DOI: https://doi.org/10.36347/sjmcr.2025.v13i07.003

Pages: 1540-1544

Postoperative acute kidney injury (AKI) is a common and serious complication of major surgical procedures, associated with increased morbidity and mortality. This retrospective descriptive study, conducted over a nine-month period from January to September 2024 in the Surgical Emergency and Intensive Care Unit of Ibn Tofail Hospital, Mohammed VI University Hospital in Marrakech, aims to analyze the management strategies of postoperative AKI in order to optimize prevention, treatment, and improve patient outcomes. Twelve patients were included, with a mean age of 50.8 years and a male-to-female sex ratio of 0.71. Half (50%) of the postoperative AKI cases were classified as severe (KDIGO stage 3). All patients had at least one identifiable risk factor for AKI, particularly major abdominal surgery (75% of cases); 50% of the patients underwent emergency surgery. Intraoperative hemorrhagic shock was observed in 75% of cases, while septic shock was noted in 25%. Associated comorbidities mainly included hypertension (41.6%) and type 2 diabetes (25%). All patients received individualized perioperative hemodynamic optimization, with an average crystalloid infusion of 2266 ml. Vasopressor support with norepinephrine was initiated early in 91.6% of cases, and 66.6% of patients required blood transfusions. Personalized therapy led to favorable renal recovery in 83.3% of cases. However, 16.6% of patients (n=2) progressed to severe oligo-anuric renal failure requiring renal replacement therapy. The mean duration of surgical procedures was 3.7 hours, and the average hospital stay was 15.5 days. The observed in-hospital mortality rate was 16.6% (2 patients), exclusively among those who required dialysis. In our cohort, the predominant contributing factors were visceral surgery, acute hemorrhagic shock, emergency surgical context, and high-risk profiles (cardiovascular comorbidities). Despite the severity of patient conditions, personalized management combining volume optimization,