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Background

Acute Kidney Injury (AKI) after surgery increases long term risk of kidney dysfunction. The major risk factor for AKI after Bariatric Surgery (BaS) is to have preoperative renal insufficiency. Little is known about the outcomes and risk factors for developing AKI in patients undergoing BaS with normal renal function. We aimed to describe factors that may increase the risk of AKI after primary BaS in patients without history of kidney disease.

Methods

Retrospective analysis of the MBSAQIP data registry for patients aged >=18 years old undergoing laparoscopic sleeve gastrectomy (SG) and laparoscopic Roux En Y gastric bypass (GBP) during 2015-2019. Patients with diagnosis of chronic kidney disease were excluded. The primary outcome was the incidence of AKI. Secondary outcomes included 30-day complications, readmissions, reoperations and mortality. Univariate analysis and multivariate analysis were performed to look for differences between patients with and without AKI.

Results

A total of 747,926 patients were included (LSG=73.1%, LRYGB=26.8%). The mean age was 44.40 +- 11.94 years, with female predominance (79.7%). AKI occurred in 446 patients (0.05%). Patients with postoperative AKI had higher rates of complications, readmissions, reoperations and mortality. Significant predictors of AKI were: male gender, prior history of venous thromboembolism (VTE), hypertension (HTN), limitation for ambulation and GBP. High albumin levels and white race were protective factors.

Conclusions

New onset AKI was associated with adverse 30-day outcomes in patients undergoing BaS. Male gender, VTE, HTN, limitation for ambulation and GBP were independent predictors of AKI.