scholarly journals Nephrotoxicity of concomitant piperacillin/tazobactam and teicoplanin compared with monotherapy

2020 ◽  
Vol 76 (1) ◽  
pp. 212-219
Author(s):  
J D Workum ◽  
C Kramers ◽  
E Kolwijck ◽  
J A Schouten ◽  
S N de Wildt ◽  
...  
Keyword(s):  
Renal Function ◽  
Serum Creatinine ◽  
Retrospective Cohort ◽  
Primary Outcome ◽  
Linear Regression Analysis ◽  
Kidney Injury ◽  
Secondary Outcome ◽  
Multivariate Linear Regression Analysis ◽  
Single Centre ◽  
Health Records

Abstract Objectives Piperacillin/tazobactam combined with vancomycin has been associated with a decline in renal function when compared with monotherapy. Teicoplanin is a glycopeptide similar to vancomycin. We investigated whether piperacillin/tazobactam combined with teicoplanin is associated with a decline in renal function as well. Methods We conducted a single-centre retrospective cohort study with data from our electronic health records from 9 August 2013 to 15 November 2019, including all adult patients that received either piperacillin/tazobactam, teicoplanin or piperacillin/tazobactam + teicoplanin. The incidence of acute kidney injury (AKI) at 48–72 h served as the primary outcome, whereas change in serum creatinine served as a secondary outcome. Results Of the 4202 included patients, 3188 (75.9%) received piperacillin/tazobactam, 791 (18.8%) received teicoplanin and 223 (5.3%) received piperacillin/tazobactam + teicoplanin. The incidence of AKI at 48–72 h after commencement of antibiotic therapy was 5.4% for piperacillin/tazobactam, 3.4% for teicoplanin and 11.7% for piperacillin/tazobactam + teicoplanin (P < 0.001). However, mean serum creatinine at 48–72 h was slightly higher in the piperacillin/tazobactam + teicoplanin group therapy compared with baseline [+1.61% (95% CI –2.25 to 5.70)], indicating a slight decrease in renal function, and decreased for piperacillin/tazobactam [–1.98% (95% CI –2.73 to –1.22)] and teicoplanin [–8.01% (95% CI –9.54 to –6.45)]. After correcting for significant confounders in a multivariate linear regression analysis, these patterns remained. Conclusions Our study suggests that piperacillin/tazobactam + teicoplanin is associated with a higher prevalence of AKI compared with monotherapy. However, as the overall decline in renal function with piperacillin/tazobactam + teicoplanin is very small, its clinical relevance is likely limited. Therefore, piperacillin/tazobactam + teicoplanin can probably be safely combined.

scholarly journals Acute Kidney Injury Adjusted for Parenchymal Mass Reduction and Long-Term Renal Function after Partial Nephrectomy

2019 ◽  
Vol 8 (9) ◽  
pp. 1482
Author(s):  
Hyun-Kyu Yoon ◽  
Ho-Jin Lee ◽  
Seokha Yoo ◽  
Sun-Kyung Park ◽  
Yongsuk Kwon ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Renal Function ◽  
Serum Creatinine ◽  
Partial Nephrectomy ◽  
Functional Recovery ◽  
Linear Regression Analysis ◽  
Kidney Injury ◽  
Mass Reduction ◽  
Baseline Serum

We sought to evaluate the association of postoperative acute kidney injury (AKI) adjusted for parenchymal mass reduction with long-term renal function in patients undergoing partial nephrectomy. A total of 629 patients undergoing partial nephrectomy were reviewed. Postoperative AKI was defined by the Kidney Disease: Improving Global Outcomes (KDIGO) serum creatinine criteria, by using either the unadjusted or adjusted baseline serum creatinine level, accounting for renal parenchymal mass reduction. Estimated glomerular filtration rates (eGFRs) were followed up to 61 months (median 28 months) after surgery. The primary outcome was the functional change ratio (FCR) of eGFR calculated by the ratio of the most recent follow-up value, at least 24 months after surgery, to eGFR at 3–12 months after surgery. Multivariable linear regression analysis was performed to evaluate whether unadjusted or adjusted AKI was an independent predictor of FCR. As a sensitivity analysis, functional recovery at 3–12 months after surgery compared to the preoperative baseline was analyzed. Median parenchymal mass reduction was 11%. Unadjusted AKI occurred in 16.5% (104/625) and adjusted AKI occurred in 8.6% (54/629). AKI using adjusted baseline creatinine was significantly associated with a long-term FCR (β = −0.129 ± 0.026, p < 0.001), while unadjusted AKI was not. Adjusted AKI was also a significant predictor of functional recovery (β = −0.243 ± 0.106, p = 0.023), while unadjusted AKI was not. AKI adjusted for the parenchymal mass reduction was significantly associated with a long-term functional decline after partial nephrectomy. A creatinine increase due to remaining parenchymal ischemic injury may be important in order to predict long-term renal functional outcomes after partial nephrectomy.

scholarly journals Robust Association between Acute Kidney Injury after Radical Nephrectomy and Long-term Renal Function

2020 ◽  
Vol 9 (3) ◽  
pp. 619
Author(s):  
Won Ho Kim ◽  
Kyung Won Shin ◽  
Sang-Hwan Ji ◽  
Young-Eun Jang ◽  
Ji-Hyun Lee ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Regression Analysis ◽  
Serum Creatinine ◽  
Radical Nephrectomy ◽  
Primary Outcome ◽  
Linear Regression Analysis ◽  
Kidney Injury ◽  
Creatinine Ratio ◽  
New Onset

The association between acute kidney injury (AKI) and long-term renal function after radical nephrectomy has not been evaluated fully. We reviewed 558 cases of radical nephrectomy. Postoperative AKI was defined by the Kidney Disease: Improving Global Outcomes (KDIGO) serum creatinine criteria. Values of estimated glomerular filtration rate (eGFR) were collected up to 36 months (median 35 months) after surgery. The primary outcome was new-onset chronic kidney disease (CKD) stage 3a or higher or all-cause mortality within three years after nephrectomy. The functional change ratio (FCR) of eGFR was defined as the ratio of the most recent GFR (24–36 months after surgery) to the new baseline during 3–12 months. A multivariable Cox proportional hazard regression analysis for new-onset CKD and a multivariable linear regression analysis for FCR were performed to evaluate the association between AKI and long-term renal outcomes. A correlation analysis was performed with the serum creatinine ratio and used to determine AKI and FCR. AKI occurred in 43.2% (n = 241/558) and our primary outcome developed in 40.5% (n = 226/558) of patients. The incidence of new-onset CKD was significantly higher in patients with AKI than those without at all follow-up time points after surgery. The Cox regression analysis showed a graded association between AKI and our primary outcome (AKI stage 1: Hazard ratio 1.71, 95% confidence interval 1.25–2.32; AKI stage 2 or 3: Hazard ratio 2.72, 95% confidence interval 1.78–4.10). The linear regression analysis for FCR showed that AKI was significantly associated with FCR (β = −0.168 ± 0.322, p = 0.011). There was a significant negative correlation between the serum creatinine ratio and FCR. In conclusion, our analysis demonstrated a robust and graded association between AKI after radical nephrectomy and long-term renal functional deterioration.

MO423PROENKEPHALIN AS A BIOMARKER OF KIDNEY FILTRATION IN ACUTE KIDNEY INJURY

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Camila Lima ◽  
Etienne Macedo
Keyword(s):  
Acute Kidney Injury ◽  
Regression Analysis ◽  
Kidney Disease ◽  
Linear Regression ◽  
Serum Creatinine ◽  
Linear Regression Analysis ◽  
Kidney Injury ◽  
Multivariate Linear Regression Analysis ◽  
Serum Cystatin ◽  
Blood Samples

Abstract Background and Aims In the last decades, clinical research biomarker (BM) to improve assessment of kidney function have been intensive, and proenkephalin (PENK) has been identified as a new BM of filtration. We hypothesized whether PENK would have a better accuracy for the diagnosis of severe AKI than serum cystatin (CYS) and the serum creatinine (Scr). We evaluate patient in the peri op of liver transplant (LT). Method Blood samples were collected during the pre and post (until 48 hours) operative (op.) period of LT in 57 eligible patients. Where was analyzed PENK (Sphingotest®), CYS (Milipex) and Scr (Quimioluminence). AKI diagnosis was based on the Kidney Disease International Global Outcomes (KDIGO) criteria using Scr. KDIGO 1 was subclassified according to the International Club of Ascites (ICA). Results Of the 57 patients undergoing LT, 50 (88%) developed AKI according to the KDIGO criteria in the first week after LT. Twenty-one patients without AKI and with KDIGO 1-A (37%) were summarized as the no AKI/mild AKI group, whereas 36 patients with KDIGO 1-B, 2 and 3 (63%) were summarized as the severe AKI group. Before the intra - operative insult only PENK was significantly higher in patients that developed severe AKI, median 55 [P25-75(44,25 – 94,55)] in no AKI/mild AKI versus 90,16 [P25-75(64,70 – 135,76)] pmol/l in severe AKI p 0,021, an AUC 0,685 (CI 0,536 – 0,833), with a cutoff 55 pmol/l, sensibility of 0,86 and specificity 0,52, accuracy 0,75 to severe AKI. Scr levels in pre-op. were non- significantly higher in severe AKI; p=0,088. The CYS in the pre-op was similar within the groups. Pos-operative 48 hours after LT, PENK was significantly higher in severe AKI, median 81 [P25-75(61,25 – 101,50)] versus 161,45 [P25-75(122,85 – 294,03)] in severe AKI - p &lt;0,0001 an AUC 0,83 (CI 0,72 - 0,94) with a cutoff 119,05 pmol/l, sensibility of 0,80 and specificity 0,90, accuracy 0,84 to severe AKI. Scr levels in post-op achieve an AUC 0,77 (CI 0,63 - 0,92) with a cutoff 1,49mg/dl, sensibility of 0,94, specificity 0,67 and accuracy 0,82. In a multivariate linear regression analysis adjusted for age, anestesia time, urine output and fluid balance, the PENK only was independently associated of severe AKI in pre-op. with OR 4,40 (CI 1,40 – 13,88) – p0,001 and the post-op. with OR 44,64 (CI 5,40 – 368,5) – p&lt;0,0001. Conclusion PENK is a promisor filtration biomarker and showed a better acuracy to severe AKI in pre-operative than standard AKI diagnostic by Scr. Prediction of severe AKI in pre-operative period by PENK can help the management of these patients in the future.

Vigilance Aid Use and Aircraft Carrier Landing Performance in Pilots of Tactical Aircraft

2020 ◽  
Vol 91 (6) ◽  
pp. 518-524
Author(s):  
Craig S. Schallhorn
Keyword(s):  
Primary Outcome ◽  
Linear Regression Analysis ◽  
Secondary Outcome ◽  
Outcome Analysis ◽  
Multivariate Linear Regression Analysis ◽  
Operational Environment ◽  
Aircraft Carrier ◽  
Mixed Effect ◽  
Flight Operations ◽  
Objective Evidence

BACKGROUND: Fatigue is a well-known hazard in aviation. In military fighter communities, policies have evolved to allow for in-flight use of pharmacological vigilance aids to counteract the negative effects of fatigue. With limited objective evidence supporting the role of these medications in continuous flight operations, the present study seeks to evaluate whether use of modafinil is associated with pilot aircraft carrier landing performance.METHODS: A retrospective, observational study was completed following carrier-based flight operations in support of Operation Inherent Resolve. All graded landing passes were included in the analysis. Mixed-effect multivariate linear regression analysis was utilized for the primary outcome of landing signal officer grade of landing performance following combat sorties for events with reported in-flight use of modafinil.RESULTS: A total of 1122 sorties were flown by 79 different pilots with an average landing pass grade of 3.86. The primary outcome of modafinil use in-flight was not generally associated with landing performance. In a subset analysis of more senior ranked aviators, modafinil use appeared to offer a relative performance improvement back to baseline (+0.19). Secondary outcome analysis revealed landing performance was associated with advanced landing technologies (+0.25), sorties later in deployment (+0.05 per 30 d), total career carrier landings (+0.03 per 100 traps), and longer mission duration (-0.04 per hour).DISCUSSION: In the context of evidence supporting subjective benefits of vigilance aid use by aircrew, the results of this study provide ample objective support to the controlled use of modafinil in the operational environment.Schallhorn CS. Vigilance aid use and aircraft carrier landing performance in pilots of tactical aircraft. Aerosp Med Hum Perform. 2020; 91(6):518–524.

scholarly journals Using circulating O-sulfotyrosine in the differential diagnosis of acute kidney injury and chronic kidney disease

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Shuai Chen ◽  
Yong-Hua Liu ◽  
Dao-Peng Dai ◽  
Zheng-Bin Zhu ◽  
Yang Dai ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Acute Kidney Injury ◽  
Renal Function ◽  
Differential Diagnosis ◽  
Kidney Disease ◽  
Linear Regression Analysis ◽  
Kidney Injury ◽  
Serum Levels ◽  
Multivariate Linear Regression Analysis ◽  
Post Translational Modification

Abstract Background Sulfation of tyrosine, yielding O-sulfotyrosine, is a common but fixed post-translational modification in eukaryotes. Patients with increased circulating O-sulfotyrosine levels experience a faster decline in renal function with progression to end-stage renal disease (ESRD). In the present study, we measured serum O-sulfotyrosine levels in individuals with chronic kidney disease (CKD) and acute kidney injury (AKI) to explore its ability to differentiate AKI from CKD. Methods A total of 135 patients (20 with AKI and 115 with CKD) were recruited prospectively for liquid chromatography-mass spectrometry assessment of circulating O-sulfotyrosine. We also studied C57BL/6 mice with CKD after 5/6 nephrectomy (Nx). Blood samples were drawn from the tail vein on Day 1, 3, 5, 7, 14, 30, 60, and 90 after CKD. Serum separation and characterization of creatinine, blood urea nitrogen (BUN), and O-sulfotyrosine was performed. Thus, the time-concentration curves of the O-sulfotyrosine level demonstrate the variation of kidney dysfunction. Results The serum levels of O-sulfotyrosine were markedly increased in patients with CKD compared with AKI. Median O-sulfotyrosine levels in CKD patients versus AKI, respectively, were as follows:243.61 ng/mL(interquartile range [IQR] = 171.90–553.86) versus 126.55 ng/mL (IQR = 48.19–185.03, P = 0.004). In patients with CKD, O-sulfotyrosine levels were positively correlated with creatinine, BUN, and Cystatin C (r = 0.63, P < 0.001; r = 0.49, P < 0.001; r = 0.61, P < 0.001, respectively) by the multivariate linear regression analysis (β = 0.71, P < 0.001; β = 0.40, P = 0.002; β = 0.73, P < 0.001, respectively). However, this association was not statistically significant in patients with AKI (r = − 0.17, P = 0.472; r = 0.11, P = 0.655; r = 0.09, P = 0.716, respectively). The receiver operating characteristic (ROC) analysis illustrated that the area under the curve was 0.80 (95% confidence interval [CI] 0.71–0.89; P < 0.001) and the optimal cut-off value of serum O-sulfotyrosine suggesting AKI was < 147.40 ng/mL with a sensitivity and specificity of 80.90 and 70.00% respectively. In animal experiments, serum levels of O-sulfotyrosine in mice were elevated on Day 7 after 5/6 nephrectomy (14.89 ± 1.05 vs. 8.88 ± 2.62 ng/mL, P < 0.001) until Day 90 (32.65 ± 5.59 vs. 8.88 ± 2.62 ng/mL, P < 0.001). Conclusion Serum O-sulfotyrosine levels were observed correlated with degrading renal function and in CKD patients substantially higher than those in AKI patients. Thus serum O-sulfotyrosine facilitated the differential diagnosis of AKI from CKD.

scholarly journals Perioperative use of serum creatinine and postoperative acute kidney injury: a single-centre, observational retrospective study to explore physicians’ perception and practice

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Gianluca Villa ◽  
Silvia De Rosa ◽  
Caterina Scirè Calabrisotto ◽  
Alessandro Nerini ◽  
Thomas Saitta ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Retrospective Study ◽  
High Risk ◽  
Abdominal Surgery ◽  
Serum Creatinine ◽  
Malignant Disease ◽  
Kidney Injury ◽  
Major Surgery ◽  
Single Centre

Abstract Background Postoperative acute kidney injury (PO-AKI) is a leading cause of short- and long-term morbidity and mortality, as well as progression to chronic kidney disease (CKD). The aim of this study was to explore the physicians’ attitude toward the use of perioperative serum creatinine (sCr) for the identification of patients at risk for PO-AKI and long-term CKD. We also evaluated the incidence and risk factors associated with PO-AKI and renal function deterioration in patients undergoing major surgery for malignant disease. Methods Adult oncological patients who underwent major abdominal surgery from November 2016 to February 2017 were considered for this single-centre, observational retrospective study. Routinely available sCr values were used to define AKI in the first three postoperative days. Long-term kidney dysfunction (LT-KDys) was defined as a reduction in the estimated glomerular filtration rate by more than 10 ml/min/m2 at 12 months postoperatively. A questionnaire was administered to 125 physicians caring for the enrolled patients to collect information on local attitudes regarding the use of sCr perioperatively and its relationship with PO-AKI. Results A total of 423 patients were observed. sCr was not available in 59 patients (13.9%); the remaining 364 (86.1%) had at least one sCr value measured to allow for detection of postoperative kidney impairment. Among these, PO-AKI was diagnosed in 8.2% of cases. Of the 334 patients who had a sCr result available at 12-month follow-up, 56 (16.8%) developed LT-KDys. Data on long-term kidney function were not available for 21% of patients. Interestingly, 33 of 423 patients (7.8%) did not have a sCr result available in the immediate postoperative period or long term. All the physicians who participated in the survey (83 out of 125) recognised that postoperative assessment of sCr is required after major oncological abdominal surgery, particularly in those patients at high risk for PO-AKI and LT-KDys. Conclusion PO-AKI after major surgery for malignant disease is common, but clinical practice of measuring sCr is variable. As a result, the exact incidence of PO-AKI and long-term renal prognosis are unclear, including in high-risk patients. Trial registration ClinicalTrials.gov, NCT04341974.

scholarly journals The association of age with decline in renal function after low anterior resection and loop ileostomy for rectal cancer: a retrospective cohort prognostic factor study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Amal Rhemouga ◽  
Stefan Buettner ◽  
Wolf O. Bechstein ◽  
Guido Woeste ◽  
Teresa Schreckenbach
Keyword(s):  
Rectal Cancer ◽  
Rectal Carcinoma ◽  
Anterior Resection ◽  
Low Anterior Resection ◽  
Older Patients ◽  
Retrospective Cohort ◽  
Loop Ileostomy ◽  
Linear Regression Analysis ◽  
Multivariate Linear Regression Analysis ◽  
Group B

Abstract Background Low anterior resection (LAR) is often performed with diverting loop ileostomy (DLI) for anastomotic protection in patients with rectal cancer. We aim to analyze, if older patients are more prone to a decline in kidney function following creation and closure of DLI after LAR for rectal carcinoma versus younger patients. Methods A retrospective cohort study from a database including 151 patients undergoing LAR for rectal carcinoma with DLI was used. Patients were divided in two age groups (Group A: <65 years, n = 79; Group B: ≥65 years, n = 72). For 123 patients undergoing DLI reversal prognostic factors for an impairment of serum creatinine (SCr) and estimated glomerular filtration rate (eGFR) 3 months after DLI reversal was analyzed using a multivariate linear regression analysis. Results SCr before LAR(T0) was significant higher in Group B (P = 0.04). Accordingly, the eGFR at T0 in group B was significantly lower (P < 0.001). No patients need to undergo hemodialysis after LAR or DLI reversal. Age and SCr at T0were able to statistically significant predict an increase in SCr (P<0.001) and eGFR (P=0.001) three months after DLI reversal (The R² for the overall model was .82 (adjusted R² = .68). Conclusion DLI creation may result in a reduction of eGFR in older patients 3 months after DLI closure. Apart from this, patients do not have a higher morbidity after creation and closure of DLI resulting from LAR regardless of their age.

scholarly journals Hydroxyethyl Starch 130/0.42 Effect’s on Renal Function in Patients After Cardiac Surgery: A Retrospective Cohort Analysis

2020 ◽  
Author(s):  
Benedict Morath ◽  
Andreas Meid ◽  
Johannes Rickmann ◽  
Jasmin Soethoff ◽  
Markus Verch ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Renal Function ◽  
Cardiac Surgery ◽  
Kidney Function ◽  
Hydroxyethyl Starch ◽  
Retrospective Cohort ◽  
Cohort Analysis ◽  
Kidney Injury ◽  
Retrospective Cohort Analysis ◽  
The Impact

Abstract Background: Fluid management is an everyday challenge in intensive care units worldwide. Data from recent trials suggest that the use of hydroxyethyl starch leads to a higher rate of acute kidney injury and mortality in septic patients. Evidence on the safety of hydroxyethyl starch used in postoperative cardiac surgery patients is lacking Methods: The aim was to determine the impact of postoperatively administered hydroxyethylstarch 130/0.42 on renal function and 90-day mortality compared to with or without balanced crystalloids in patients after elective cardiac surgery. A retrospective cohort analysis was performed including 2245 patients undergoing elective coronary artery bypass grafting or, aortic valve replacement, or a combination of both between 2015 - 2019. Acute kidney injury was defined according to the ‘kidney disease improving global outcomes’ criteria. Multivariate logistic regression yielded adjusted associations of postoperative hydroxyethyl starch administration with acute kidney injury during hospital stay and 90-day mortality. Linear mixed-effects models predicted trajectories of estimated glomerular filtration rates over the postoperative period to explore the impact of dosage and timing of hydroxyethyl starch administration.Results: A total of 1009 patients (45.0 %) suffered from acute kidney injury. Significantly less acute kidney injury of any stage occurred in patients receiving hydroxyethyl starch compared to patients receiving only crystalloids for fluid resuscitation (43.7 % vs. 51.2 % p=0.008). In multivariate analysis, the administration of hydroxyethyl starch showed a protective effect (OR 0.89 95% confidence interval (CI) (0.82-0.96)) which was less prominent in patients receiving only crystalloids (OR 0.98, 95% CI (0.95-1.00)). No association between hydroxyethyl starch and 90-day mortality (OR 1.05 95% CI (0.88-1.25)) was detected. Renal function trajectories were dose-dependent and biphasic and hydroxyethyl starch could even slow down the late postoperative decline of kidney function.Conclusion: This study showed no association between hydroxyethyl starch and the postoperative occurrence of acute kidney injury and may add evidence to the discussion about the use of hydroxyethyl starch in cardiac surgery patients. In addition, hydroxyethyl starch administered early after surgery in adequate low doses might even prevent the decline of the kidney function after cardiac surgery.

Perioperative Use of Serum Creatinine and Postoperative Acute Kidney Injury: a Single Centre, Observational Retrospective Study to Explore Physicians’ Perception and Practice.

2021 ◽  
Author(s):  
Gianluca Villa ◽  
Silvia De Rosa ◽  
Caterina Scirè Calabrisotto ◽  
Alessandro Nerini ◽  
Thomas Saitta ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Retrospective Study ◽  
High Risk ◽  
Abdominal Surgery ◽  
Serum Creatinine ◽  
Malignant Disease ◽  
Kidney Injury ◽  
Major Surgery ◽  
Single Centre

Abstract Background. Postoperative acute kidney injury (PO-AKI) is a leading cause of short- and long-term morbidity and mortality, as well as progression to chronic kidney disease (CKD). The aim of this study was to explore the physicians’ attitude toward use of serum creatinine (sCr) for identification of patients at risk for PO-AKI and patients who should be reassessed in the long-term for progression toward CKD. We also evaluated the incidence and risk factors associated with PO-AKI and renal function deterioration in patients undergoing major surgery for malignant disease.Methods. Adult oncological patients who underwent major abdominal surgery from November 2016 to February 2017 were considered for this single centre, observational retrospective study. Routinely available sCr values were used to define AKI in the first three postoperative days. Long-term kidney dysfunction (LT-KDys) was defined as a reduction in the estimated glomerular filtration rate by more than 10 ml/min/m2 at 12 months postoperatively. A questionnaire was administered to 125 physicians caring for the enrolled patients to collect information on local attitudes regarding use of sCr perioperatively and its relationship with PO-AKI.Results. A total of 423 patients were observed. sCr was not available in 59 patients (13.9%); the remaining 364 (86.1%) had at least one sCr value measured to allow for detection of postoperative kidney impairment. Among these, PO-AKI was diagnosed in 8.2% of cases. Of the 334 patients who had a sCr result available at 12-month follow up, 56 (16.8%) developed LT-KDys. Data on long-term kidney function were not available for 21% of patients. Interestingly, 33 of 423 patients (7.8%) did not have a sCr result available in the immediate postoperative period or long-term. All the physicians who participated in the survey (83 out of 125) recognised that postoperative assessment of sCr is required after major oncological abdominal surgery, particularly in those patients at high-risk for PO-AKI and LT-KDys.Conclusion. PO-AKI after major surgery for malignant disease is common but clinical practice of measuring sCr is variable. As a result, the exact incidence of PO-AKI and long-term renal prognosis are unclear, including in high-risk patients.Trial registration. Retrospectively registered in Clinicaltrialgov NCT04341974

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