Anaesthetic profile and perioperative mobi-mortality according to renal function in patients undergoing urgent and elective surgery at Monkole Hospital, Kinshasa: a cross-sectional study

Abstract

Background Chronic kidney disease (CKD) increases perioperative risk through metabolic, cardiovascular, and hematologic disturbances that complicate anaesthetic management. Evidence from sub-Saharan Africa on surgical outcomes across CKD stages is limited. Objective To describe anaesthetic practices and assess perioperative morbidity and mortality in CKD patients undergoing surgery at Monkole Hospital, Kinshasa. Methods This retrospective cross-sectional study included adult CKD patients who underwent urgent or elective surgery between February 2018 and December 2024. Renal function was classified using the CKD-EPI 2021 equation into GFR categories G1–G5. Outcomes included intraoperative incidents, perioperative complications, transfusion requirements, opioid use, and in-hospital mortality. Multivariate logistic regression identified predictors of adverse outcomes, comparing patients with GFR < 60 and ≥60 mL/min/1.73 m 2 . Results Among 418 patients, 48.1% were G3, 24.6% G2, and 15.3% G1. Complications and mortality rose with declining renal function. Patients with GFR < 60 mL/min/1.73 m 2 had higher mortality than those with GFR ≥ 60 (11.2% vs. 5.4%). After adjustment, GFR < 60 remained independently associated with mortality (OR 2.61, 95% CI 1.01–6.71). Conclusion Reduced renal function independently predicted increased perioperative mortality, highlighting the need for improved risk stratification in CKD patients.