Acute Kidney Injury in Patients Undergoing Cardiac Transplantation: A Meta-Analysis

Lertjitbanjong, Ploypin; Hansrivijit, Panupong; Crisafio, Anthony; Mao, Michael A; Watthanasuntorn, Kanramon; Aeddula, Narothama Reddy; Kaewput, Wisit; Cheungpasitporn, Wisit

doi:10.3390/medicines6040108

Cited by 39 publications

(51 citation statements)

References 63 publications

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“…Previous meta-analyses also indicated the incidence rates of AKI in other types of surgeries such as total hip arthroplasty (6.3%) [ 15 ], cardiac transplantation (47.1%) [ 16 ], and liver transplantation (40.8%) [ 51 ]. The pooled incidence rates of AKI in patients with CHD ranged from 30 to 45%, which was relatively higher than those in other types of surgery.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, AKI may cause prolonged mechanical ventilation and hospital stay and high morbidity and mortality rates [ 11 – 14 ]. Several previous systematic reviews and meta-analyses mainly focused on the incidence rate of AKI in patients who had undergone total hip arthroplasties [ 15 ] or cardiac transplantation [ 16 ], but no meta-analysis of pooled incidence rates of AKI in patients with CHD from relevant studies has been reported yet.…”

Section: Introductionmentioning

confidence: 99%

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A meta-analysis of the incidence rate of postoperative acute kidney injury in patients with congenital heart disease

Li¹,

Niu²,

Huang³

et al. 2020

BMC Nephrol

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Background Acute kidney injury (AKI) is a common complication of cardiac surgery. However, the incidence rate of AKI in patients with congenital heart disease (CHD) greatly varies between reports owing to the different definitions used for AKI. Therefore, this study was designed as a meta-analysis aimed at summarizing the incidence rate of AKI in patients with congenital heart disease (CHD) on the basis of different AKI criteria. Methods Studies published till April 24, 2020, on the incidence rate of AKI in patients with CHD, were retrieved from electronic databases and printed literature. To pool data from the included studies, the effect size, a combined statistics, was chosen and presented with the incidence rate and 95% confidence interval (CI). Heterogeneity was evaluated using I 2 statistics and Cochran Q test. The incidence rates obtained from the subgroup analysis according to study location, type of surgery, type of cohort, age, and AKI criteria) were also evaluated to determine the correlation of AKI with these factors. Publication bias was estimated using the Egger test. Results Thirty studies, comprising 9925 patients with AKI who had CHD, were included. Overall, the pooled incidence rate of AKI in the patients with CHD was 38.4% (95% CI, 32.0–44.7%). However, the incidence rate was not significantly affected by gender, study location, type of surgery, type of cohort, and AKI criteria. Moreover, age was significantly associated with the incidence of AKI, and the incidence rate was higher in the patients aged < 1 month than in those aged 1 month to 18 years, < 18 years, and ≥ 18 years ( P < 0.05). Conclusions In this study, the estimated incidence rate of AKI in patients with CHD was 38.4% and may be influenced by age. These findings highlight the importance of further investigation of the specific causes of and effective preventive measures for AKI.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A meta-analysis of the incidence rate of postoperative acute kidney injury in patients with congenital heart disease

Li¹,

Niu²,

Huang³

et al. 2020

BMC Nephrol

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show abstract

“…The in‐hospital mortality was 4.3%, with the odds ratio of 4.93 ( P < .001). AKI has also been reported to increase the mortality in several conditions, such as critical illness, acute coronary syndrome, solid organ/hematologic transplantation, cirrhosis, stroke and cardiac surgery 26‐34 . In addition, greater degree of resource utilisation, including renal replacement therapy, invasive/non‐invasive mechanical ventilation support and blood transfusion has been correlated with AKI.…”

Section: Discussionmentioning

confidence: 99%

Acute kidney injury among salicylate intoxication hospitalisations in the United States

et al. 2020

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Background This study aimed to evaluate the risk factors and the association of acute kidney injury (AKI) with outcomes, and resource utilisation in patients hospitalised because of salicylate intoxication in the United States. Methods Hospitalised patients with a primary diagnosis of salicylate intoxication from 2003 to 2014 were identified in the National Inpatient Sample (NIS) database. End‐stage kidney disease patients were excluded. The occurrence of AKI was identified using hospital diagnosis code. Clinical characteristics, in‐hospital treatment, outcomes and resource utilisation were compared between patients with and without AKI. Results A total of 13 787 eligible hospital admissions were included in the analysis. AKI occurred in 1279 (9.3%) admissions. Older age, male sex, more recent year of hospitalisation, anaemia, hypertension, congestive heart failure, chronic kidney disease, volume depletion, sepsis and ventricular arrhythmia/cardiac arrest were significantly associated with increased risk of AKI, whereas Hispanic race was associated with decreased risk. AKI was significantly associated with increased risk of organ failure, and in‐hospital mortality. In addition, the need for ventilation support, blood component transfusion, renal replacement therapy, length of hospital stay and hospitalisation cost were higher in AKI patients. Conclusion Approximately one tenth of salicylate intoxication patients developed AKI during hospitalisation. AKI was associated with higher morbidity, mortality and resource utilisations.

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“…However, patients who develop severe AKI frequently receive renal replacement therapy (RRT) as a salvage treatment. The need for RRT has been reported to be one of the most important predictors of a poor prognosis after HTx [13]. Although some clinical outcomes associated with AKI requiring RRT have been described, its impact on long-term survival has not been addressed.…”

Section: Introductionmentioning

confidence: 99%

Incidence, risk factors and clinical outcomes of acute kidney injury after heart transplantation: a retrospective single center study

Jiang

Kong

Xue

et al. 2020

J Cardiothorac Surg

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Objectives This study aimed to identify the incidence rate of Acute kidney injury (AKI) in our center and predict in-hospital mortality and long-term survival after heart transplantation (HTx). Methods This single-center, retrospective study from October 2009 and March 2020 analyzed the pre-, intra-, and postoperative characteristics of 95 patients who underwent HTx. AKI was defined according to the Kidney Disease: Improving Global Outcomes (KDIGO) criteria. Risk factors were analyzed by multivariable logistic regression models. The log-rank test was used to compare long-term survival. Results Thirty-three (34.7%) patients developed AKI. The mortality in hospital in HTx patients with and without AKI were 21.21 and 6.45%, respectively (P < 0.05). Recipients in AKI who required renal replacement therapy (RRT) had a hospital mortality rate of 43.75% compared to 6.45% in those without AKI or RRT (P < 0.0001). A long cardiopulmonary bypass (CPB) time (OR:11.393, 95% CI: 2.183 to 59.465, P = 0.0039) was positively related to the occurrence of AKI. A high intraoperative urine volume (OR: 0.031, 95% CI: 0.005 to 0.212, P = 0.0004) was negatively correlated with AKI. AKI requiring RRT (OR, 11.348; 95% CI, 2.418–53.267, P = 0.002) was a risk factor for mortality in hospital. Overall survival in patients without AKI at 1 and 3 years was not different from that in patients with AKI (P = 0.096). Conclusions AKI is common after HTx. AKI requiring RRT could contribute powerful prognostic information to predict mortality in hospital. A long CPB time and low intraoperative urine volume are associated with the occurrence of AKI.

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Acute Kidney Injury in Patients Undergoing Cardiac Transplantation: A Meta-Analysis

Cited by 39 publications

References 63 publications

A meta-analysis of the incidence rate of postoperative acute kidney injury in patients with congenital heart disease

A meta-analysis of the incidence rate of postoperative acute kidney injury in patients with congenital heart disease

Acute kidney injury among salicylate intoxication hospitalisations in the United States

Incidence, risk factors and clinical outcomes of acute kidney injury after heart transplantation: a retrospective single center study

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