Impact of postoperative acute kidney failure in long-term survival after heart valve surgery

Rodríguez-Cubillo, Beatriz; Carnero-Alcázar, Manuel; Cobiella-Carnicer, Javier; Rodríguez-Moreno, Antolina; Alswies, Ali; Velo-Plaza, Mercedes; Pérez-Camargo, Daniel; Fructuoso, Ana Sánchez; Maroto-Castellanos, Luis C.

doi:10.1093/icvts/ivz035

Cited by 9 publications

(10 citation statements)

References 26 publications

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“…Postoperative AKI has been reported to be associated with increased short-and long-term mortality after cardiac surgery, [14][15][16] and previous studies reported that postoperative renal replacement therapy increased postoperative mortality. 17,18 Preoperative eGFR < 60 ml/min/1.73 m 2 is a reported risk factor for postoperative AKI in patients undergoing cardiac surgery, [21][22][23] which was consistent with our results. CKD has consistently been an independent risk factor for the development of cardiovascular disease, including coronary artery disease and valvular disease, 4,5 and concomitant surgery, such as coronary artery bypass grafting and valvular surgery are risk factors for postoperative AKI.…”

Section: Discussionsupporting

confidence: 91%

“…Preoperative eGFR < 60 ml/min/1.73 m 2 is a reported risk factor for postoperative AKI in patients undergoing cardiac surgery, 21–23 which was consistent with our results. CKD has consistently been an independent risk factor for the development of cardiovascular disease, including coronary artery disease and valvular disease, 4,5 and concomitant surgery, such as coronary artery bypass grafting and valvular surgery are risk factors for postoperative AKI 24 .…”

Section: Discussionsupporting

confidence: 90%

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Total arch replacement in patients with chronic kidney disease

et al. 2020

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Background We investigated the effect of preoperative renal dysfunction on postoperative outcomes in patients undergoing elective isolated total arch replacement (TAR) with mild hypothermic lower body circulatory arrest with antegrade selective cerebral perfusion (SCP). Methods One hundred and forty‐four patients who had undergone elective isolated TAR between January 2002 and December 2019 were retrospectively analyzed. Patients were divided into two groups according to whether their preoperative estimated glomerular filtration rate (eGFR) was lower than or higher than 60 ml/min/1.73 m2. We compared perioperative data and mid‐term outcomes after adjusting for patients' baseline characteristics using weighted logistic regression analysis and inverse probability of treatment weighting. Results More patients underwent postoperative stroke in the chronic kidney disease group compared with the normal group (2.8% vs. 0%, respectively; p = .049). Overall 30‐day mortality and hospital mortality were 0% in both groups, and there was no significant difference in overall survival between the two groups (log‐rank test, p = .129). Multivariate Cox proportional hazard analysis showed that eGFR < 60 ml/min/1.73 m2 was not an independent predictor (hazard ratio: 1.636, 95% confidence interval 0.829–3.231; p = .156). Conclusions Preoperative eGFR <60 ml/min/1.73 m2 was not associated with worse outcomes after elective isolated TAR with mild hypothermic lower body circulatory arrest with antegrade SCP.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 90%

Total arch replacement in patients with chronic kidney disease

et al. 2020

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“…Postoperative AKI-rH is another cause to high mortality. More than 35% of patients before heart valve surgery have a previous history of chronic kidney disease, it is also a significant independent predictor of postoperative short-and long-term mortality [ 14 , 40 ]. Approximately 40–50% of patients underwent heart valve surgery have acute kidney injury (AKI) attributed to ischemia–reperfusion injury during surgery, especially for the elder, diabetic and coronary artery disease (CAD) patients [ 40 , 41 ].…”

Section: Discussionmentioning

confidence: 99%

The multivariable prognostic models for severe complications after heart valve surgery

Liu

Xiao

Duan

et al. 2021

BMC Cardiovasc Disord

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Background To provide multivariable prognostic models for severe complications prediction after heart valve surgery, including low cardiac output syndrome (LCOS), acute kidney injury requiring hemodialysis (AKI-rH) and multiple organ dysfunction syndrome (MODS). Methods We developed multivariate logistic regression models to predict severe complications after heart valve surgery using 930 patients collected retrospectively from the first affiliated hospital of Sun Yat-Sen University from January 2014 to December 2015. The validation was conducted using a retrospective dataset of 713 patients from the same hospital from January 2016 to March 2017. We considered two kinds of prognostic models: the PRF models which were built by using the preoperative risk factors only, and the PIRF models which were built by using both of the preoperative and intraoperative risk factors. The least absolute shrinkage selector operator was used for developing the models. We assessed and compared the discriminative abilities for both of the PRF and PIRF models via the receiver operating characteristic (ROC) curve. Results Compared with the PRF models, the PIRF modes selected additional intraoperative factors, such as auxiliary cardiopulmonary bypass time and combined tricuspid valve replacement. Area under the ROC curves (AUCs) of PRF models for predicting LCOS, AKI-rH and MODS are 0.565 (0.466, 0.664), 0.688 (0.62, 0.757) and 0.657 (0.563, 0.751), respectively. As a comparison, the AUCs of the PIRF models for predicting LOCS, AKI-rH and MODS are 0.821 (0.747, 0.896), 0.78 (0.717, 0.843) and 0.774 (0.7, 0.847), respectively. Conclusions Adding the intraoperative factors can increase the predictive power of the prognostic models for severe complications prediction after heart valve surgery.

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“…Postoperative AKI-rH is another cause to high mortality. More than 35% preoperative cardiac surgery patients have previous history of chronic kidney disease, it is also a signi cant independent predictor of postoperative short and long term mortality [14,33]. Approximately 40%~50% postoperative cardiac surgery patients have acute kidney injury (AKI) attributed to ischemia-reperfusion injury during the surgery, especially for the elder, diabetic and coronary artery disease (CAD) patients [33,34].…”

Section: Discussionmentioning

confidence: 99%

“…More than 35% preoperative cardiac surgery patients have previous history of chronic kidney disease, it is also a signi cant independent predictor of postoperative short and long term mortality [14,33]. Approximately 40%~50% postoperative cardiac surgery patients have acute kidney injury (AKI) attributed to ischemia-reperfusion injury during the surgery, especially for the elder, diabetic and coronary artery disease (CAD) patients [33,34]. The incidence of AKI-rH is nearly 1%~3%, it is rising due to increasing surgery complexity, and AKI-rH tends to cause endstage renal disease (ESRD) [4,29,35].…”

Section: Discussionmentioning

confidence: 99%

The Prognostic Multivariate Models For Severe Complications After Heart Valve Surgery

Liu

Xiao

Duan

et al. 2021

Preprint

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Background: To provide prognostic multivariate models for severe complications prediction after heart valvular surgery, such as low cardiac output syndrome (LOCS), acute kidney injury requiring hemodialysis (AKI-rH) and multiple organ dysfunction syndrome (MODS).Methods: We developed multivariate logistic regression models to predict the severe complications after heart valvular surgery using 930 patients collected retrospectively from the first affiliated hospital of Sun Yat-Sen University from January 2014 to December 2015. The validation was conducted using a retrospective dataset of 713 patients from the same hospital from January 2016 to March 2017. We considered two kinds of prognostic models: the PRF models which were built by using the preoperative risk factors only, and the PIRF models which were built by using both of the preoperative and intraoperative risk factors. The Least absolute shrinkage selector operator was used for developing the models. We assessed and compared the discriminative abilities for both of the PRF and PIRF models via the receiver operating characteristic curve. Results: Compared with the PRF models, the PIRF modes selected additional intraoperative factors, such as auxiliary cardiopulmonary bypass time and combined tricuspid valve replacement. The area under the curves (AUCs) of the PRF models for predicting LOCS, AKI-rH and MODS are 0.565 (0.466, 0.664), 0.688 (0.62, 0.757) and 0.657 (0.563, 0.751), respectively. As a comparison, the AUCs of the PIRF models for predicting LOCS, AKI-rH and MODS are 0.821 (0.747, 0.896), 0.78 (0.717, 0.843) and 0.774 (0.7, 0.847), respectively. Conclusions: Adding the intraoperative factors can increase the predictive power of the prognostic models for severe complications prediction after heart valvular surgery.

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Impact of postoperative acute kidney failure in long-term survival after heart valve surgery

Cited by 9 publications

References 26 publications

Total arch replacement in patients with chronic kidney disease

Total arch replacement in patients with chronic kidney disease

The multivariable prognostic models for severe complications after heart valve surgery

The Prognostic Multivariate Models For Severe Complications After Heart Valve Surgery

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