Evaluation of Post-Operative AKI in Major Open vs Laparoscopic Surgeries: A Prospective Comparative Study

Durgesh Arvind Tiwari, Pawan Kumar Singh, Priyesh Shukla, Yogendra Kumar Verma

Abstract: Background: Postoperative acute kidney injury (AKI) is a common and under-recognised complication of major abdominal surgery. Laparoscopy reduces tissue trauma and blood loss but introduces pneumoperitoneum, which can compromise renal perfusion. Whether the surgical approach itself independently determines early renal outcome remains unsettled, and prospective Indian data are sparse. Methods: A prospective comparative observational study was conducted in the Department of General Surgery, GSVM Medical College and LLR Hospital, Kanpur. One hundred consecutive adults with normal baseline renal function undergoing major elective abdominal surgery were grouped by surgical approach: open (Group A, n=48) and laparoscopic (Group B, n=52). Serum creatinine and cystatin-C were measured preoperatively and on postoperative days 1 and 2; estimated glomerular filtration rate (eGFR) was derived using the race-free 2021 CKD-EPI creatinine-cystatin C equation. AKI was classified by RIFLE criteria. Perioperative variables were analysed as candidate risk factors. Results: Postoperative AKI occurred in 12 of 100 patients (12.0%) - 7 of 48 (14.6%) after open and 5 of 52 (9.6%) after laparoscopic surgery (p=0.544; OR 1.60, 95% CI 0.47-5.45). All events were confined to RIFLE stage Risk; none required dialysis. Intraoperative hypotension was the dominant determinant: 11 of 11 patients with a mean arterial pressure below 65 mmHg developed AKI, compared with 1 of 89 without (p

Keywords: Acute kidney injury; Laparoscopic surgery; Intraoperative hypotension; RIFLE criteria; Cystatin C; CKD-EPI

How to Cite?: Durgesh Arvind Tiwari, Pawan Kumar Singh, Priyesh Shukla, Yogendra Kumar Verma, "Evaluation of Post-Operative AKI in Major Open vs Laparoscopic Surgeries: A Prospective Comparative Study", Volume 15 Issue 9, September 2026, International Journal of Science and Research (IJSR), Pages: 1506-1510, https://www.ijsr.net/getabstract.php?paperid=SR26923122736, DOI: https://dx.doi.org/10.21275/SR26923122736

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