Epidemiology of Postoperative Acute Kidney Injury in Hungarian Intensive Care Units: An Exploratory Analysis

Abstract

Background: The aim of this study was to evaluate the incidence and outcome of postoperative acute kidney injury (AKI) after major noncardiac surgery in Hungarian intensive care units (ICUs). Methods: We conducted an analysis of a multicenter survey on the epidemiology of AKI in Hungarian ICUs in respect of surgical interventions. The cohort study consisted of all patients (n = 295) over the age of 18 years who were admitted to ICUs after surgery between 1 October 2009 and 30 November 2009. AKI was defined and classified by the acute kidney injury network (AKIN) criteria. Results: Forty-eight (18.1%) patients had AKI during their ICU stay. By AKIN criteria, 27 (10.2%) patients were in Stage 1, 11 (4.2%) patients in Stage 2, and 10 (3.8%) patients in Stage 3. The overall mortality rate of AKI was 39.6% (AKI 1: 25.9%, AKI 2: 40%, and AKI 3: 54.5%; p < 0.001) and the ICU mortality rate was 33.3% (AKI 1: 18.5%, AKI 2: 10%, and AKI 3: 54.5%; p < 0.001). According to logistic regression analysis, age (OR: 1.048; CI: 1.014–1.082; p = 0.005), vasopressor treatment (OR: 9.751; CI: 8.579–10.923; p < 0.001), sepsis (OR: 10.791; CI: 9.353–12.233; p = 0.001), serum-creatinine peak-concentration (OR: 1.035; CI: 1.021–1.047; p < 0.001), and intra-abdominal surgery (OR: 2.558; CI: 1.75–3.366; p = 0.020) were independent predictors for AKI. Conclusions: The results of this study confirm that there is a high incidence of AKI following major noncardiac surgery, which is associated with higher ICU and in-hospital mortality.