Acute Kidney Injury After Cardiovascular Surgery: An Overview

Olivero, Juan J.; Nguyen, Peter; Kagan, Anna

doi:10.14797/mdcj-8-3-31

Cited by 36 publications

(32 citation statements)

References 46 publications

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“…), multiple organ failure and other factors. [16][17][18][19][20] Therefore, it is necessary to strictly monitor patient's hemodynamics to reduce volatility of renal perfusion. In addition, for high-risk patients with insufficient effective circulating blood volume, these drugs should be used with caution at early stage of post-operation in addition to closely monitoring changes in renal function.…”

Section: Discussionmentioning

confidence: 99%

Risk factors of acute kidney injury after acute myocardial infarction

et al. 2016

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Objectives: To study the risk factors for acute kidney injury (AKI) in-patients with acute myocardial infarction (AMI). Methods: A total of 1371 cases of adult in-patients with AMI in the First People's Hospital of Changzhou from January 2008 to December 2012 were retrospectively analyzed. Based on the occurrence of AKI diagnosed according to the 2012 KDIGO AKI criteria, they were divided into AKI group and non-AKI group and further into conservative treatment groups, coronary angiography (CAG) groups, and coronary artery bypass grafting (CABG) groups based on the timing of AKI occurrence, respectively. Related risk factors of AKI were analyzed by univariate and multivariate logistic regressions. Results: 410 (29.9%) developed AKI. Patients with AKI had significantly increased in-hospital mortality than patients without AKI. Multivariate logistic regression analysis showed that decreased baseline eGFR, increased fasting plasma glucose (FPG), use of diuretics and Killip grade IV were independent risk factors of AKI, while increased DBP on admission was a protective factor for patients in conservative treatment group. Decreased baseline eGFR, increased FPG, use of diuretics, intraoperative hypotension and acute infection were independent risk factors of AKI for patients in the CAG group. Decreased baseline eGFR, increased FPG, use of diuretics and low cardiac output syndrome after operation were independent risk factors of AKI for patients in the CABG group. Conclusions: AKI is a common complication and associated with increased mortality after AMI. Decreased baseline renal function, increased FPG and use of diuretics were common independent risk factors of AKI after AMI. ARTICLE HISTORY

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Section: Discussionmentioning

confidence: 99%

Risk factors of acute kidney injury after acute myocardial infarction

et al. 2016

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“…AKI might also result from atheroembolic renal insult, hemoglobinuria or myoglobinuria, age, hyperbilirubinemia, sepsis, angiotensin converting enzyme inhibitors, angiotensin receptor blockers, and the use of anti-inflammatory non-steroidal or radio-contrast dye immediately prior to surgery [40]. However, the most predictable risk factor for AKI is pre-existing chronic kidney disease [41].…”

Section: Discussionmentioning

confidence: 99%

Prognostic Value of Acute Kidney Injury after Cardiac Surgery according to Kidney Disease: Improving Global Outcomes Definition and Staging (KDIGO) Criteria

2014

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ObjectivesThe definition of acute renal failure has been recently reviewed, and the term acute kidney injury (AKI) was proposed to cover the entire spectrum of the syndrome, ranging from small changes in renal function markers to dialysis needs. This study was aimed to evaluate the incidence, morbidity and mortality associated with AKI (based on KDIGO criteria) in patients after cardiac surgery (coronary artery bypass grafting or cardiac valve surgery) and to determine the value of this feature as a predictor of hospital mortality (30 days).MethodsFrom January 2003 to June 2013, a total of 2,804 patients underwent cardiac surgery in our service. Cox proportional hazard models were used to determine the association between the development of AKI and 30-day mortality.ResultsA total of 1,175 (42%) patients met the diagnostic criteria for AKI based on KDIGO classification during the first 7 postoperative days: 978 (35%) patients met the diagnostic criteria for stage 1 while 100 (4%) patients met the diagnostic criteria for stage 2 and 97 (3%) patients met the diagnostic criteria for stage 3. A total of 63 (2%) patients required dialysis treatment. Overall, the 30-day mortality was 7.1% (2.2%) for patients without AKI and 8.2%, 31% and 55% for patients with AKI at stages 1, 2 and 3, respectively. The KDIGO stage 3 patients who did not require dialysis had a mortality rate of 41%, while the mortality of dialysis patients was 62%. The adjusted Cox regression analysis revealed that AKI based on KDIGO criteria (stages 1–3) was an independent predictor of 30-day mortality (P<0.001 for all. Hazard ratio = 3.35, 11.94 and 24.85).ConclusionIn the population evaluated in the present study, even slight changes in the renal function based on KDIGO criteria were considered as independent predictors of 30-day mortality after cardiac surgery.

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“…The diagnosis of AKI is based on two functional markers, an increase of serum creatinine and a reduction of urinary excretion. Predictors of perioperative AKI in patients undergoing heart surgery include preoperative creatinine level, endstage renal disease, 2-2 phenotype of haptoglobin, advanced age, diabetes mellitus, congestive heart failure, generalized atherosclerosis, cardiovascular collapse, nitric oxide, cyanotic heart disease, duration of surgery and elevated postoperative lactate level [4][5][6][7][8][9]. In patients with severe AKI, oliguria and fluid accumulation, renal replacement therapy is the basic method of treatment [10].…”

Section: Introductionmentioning

confidence: 99%

Anisocytosis predicts postoperative renal replacement therapy in patients undergoing heart valve surgery

et al. 2020

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Background: Acute kidney injury (AKI) is one of the serious postoperative complications in patients undergoing heart valve surgery. The aim of the present study was to identify selected biomarkers to predict AKI requiring renal replacement. Methods: A prospective study was conducted on a group of 751 patients undergoing heart valve surgery. The data on risk factors, preoperative complete blood count, course of operations and postoperative period was assessed. The primary endpoint at the 30-day follow-up was postoperative AKI requiring renal replacement therapy. The secondary end-point was death from all causes in patients with postoperative AKI requiring renal replacement. Results: The primary endpoint occurred in 46 patients. At multivariate analysis: age, red cell distribution width (RDW) and C-reactive protein remained independent predictors of the primary endpoint. Hemoglobin and RDW were associated with an increased risk of death. Conclusions: Elevated RDW is associated with a higher risk of postoperative AKI and death in patients with AKI. (Cardiol J XXXX; XX, X: xx-xx)

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Acute Kidney Injury After Cardiovascular Surgery: An Overview

Cited by 36 publications

References 46 publications

Risk factors of acute kidney injury after acute myocardial infarction

Risk factors of acute kidney injury after acute myocardial infarction

Prognostic Value of Acute Kidney Injury after Cardiac Surgery according to Kidney Disease: Improving Global Outcomes Definition and Staging (KDIGO) Criteria

Anisocytosis predicts postoperative renal replacement therapy in patients undergoing heart valve surgery

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