Ostomy-Related AKI Linked to Higher Mortality and MAKE Risk, suggests study

The primary indication for ostomy creation was cancer, accounting for 46% of cases. Clinically, patients with Ostomy-AKI had a mean ostomy output of 980 ml/day (range: 760–1700 ml), and 82.9% required fluid adjustment during management. The primary endpoints evaluated were major adverse kidney events (MAKE) at 10 days (MAKE10) and at 30–90 days (MAKE30–90), defined as death, initiation of new dialysis, or a ≥25% decline in estimated glomerular filtration rate (eGFR).

Key Findings

Etiology of AKI:

• Hypovolemia was more frequent in Ostomy-AKI (48.9% vs 24.5%)

Severity of AKI (Stage 3):

• Ostomy-AKI: 82.9%

• General-AKI: 63.9%

MAKE at 10 days (MAKE10):

• Both groups: 94% (no difference)

MAKE at 30–90 days (MAKE30-90):

• Ostomy-AKI: 65.9%

• General-AKI: 49.3%

Mortality (30–90 days):

• Ostomy-AKI: 59.5%

• General-AKI: 37%

• Ostomy-AKI doubled the risk of death (OR 2.757, CI 1.273–5.973, p=0.01)

Risk of MAKE30-90:

• Ostomy-AKI increased the risk 2.4 times (OR 2.403, CI 1.090–5.299, p=0.03)

Compared to General-AKI, Ostomy-AKI patients have a greater frequency of hypovolemia, more severe AKI, and adverse long-term outcomes, such as 59.5% mortality and a 2.5-fold increase in MAKE risk at 30–90 days. The findings emphasize the importance of aggressive kidney care in patients after recent ostomy surgery to minimize the burden of kidney complications and promote survival.

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