Abstract
Background & Objectives: Despite recent advances in understanding the pathophysiology and treatment modalities, Acute Kidney Injury (AKI) remains a common condition among post-operative patients who are admitted to the intensive care unit1. The determinants of renal function are multi factorial and are profoundly altered in the peri-operative period. The objective of this study was to identify factors associated with the development of postoperative AKI and its clinical outcomes among non cardiac post surgical patients admitted to the surgical intensive care unit. Materials & Methods: A prospective study was carried out at the surgical intensive care unit, Teaching Hospital Anuradhapura, over a 6 month period in 2013. Demographic, clinical and physiological data of patients were recorded on admission and during the course of illness, to assess the pre-operative status, intra-operative and post-operative complications. Acute renal failure (ARF) was diagnosed according to the AKIN criteria2. Organ dysfunction was assessed using SOFA score3. Univariate analysis was done to determine significant association of variables (p< 0.05) using Chi-square test. Results: Thirty eight patients met the inclusion criteria during the study period. Fourteen (37%) patients developed ARF and among them 10 (27%) needed either intermittent haemodialysis or continuous renal replacement therapy. Age, gender and BMI were not significantly associated with development of post-operative ARF. Acute lung injury/ ARDS (p=0.048), SOFA score on admission (p=0.048) and ASA grading (p=0.038) were significantly associated with ARF. Type of surgery (emergency or elective), duration of surgery, severity of surgery and blood transfusion during surgery were not significantly associated with ARF. Development of ARF was significantly associated with increased length of ICU stay. Conclusion: In our study important risk factors for development of ARF peri-operatively were acute lung injury/ ARDS, SOFA score on admission and ASA grading.
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