{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T22:40:16Z","timestamp":1792795216413,"version":"4.5.0"},"reference-count":35,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,3,11]],"date-time":"2024-03-11T00:00:00Z","timestamp":1710115200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,3,11]],"date-time":"2024-03-11T00:00:00Z","timestamp":1710115200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Nephrol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>In this retrospective review, the relative importance of systemic inflammation among other causes of acute kidney injury (AKI) was investigated in 1224 consecutive colorectal surgery patients. A potential benefit from reducing excessive postoperative inflammation on AKI might then be estimated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      AKI was determined using the Kidney Disease Improving Global Outcomes (KDIGO) criteria. The entire population (mixed group), composed of patients with or without sepsis, and a subpopulation of patients without sepsis (aseptic group) were examined. Markers indicative of inflammation were procedure duration, the first postoperative white blood cell (POD # 1 WBC) for the mixed population, and the neutrophil-to-lymphocyte ratio (POD #1 NLR) for the aseptic population. Multivariable logistic regression was then performed using significant (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.05) predictors. The importance of inflammation among independent predictors of AKI and AKI-related complications was then assessed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      AKI occurred in 24.6% of the total population. For the mixed population, there was a link between inflammation (POD # 1 WBC) and AKI (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.0001), on univariate regression. Medications with anti-inflammatory properties reduced AKI: ketorolac (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.047) and steroids (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.038). Similarly, in an aseptic population, inflammation (POD # 1 NLR) contributed significantly to AKI (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.000). On multivariable analysis for the mixed and aseptic population, the POD #1 WBC and the POD #1 NLR were independently associated with AKI (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.000,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.022), as was procedure duration (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.0001,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.0001). Inflammation-related parameters were the most significant contributors to AKI. AKI correlated with complications: postoperative infections (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.016), chronic renal insufficiency (CRI,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.0001), non-infectious complications (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.010), 30-day readmissions (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.001), and length of stay (LOS,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.0001). Inflammation, in patients with or without sepsis, was similarly a predictor of complications: postoperative infections (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.002,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.008), in-hospital complications (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.000,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.002), 30-day readmissions (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.012,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.371), and LOS (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.0001,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.006), respectively.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Systemic inflammation is an important cause of AKI. Limiting early postsurgical inflammation has the potential to improve postoperative outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12882-024-03526-w","type":"journal-article","created":{"date-parts":[[2024,3,11]],"date-time":"2024-03-11T13:02:00Z","timestamp":1710162120000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Systemic inflammation and acute kidney injury after colorectal surgery"],"prefix":"10.1186","volume":"25","author":[{"given":"John D.","family":"Mannion","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Assar","family":"Rather","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adrianne","family":"Fisher","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelly","family":"Gardner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nessreen","family":"Ghanem","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheila","family":"Dirocco","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gary","family":"Siegelman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,3,11]]},"reference":[{"key":"3526_CR1","doi-asserted-by":"publisher","unstructured":"Gomelsky A et al. 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This review was performed following the principles of the Declaration of Helsinki. The necessity for informed consent was waived by the Bayhealth IRB.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"This work has not yet been presented to any meeting.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Meeting presentation"}},{"value":"Not Applicable.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"Benign-appearing increases in creatinine after colorectal surgery are associated with complications that are wide-ranging, often delayed, and serious. Systemic inflammation, more than what is needed for healing, could be the cause. In 1224 consecutive colorectal operations, parameters associated with inflammation were independently associated with AKI and AKI-related complications.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Precis"}},{"value":"The authors declare no competing interests.","order":6,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"92"}}