• Ethan Bohn, Sadeesh Srinathan, Joel Adu-Quaye, and Duane Funk.
• Department of Anesthesiology, Perioperative and Pain Medicine, Max Rady College of Medicine, University of Manitoba, 2nd Floor Harry Medovy House, 671 William Avenue, Winnipeg, MB, R3E 0Z2, Canada.
• Can J Anaesth. 2023 Dec 1; 70 (12): 190119081901-1908.

PurposePatients undergoing lung resection are at increased risk for acute kidney injury (AKI) in the immediate postoperative period, with important consequences for longer term morbidity and mortality. Lung resection surgery has unique considerations that could increase the risk of AKI, including lung resection volume, duration of one-lung ventilation (OLV), and intraoperative fluid restriction. Yet, specific risk factor data are lacking. The objective of this study was to identify independent risk factors for early AKI after lung resection surgery.MethodsWe conducted a retrospective case-control study of all patients presenting for elective lung resection surgery at an academic medical centre over a four-year period. Cases were patients who experienced an AKI and control patients were those who did not experience an AKI, based on KDIGO criteria. Baseline demographics and comorbidities along with duration of OLV and amount of lung resected were collected by retrospective chart review. The data were analyzed using multivariable logistic regression to identify independent predictors of AKI.ResultsAcute kidney injury occurred within 48 hr in 57/1,045 (5.5%; 95% confidence interval, 4.2 to 7.0) of patients. On multivariable analysis, our model of best fit included preoperative serum creatinine, male sex, use of angiotensin II receptor blockers, and duration of OLV. The rate of complications, intensive care unit admission, and risk of death were all higher in the group of patients who experienced AKI.ConclusionsAcute kidney injury occurs frequently after lung resection surgery and is associated with increased risk of postoperative complications. Increased duration of OLV may be a risk factor for AKI in this population.© 2023. Canadian Anesthesiologists' Society.

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