grant No. 2018YFC2001902).

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Author notes

  1. Qi Sun and Yujing Zhao contributed equally as co-first authors.

Authors and Affiliations

  1. Department of Anesthesiology, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China

    Qi Sun, Yujing Zhao, Binyi Liao, Junmei Xu & Yulong Cui

  2. Hunan Province Center for Clinical Anesthesia and Anesthesiology, Research Institute of Central South University, Changsha, China

    Qi Sun, Yujing Zhao, Binyi Liao, Junmei Xu & Yulong Cui

  3. Department of Biostatistics, Le9 Healthcare Technology Co., Ltd., Shanghai, China

    Lei Mo

Authors
  1. Qi Sun
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  2. Yujing Zhao
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  4. Lei Mo
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  5. Junmei Xu
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Contributions

QS, YZ, and BL contributed to all aspects of this manuscript, including study conception, methodology, data acquisition and analysis and drafting the article. LM contributed to the data acquisition and analysis. JX and YC contributed to study conception, project administration, writing—review and editing the manuscript. All authors gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Corresponding authors

Correspondence to Junmei Xu or Yulong Cui.

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Conflict of interest

None.

Ethical approval

The study protocol was approved by the Medical Ethical Committee in the Second Xiangya Hospital (2019K165) and had registered on http://www.chictr.org.cn (No. ChiCTR1900027007; October 28, 2019). All subjects were anonymized so informed consent was not required. The committee waived the need for written informed consent because patients were not subjected to any investigational actions and only patient information relevant to usual care was obtained. This study conformed to the ethical guidelines of the 1975 Declaration of Helsinki and Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines.

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Cite this article

Sun, Q., Zhao, Y., Liao, B. et al. Risk factors of perioperative acute kidney injury in elderly patients: a single-center retrospective study. Int Urol Nephrol 55, 459–467 (2023). https://doi.org/10.1007/s11255-022-03345-8

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  • DOI: https://doi.org/10.1007/s11255-022-03345-8

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