Adult patients undergoing noncardiac surgery demonstrate varying associations with distinct levels of hypotension when stratified by preoperative risk factors.

Specific levels of absolute hypotension, but not relative hypotension, are an important independent risk factor for acute kidney injury (AKI).

Among 138,021 cases reviewed, 12,431 (9.0%) developed postoperative acute kidney injury.

Major risk factors included anemia, estimated glomerular filtration rate, surgery type, American Society of Anesthesiologists Physical Status, and expected anesthesia duration.

Using such factors and others for risk stratification, patients with low baseline risk demonstrated no associations between intraoperative hypotension and acute kidney injury.

Major noncardiac surgical procedures performed on adult patients across eight hospitals between 2008 and 2015 were reviewed.

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