• Toshiyuki Mizota, Li Dong, Chikashi Takeda, Atsuko Shiraki, Shino Matsukawa, Satoshi Shimizu, and Shinichi Kai.
• Department of Anesthesia, Kyoto University Hospital, Kyoto, Japan. Electronic address: mizota@kuhp.kyoto-u.ac.jp.
• J Crit Care. 2019 Apr 1; 50: 17-22.

PurposeWe conducted a retrospective cohort study to determine incidences of transient and persistent acute kidney injury (AKI) after major abdominal surgery and their impacts on long-term outcome.Materials And MethodsWe enrolled 3751 patients undergoing major abdominal surgery. Postoperative AKI was classified as transient or persistent based on the return of serum creatinine to the non-AKI range within 7 days post-surgery. Primary outcome was mortality within 1 year. We used multivariable Cox proportional hazard regression analysis to assess independent associations between AKI type and mortality.ResultsMost patients with AKI were classified as transient (84%). Compared to patients without AKI, both patients with transient and persistent AKI demonstrated elevated 1-year mortality rates [adjusted hazard ratio (95% confidence interval): 2.01 (1.34-2.93); P = 0.001, and 6.20 (3.00-11.43); P < 0.001, respectively] and greater risk of chronic kidney disease progression at 1 year [adjusted odds ratio (95% confidence interval): 3.87 (2.12-7.08) and 23.70 (9.64-58.22), respectively; both P < 0.001].ConclusionsAlthough most AKI cases after major abdominal surgery recover completely within 7 days, even these patients with transient AKI are at higher risk for 1-year mortality and chronic kidney disease progression compared to patients without AKI.Copyright © 2018 Elsevier Inc. All rights reserved.

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