Chronic kidney disease and postoperative risk in abdominal surgery – a review of current concepts and clinical significance

Chronic kidney disease (CKD) represents a major global health burden and is associated with increased morbidity, mortality, and adverse outcomes in surgical patients. Individuals with CKD undergoing abdominal surgery demonstrate a significantly higher risk of postoperative complications, including acute kidney injury, infectious complications, cardiovascular events, and increased hospital mortality. Reduced renal functional reserve, chronic inflammation, endothelial dysfunction, disturbances in fluid and electrolyte balance, and the frequent presence of comorbid conditions contribute to the elevated perioperative risk observed in this population. This review discusses the epidemiology, pathophysiological mechanisms, and clinical significance of chronic kidney disease as a risk factor for adverse postoperative outcomes in abdominal surgery. Additionally, current approaches to perioperative assessment and management of patients with CKD are presented to reduce complications and improve surgical outcomes.