ORIGINAL RESEARCH
Intensive Care
doi: 10.25005/2074-0581-2025-27-2-280-290
ACUTE KIDNEY INJURY AFTER SURGERY OF THE ACUTE ABDOMEN: INDEPENDENT RISK PREDICTORS

M.I. TUROVETS¹, YU.I. VEDENIN², D.A. KAZANTSEV¹, A.S. POPOV¹, A.V. EKSTREM¹, I.V. SKACHKO¹, A.V. LOPUSHKOV³

1Department of Anesthesiology and Resuscitation, Transfusiology and Emergency Medical Care, Institute of Continuous Medical and Pharmaceutical Education, Volgograd State Medical University, Volgograd, Russian Federation
2Department of Surgical Diseases № 1, Institute of Continuous Medical and Pharmaceutical Education, Volgograd State Medical University, Volgograd, Russian Federation
3Department of Faculty Surgery, Volgograd State Medical University, Volgograd, Russian Federation

Objective: To identify independent predictors of postoperative acute kidney injury (AKI) in patients undergoing surgery for the acute abdomen.

Methods: A comparative cohort study was conducted to evaluate the surgical treatment outcomes for 271 patients with acute abdomen. All patients were admitted to the intensive care unit for postoperative care and management. The primary endpoint of the study was the development of AKI. Receiver operating characteristic (ROC) analysis was performed to evaluate the sensitivity and specificity, integrating categorical and numerical variables in the prediction of AKI. To identify independent predictors of AKI, the adjusted odds ratio was calculated using binary logistic regression analysis, which included statistically significant risk factors.

Results: In the first postoperative week, AKI was diagnosed in 69.7% of patients, with 30.2% of these cases classified as stage III, necessitating renal replacement therapy (RRT). Patients with AKI were statistically older, with an average age of 63.2±8.3 years, compared to 58.8±9.6 years for those without AKI (p<0.001). Additionally, patients with AKI were more likely to have identified comorbidities, including type 2 diabetes mellitus (16.9% vs. 4.9%, p=0.007), chronic kidney disease (36.5% vs. 13.4%, p<0.001), obesity (17.5% vs. 7.3%, p=0.029), and obstructive jaundice (39.7% vs. 11.0%, p<0.001). Furthermore, those with AKI had higher preoperative levels of proinflammatory cytokines, such as tumor necrosis factor-α (TNF-α) (31.4±10.9 vs. 27.4±10.0 pg/ml, p=0.005) and C-reactive protein (CRP) (90.9±26.3 vs. 79.4±27.7 mg/l, p=0.001). Binary logistic regression analysis identified independent risk factors for AKI from the statistically significant predictors. The model demonstrated a specificity of 85.4% and a sensitivity of 95.8%.

Conclusion: In cases of acute abdomen, independent predictors of AKI in the postoperative period include age over 60 years, a glomerular filtration rate (GFR) of less than 69 ml/min, and obstructive jaundice.

Keywords: Acute kidney injury, acute abdomen, postoperative complication, risk factor, independent predictor.

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Authors' information:

Turovets Mikhail Ivanovich,
Doctor of Medical Sciences, Associate Professor, Professor of the Department of Anesthesiology and Resuscitation, Transfusiology and Emergency Medical Care, Institute of Continuous Medical and Pharmaceutical Education, Volgograd State Medical University
Researcher ID: AAF-7744-2021
Scopus ID: 57064388000
ORCID ID: 0000-0003-0793-5098
SPIN: 5140-3027
Author ID: 628217
E-mail: turovets_aro@mail.ru

Vedenin Yuriy Igorevich,
Doctor of Medical Sciences, Associate Professor, Head of the Department of Surgical Diseases № 1, Institute of Continuous Medical and Pharmaceutical Education, Volgograd State Medical University
ORCID ID: 0000-0001-9004-7694
SPIN: 9776-7361
Author ID: 980220
E-mail: vedenin82@mail.ru

Kazantsev Dmitriy Andreevich,
Assistant of the Department of Anesthesiology and Resuscitation, Transfusiology and Emergency Medical Care, Institute of Continuous Medical and Pharmaceutical Education, Volgograd State Medical University
ORCID ID: 0000-0002-8252-6641
SPIN: 1053-1922
Author ID: 727032
E-mail: kdaorit@gmail.com

Popov Aleksandr Sergeevich,
Doctor of Medical Sciences, Full Professor, Head of the Department of Anesthesiology and Resuscitation, Transfusiology and Emergency Medical Care, Institute of Continuous Medical and Pharmaceutical Education, Volgograd State Medical University
Researcher ID: C-1645-2016
Scopus ID: 57221372089
ORCID ID: 0000-0003-2241-8144
SPIN: 5096-9060
Author ID: 615567
E-mail: airvma@yandex.ru

Ekstrem Andrey Viktorovich,
Candidate of Medical Sciences, Associate Professor, Associate Professor of the Department of Anesthesiology and Resuscitation, Transfusiology and Emergency Medical Care, Institute of Continuous Medical and Pharmaceutical Education, Volgograd State Medical University
Researcher ID: D-9402-2016
ORCID ID: 0000-0002-0453-6158
SPIN: 5151-1515
Author ID: 653044
E-mail: extrvma@yandex.ru

Skachko Igor Vladimirovich,
Assistant of the Department of Anesthesiology and Resuscitation, Transfusiology and Emergency Medical Care, Institute of Continuous Medical and Pharmaceutical Education, Volgograd State Medical University
ORCID ID: 0009-0007-6050-8710
SPIN: 4215-2199
Author ID: 1264564
E-mail: skachko.1999@list.ru

Lopushkov Andrey Vladimirovich,
Assistant of the Department of Faculty Surgery, Volgograd State Medical University
ORCID ID: 0000-0001-7626-7383
SPIN: 9433-0920
Author ID: 1189217
E-mail: andreu85@bk.ru

Information about support in the form of grants, equipment, medications

The research was carried out in accordance with the research plan of Volgograd State Medical University (state registration number – 123092800010-4). The authors did not receive financial support from manufacturers of medicines and medical equipment

Conflicts of interest: No conflict

Address for correspondence:

Kazantsev Dmitriy Andreevich
Assistant of the Department of Anesthesiology and Resuscitation, Transfusiology and Emergency Medical Care, Institute of Continuous Medical and Pharmaceutical Education, Volgograd State Medical University

400131, Russian Federation, Volgograd, Pavshikh Bortsov Sq., 1

Tel.: +7 (902) 6529490

E-mail: kdaorit@gmail.com


This work is licensed under a Creative Commons Attribution 4.0 International License.

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