Acute Kidney Injury After Major Abdominal Surgery: Epidemiology and Management Challenges



Of all the cases of AKI during acute care hospitalization, up to 40 % are observed in the perioperative settings. AKI after major abdominal surgery, although less frequent than cardiovascular surgical settings, similarly leads to increased morbidity and high mortality. The present chapter discusses patient-related, intraoperative and postoperative factors that are linked with AKI and are unique to this surgical setting. Present AKI care in hospitals represents a poorly coordinated effort, and a multidisciplinary management algorithm that encompasses perioperative risk scoring, early detection, elimination of aggravating factors, and early input from renal specialists may improve clinical outcomes. Following development of AKI after abdominal surgery, several strategies, including the use of a chloride-restrictive parenteral fluid, can prove to be reno-protective and result in improved surgical outcomes.


Acute Kidney Injury Major Abdominal Surgery Noncardiac Surgery Kidney Disease Improve Global Outcome Parenteral Fluid 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Competing Interests

SA has received educational support and travel bursaries from Baxter Healthcare and Fresenius Kabi. DNL has received research funding and speaker’s honoraria from BBraun, Fresenius Kabi, and Baxter Healthcare.


No external funding was received for this article.


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© Springer Science+Business Media New York 2015

Authors and Affiliations

  1. 1.Division of Gastrointestinal Surgery, Nottingham Digestive Diseases Centre NIHR Biomedical Research UnitQueen’s Medical CentreNottinghamUK
  2. 2.Division of Gastrointestinal Surgery, Nottingham Digestive Diseases Centre NIHR Biomedical Research UnitNottingham University Hospitals, Queen’s Medical CentreNottinghamUK

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