Factors and outcomes associated with acute kidney injury in brain tumor resection patients: insights from a large US database (2010–2019)

Acute kidney injury (AKI) is a major perioperative complication following brain tumor resection, yet multi-center studies on this topic remain scarce. This study aimed to determine the incidence, risk factors, and clinical outcomes associated with AKI in patients undergoing brain tumor resection, utilizing a nationally representative dataset. We analyzed brain tumor resection admissions from the United States' National Inpatient Sample database (2010-2019), identifying hospitalizations with and without AKI using International Classification of Diseases, Ninth Revision, Clinical Modification and International Classification of Diseases, Tenth Revision, Clinical Modification codes. Multivariable logistic regression analyses were performed to evaluate the associations between patient/hospital characteristics, comorbidities, complications and AKI. Among more than 40,000 brain tumor resection admissions, AKI occurred in 3.1% of hospitalizations, with prevalence rising from 1.8% in 2010 to 4.4% in 2019. AKI-associated admissions had higher costs (median $171,904 vs. $99,821, <i>p</i> < .001), longer hospital stays (median 11 vs. 5 days), increased mortality (8.3% vs. 1.2%, <i>p</i> < .001), higher dialysis requirement (1.1% vs. 0.01%, <i>p</i> < .001), and mechanical ventilation (12.1% vs. 3.0%, <i>p</i> < .001). Associated risk factors for AKI included: age ≥65 years, Black/Hispanic race, congestive heart failure, diabetes, fluid and electrolyte disorders, other neurological disorders, obesity, and chronic kidney disease excluding end-stage renal disease. Medical complications associated with increased AKI risk included septicemia, deep vein thrombosis, urinary tract infection, pneumonia, and cerebral edema. Female sex and elective admission were protective factors. Prompt identification of these risk factors is crucial for optimizing perioperative management and improving clinical outcomes.