Incidence and Risk Factors of Acute Kidney Injury After Spinal Tuberculosis Surgery: A Case-control Study with Propensity Score Analysis

The aim of this study was to determine the incidence and risk factors of postoperative acute kidney injury (AKI) in patients with spinal tuberculosis surgery. And in this retrospective case-control study, patients were diagnosed with AKI after surgery according to kidney disease: improving global outcomes (KDIGO) guidelines. Multivariate logistic regression model was used to calculate the association between perioperative factors and AKI. A propensity score matching (PSM) evaluation was developed for adjustment and matching. The final result was that a total of 86 patients diagnosed AKI and 957 without AKI were selected from 1043 patients. After PSM analysis, preoperative anemia (OR, 3.57; 95%CI, 1.45-8.79; P =0.006), higher erythrocyte sedi-mentation rate (ESR) level (OR, 1.01; 95%CI, 1.00-1.03; P =0.029), intraoperative hypotension (OR, 3.42; 95%CI, 1.40-8.33; P =0.007) were predictors for postoperative AKI, and intraoperative dexmedetomidine (DEX) used (OR, 0.36; 95%CI, 0.14-0.91; P =0.030) was associated with a reduced risk for AKI. Patients with postoperative AKI were associated with increased rates of demanded for intensive care unit (ICU), and prolonged hospital length of stay (P<0.05). The final conclusion was that the postoperative AKI incidence was 8.25%. Moreover, Preoperative anemia, higher level of ESR and intraoperative hypotension can significantly increase the risk of AKI after spinal tuberculosis surgery. DEX infusion was associated with lower incidence of postoperative AKI.