Chronic kidney disease and postoperative risk in abdominal surgery – a review of current concepts and clinical significance

Authors

  • Rumen Filev Department of Nephrology, Department of Internal Medicine, St. Anna University Hospital; Department of Internal Medicine, Medical University of Sofia Author https://orcid.org/0000-0003-1174-3128
  • Boris Bogov Department of Nephrology, Department of Internal Medicine, St. Anna University Hospital; Department of Internal Medicine, Medical University of Sofia Author https://orcid.org/0000-0003-4578-6265
  • Atanas Yonkov Department of General and Hepato-pancreatic Surgery, University Hospital “Alexandrovska”; Department of General and Operative Surgery, Medical University of Sofia Author https://orcid.org/0000-0002-6391-0752

DOI:

https://doi.org/10.67572/8zdrg686

Keywords:

chronic kidney disease, abdominal surgery, perioperative risk, acute kidney injury, postoperative complications

Abstract

Chronic kidney disease (CKD) represents a major global health burden and is associated with increased morbidity, mortality, and adverse outcomes in surgical patients. Individuals with CKD undergoing abdominal surgery demonstrate a significantly higher risk of postoperative complications, including acute kidney injury, infectious complications, cardiovascular events, and increased hospital mortality. Reduced renal functional reserve, chronic inflammation, endothelial dysfunction, disturbances in fluid and electrolyte balance, and the frequent presence of comorbid conditions contribute to the elevated perioperative risk observed in this population. This review discusses the epidemiology, pathophysiological mechanisms, and clinical significance of chronic kidney disease as a risk factor for adverse postoperative outcomes in abdominal surgery. Additionally, current approaches to perioperative assessment and management of patients with CKD are presented to reduce complications and improve surgical outcomes.

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Published

11.06.2026

Issue

Vol. 90 No. 2 (2026): Surgery

Section

LITERATURE REVIEW

License

Copyright (c) 2026 Rumen Filev, Boris Bogov, Atanas Yonkov (Author)

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

How to Cite

Filev, R., Bogov, B., & Yonkov, A. (2026). Chronic kidney disease and postoperative risk in abdominal surgery – a review of current concepts and clinical significance. Surgery, 90(2). https://doi.org/10.67572/8zdrg686