Acute kidney injury prevalence in patients with colorectal cancer undergoing surgery with curative intent

Introduction
Acute kidney injury (AKI) is a frequent postoperative complication. However, data on the incidence of AKI in patients with colorectal cancer (CRC) undergoing surgery with curative intent are still limited. We examined the relationship between postoperative AKI among CRC surgery patients and preoperative therapy or no prior therapy.

Material and methods
A total of 326 consecutive patients from the regional oncology center undergoing CRC surgery in the period January to December 2019 were included in the observational cohort study. We defined AKI as a 50% increase in plasma creatinine or initiation of renal replacement therapy within 7 days after surgery or an absolute increase in creatinine of 0.3 mg/dl within 48 hours.

Results
Acute kidney injury occurred in 36 patients (11%), 27 of whom underwent rectum resection, and 9 underwent colon resection. The incidence of AKI was identical in both types of surgery. Among 54 patients undergoing neoadjuvant radiochemotherapy, 6 patients (11%) developed AKI, while there was no case of AKI in 31 patients with neoadjuvant radiotherapy. Among 36 patients with AKI, 33 had hypertension, 27 had diabetes and 18 had at least stage 3 of chronic kidney disease before the surgery.

Conclusions
Acute kidney injury after surgery for CRC is a relatively frequent postoperative complication, in particular, in patients with prior impairment in kidney function and comorbidities such as hypertension and diabetes. Appropriate preoperative therapy, including optimal hydration, withdrawal of potentially nephrotoxic drugs, etc., may reduce the incidence of AKI.