Frequency and Predictors of Acute Kidney Injury Following Major Abdominal Surgery: A Prospective Cross-Sectional Study from a Sudanese Tertiary Center

Background: Acute Kidney Injury (AKI) is a significant postoperative complication associated with increased morbidity and mortality. There is limited data on the epidemiology of acute kidney injury following general surgery in Sudan and the broader sub-Saharan African region. This study aimed to determine the frequency and identify the risk factors associated with AKI following major general surgery. Methods: A hospital-based, prospective cross-sectional study was conducted at Ibrahim Malik Teaching Hospital, Khartoum, Sudan, from November 2021 to February 2022. Consecutive adult patients (aged ≥18 years) undergoing major general surgery were enrolled. Patients with pre-existing renal disease were excluded. Data were collected using a structured questionnaire. AKI was defined using the Kidney Disease: Improving Global Outcomes (KDIGO) serum creatinine criteria. Data were analyzed using SPSS version 26.0. Results: Ninety-seven patients were included. The mean age was 40.6 ± 15.8 years, with a 1:1 male-to-female ratio. The overall frequency of postoperative AKI was 10.3% (n=10). AKI showed a significant statistical association with laparotomy (100% vs. 37.9%, p<0.001), intraoperative hypotension (100% vs. 5.7%, p<0.001), intraoperative massive bleeding (80.0% vs. 1.1%, p<0.001), emergency surgery (90.0% vs. 40.2%, p=0.003), and late postoperative recovery (30.0% vs. 1.1%, p<0.001). Pre-existing diabetes mellitus and hypertension were not significantly associated with AKI. Conclusion: The frequency of postoperative AKI is considerable. The type of surgery and intraoperative hemodynamic events were the strongest identifiable risk factors, suggesting that patients require meticulous intraoperative management.