Abstract
BackgroundIt is necessary to define the problem of acute kidney injury (AKI) after non-cardiac surgery in order to design interventions to prevent AKI. The study aimed to evaluate the occurrence, determinants and outcome of AKI among children undergoing general (non-cardiac) surgery.MethodsThis was a prospective cohort study of patients aged ≤ 15 years who had general surgery over 18 months period at a tertiary hospital in Nigeria. AKI was evaluated at 6 and 24 h and within 7 days of surgery. Data were analysed using SPSS version 21.ResultsA total of 93 patients were studied with age ranging from 3 days to 15 years (median = 4 years). AKI occurred within 24 h of surgery in 32 (34.4%) and cumulatively over 7 days in 33 (35.5%). Patients who had sepsis were nearly four times as likely as others to develop perioperative AKI (OR = 3.52, 95% CI 1.21, 10.20, p = 0.021). Crude mortality rate was 12.1% (4/33); no mortality was recorded among those without AKI, p = 0.014.ConclusionPerioperative AKI occurred in 35.5% of children who underwent general (non-cardiac) surgery. Patients who had sepsis were four times more likely than others to develop AKI. Mortality was documented only in patients who had AKI.
Highlights
It is necessary to define the problem of acute kidney injury (AKI) after non-cardiac surgery in order to design interventions to prevent AKI
As much as 73 to 80% of AKI occur in the community in low- and middle-income countries (LMICs), compared to 20% in high-income countries (HICs) [4, 6, 7]
A perioperative risk factor was identified in 4% to 6% of children with AKI in LMICs and in as much as 27% in HICs [4]
Summary
It is necessary to define the problem of acute kidney injury (AKI) after non-cardiac surgery in order to design interventions to prevent AKI. Acute kidney injury (AKI) may occur after surgery, and it is a major perioperative event. As much as 73 to 80% of AKI occur in the community in low- and middle-income countries (LMICs), compared to 20% in high-income countries (HICs) [4, 6, 7]. A perioperative risk factor was identified in 4% to 6% of children with AKI in LMICs and in as much as 27% in HICs [4]. The risk factors for community-acquired AKI in children are largely related to public health infrastructural challenges such as sanitation, infectious diseases, and diarrhoeal diseases [4], but this cannot be said of perioperative AKI, where the variables surrounding the development of AKI are largely related to the characteristics and severity of the disease and its management in respective healthcare settings
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