Awareness, incidence and clinical significance of acute kidney injury after non-general anesthesia: A retrospective cohort study.

Abstract

Postoperative acute kidney injury is associated with high mortality and poor prognosis. Additional investigations into the risk factors for this condition and the outcomes of patients who undergo surgeries under non-general anesthesia (GA) are necessary.This retrospective cohort study included data on all surgeries performed in adult patients from January 2006 to December 2015 at a tertiary hospital in Korea. Patients were divided into those undergoing surgeries with non-GA and those undergoing surgeries with GA. We analyzed the nephrological evaluation patterns, the risk factors for acute kidney injury, and prognoses after acute kidney injury by reviewing mortality, progression to end-stage renal disease, and serum creatinine doubling/estimated glomerular filtration rate halving from baseline.Of 74,524 patients, 20,332 underwent surgery with non-GA. These patients had baseline (adjusted odds ratio [OR], .68, 95% confidence interval [CI], .63-.72; P < .01] and follow-up serum creatinine levels (adjusted OR, .34; 95% CI, .33-.36; P < .01) less frequently measured than those undergoing GA. However, the incidence of acute kidney injury did not differ significantly between the 2 groups. Moreover, postoperative acute kidney injury after non-GA surgery showed a worse clinical prognosis which was similar with that of GA operations.Patients undergoing surgeries under non-GA did not receive sufficient evaluation for their risks of acute kidney injury. As an acute kidney injury in non-GA was associated a worse prognosis as in GA surgeries, more clinical attention should be considered.