Dr Mohamad Fuad bin Mohamad Piruz

Moderator: Dr Zakaria bin Abdul Razak

7 November 2025

Introduction:

• Acute Kidney Injury (AKI) is a sudden decline in kidney function, often due to hemodynamic changes or a systemic nephrotoxic insult.
• Affects up to 50% of surgical patients.
• Defined by oliguria (<0.5 mL/kg/h >6 h) or increase of  serum creatinine ≥0.3 mg/dL (26 µmol/L) within 48 h.
• Associated with 2–5 times higher mortality and 3–8 times higher risk of developing CKD.
• 10–30% may require temporary or long-term hemodialysis.
• Leads to longer hospital stay and increase cost and resources use.

Take Home Messages

1. AKI is a common perioperative complication with increased morbidity and mortality
2. Mild to moderate AKI occurs more often than severe AKI
3. Risk factors differ across surgical populations, and many are preventable
4. Main goals are early identification, accurate risk stratification, prevention, and renal recovery
5. Preoperative assessment should evaluate kidney health, renal reserve, and susceptibility to injury
6. Postoperative assessment should review intraoperative insults using clinical findings, biomarkers, and imaging
7. Early treatment and protective strategies help prevent further injury and promote recovery

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