Since my field is universitary teaching in engineering and I'm not a native english speaker I'm afraid this post won't be flawless at all, but I hope I can be clear.
My father, a 54 years old man with good health condition had a very enlarged prostate, so a prostatectomy was performed on January 16th, 7:00 PM. Due to non disclosed information, his surgery took almost 3 hours. On January 18th at 2:50 AM he had a respiratory failure closely followed by a heart attack. After 10 minutes of CPR he was sucessfully revived and half an hour later he entered the ICU. By 5:30 AM the intensivist told us he was completely anuric (I don't know if anuria can be diagnosed after less than 3 hours or if the anuria was already present by the time of the heart attack).
For the next few days his condition was very serious, but he survived. However, despite recovering urine volumes, his renal function hasn't improved since day one, so he has been subject to dialysis for 4 weeks so far, 3-4 per week. Additionally, he is under mechanical ventilation and sedation also since day one. According to the doctors, the cause of the AKI is unknown. They have discarded a pulmonary embolism, his heart condition was completely normal since day 5 and there hasn't been any indication of sepsis.
According to what I have been told and what I've seen in quite a number of journals, his kidneys should have started to recovery as soon as his heart condition improved if the origin of the AKI was the heart failure. That hasn't happened so far and his creatinine levels remain at 6,5 mg/dL after dialysis and 8 mg/dL the day after dialysis (I can't remember his BUN levels).
I've read that post abdominal surgery AKI is somewhat common, specially if the surgery was prolonged. Additionally, I'm almost sure my father required a transfusion the day after his surgery (he was very pale, weak and probably hypotense) and even a resident doctor suggested that, but no transfusion has done. Until the medical history data is disclosed, I don't know if there were indications of oliguria, his fluid levels and other useful information.
It is likely his AKI developed right after the surgery and not as a consequence of his heart failure? If that is the case, I think somebody could have been done to foresee and prevent that. I appreciate any help.