Poor nutritional status and frailty associated with acute kidney injury after cardiac surgery: A retrospective observational study

Aykut, Aslıhan; Salman, Nevriye

doi:10.1111/jocs.17134

Cited by 6 publications

(17 citation statements)

References 32 publications

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“…Full-text review was independently performed by two authors on the remaining 22 publications, of which 13 met our predefined criteria for inclusion. The 13 eligible articles were retrospective studies published between 2019 and 2022, including a total of 9185 patients [12,17,[19][20][21][22][23][24][25][26][27][28][29]. The characteristics of the included studies are summarized in Table 1.…”

Section: Characteristics and Quality Of Studiesmentioning

confidence: 99%

“…The definition of PO-AK summarized in supplemental Table S2. Among the included studies, five used the K Disease Improving Global Outcomes (KDIGO) classification (stages I-III) [19,21,22 The characteristics of the included studies are summarized in Table 1. All studies included middle-aged patients (mean or median age: 44 to 69 years), with male proportions ranging between 56.8% and 88%.…”

Section: Characteristics and Quality Of Studiesmentioning

confidence: 99%

“…Twelve studies reported details on body mass index (i.e., 20-31 kg/m 2 ), while this information was unavailable in one study [20]. Among the included studies, seven explicitly reported the exclusion of patients with chronic kidney disease [12,20,22,25,[27][28][29], whereas five did not specify whether such exclusions were made [17,19,21,23,26]. Contrarily, one study reported a chronic kidney disease incidence of 5.6% among the study population [24].…”

Section: Characteristics and Quality Of Studiesmentioning

confidence: 99%

“…Contrarily, one study reported a chronic kidney disease incidence of 5.6% among the study population [24]. Preoperative creatinine levels were available in nine studies (Supplemental Table S2) [12,19,[21][22][23]25,26,28,29], whereas five studies did not provide this information. There was a wide variation in sample size among the studies, with a range of 41-3543.…”

Section: Characteristics and Quality Of Studiesmentioning

confidence: 99%

“…There was a wide variation in sample size among the studies, with a range of 41-3543. The 13 included studies focused on three major surgical approaches, including cardiac surgery (n = 5) [12,21,22,24,25], abdominal surgery (n = 5) [19,20,[27][28][29], and lung surgery (n = 3) [17,23,26]. Four studies reported surgical procedures were performed electively [12,19,28,29], while other studies did not specify this information.…”

Section: Characteristics and Quality Of Studiesmentioning

confidence: 99%

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Association of Preoperative Prognostic Nutritional Index with Risk of Postoperative Acute Kidney Injury: A Meta-Analysis of Observational Studies

Liu

Chen

et al. 2023

Nutrients

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This meta-analysis aimed to assess the clinical association of the preoperative prognostic nutritional index (pre-PNI) with the risk of postoperative acute kidney injury. Four databases (e.g., Medline) were searched from inception to December 2022 to investigate the association between pre-PNI (i.e., low vs. high) and PO-PNI as well as the correlation between pre-PNI and other postoperative prognostic indices. Overall, 13 observational studies, including 9185 patients, were eligible for analysis. A low PNI was related to increased risks of PO-AKI [odd ratio (OR) = 1.65, p = 0.001, 3811 patients], postoperative infection (OR = 2.1, p < 0.00001, 2291 patients), and mortality (OR = 1.93, p < 0.0001, 2159 patients). Albeit statistically nonsignificant, a trend was noted, linking a low PNI to higher risks of postoperative bleeding (OR = 2.5, p = 0.12, 1157 patients) and stroke (OR = 1.62, p = 0.07, 2036 patients). Pooled results revealed a prolonged intensive care unit (ICU) stay in patients with low PNIs compared to those with high PNIs (MD: 0.98 days, p = 0.02, 2209 patients) without a difference in hospital stay between the two groups (MD: 1.58 days, p = 0.35, 2249 patients). This meta-analysis demonstrated an inverse correlation between PNI and the risks of PO-AKI, postoperative infection, and mortality, as well as the length of ICU stay, which warrants further investigations for verification.

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Section: Characteristics and Quality Of Studiesmentioning

confidence: 99%

Section: Characteristics and Quality Of Studiesmentioning

confidence: 99%

Section: Characteristics and Quality Of Studiesmentioning

confidence: 99%

Section: Characteristics and Quality Of Studiesmentioning

confidence: 99%

Section: Characteristics and Quality Of Studiesmentioning

confidence: 99%

See 3 more Smart Citations

Association of Preoperative Prognostic Nutritional Index with Risk of Postoperative Acute Kidney Injury: A Meta-Analysis of Observational Studies

Liu

Chen

et al. 2023

Nutrients

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Prognostic value of preoperative nutritional status for postoperative moderate to severe acute kidney injury among older patients undergoing coronary artery bypass graft surgery: a retrospective study based on the MIMIC-IV database

Bao,

Qiu,

et al. 2024

Renal Failure

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Objective To investigate the association between preoperative nutritional scores and moderate-to-severe acute kidney injury (AKI) after coronary artery bypass graft (CABG) surgery and the predictive significance of nutritional indices for moderate to severe AKI. Methods This study retrospectively included older patients underwent CABG surgery from the Medical Information Mart for Intensive Care (MIMIC) database. Nutritional scores were calculated by the Geriatric Nutritional Risk Index (GNRI) and the Prognostic Nutritional Index (PNI), respectively. Moderate-to-severe injury was determined by KDIGO criteria. Logistic regression, subgroup analysis, and restricted cubic splines were utilized to investigate the association. The predictive value was also assessed by the area under the curve (AUC), net reclassification index (NRI), and integrated discrimination improvement (IDI). Results A total of 1,007 patients were retrospectively included, of which 100 (9.9%) and 380 (37.7%) had malnutrition calculated by GNRI and PNI scores. The incidence of moderate-to-severe AKI was 524 (52.0%). After adjustment for selected risk factors, worse nutritional scores were associated with a higher incidence of moderate-to-severe AKI ( P GNRI <0.001; P PNI =0.001). Integrating these indices into different base models improves their performance, as manifested by significant improvements in AUCs and NRIs ( p < 0.05). Conclusion Worse preoperative nutritional status was associated with an elevated risk of postoperative moderate-to-severe AKI. Integrating these indices into base models improve their predictive performance. These results highlight the importance of assessing nutritional status among older patients had CABG surgery.

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Prognostic significance of preoperative nutritional status for postoperative acute kidney injury in older patients undergoing major abdominal surgery: a retrospective cohort study

Sun,

Zhou,

et al. 2023

International Journal of Surgery

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Background: The association between malnutrition and postoperative acute kidney injury (AKI) has not been well studied. In this study, we examined the association between preoperative nutritional status and postoperative AKI in older patients who underwent major abdominal surgery, as well as the predictive value of malnutrition for AKI. Materials and methods: We retrospectively included patients aged 65 or older who underwent major elective abdominal surgery. The nutritional status of the patient was evaluated using 3 objective nutritional indices, such as the geriatric nutritional risk index (GNRI), the prognostic nutritional index (PNI), and the controlling nutritional status (CONUT). AKI was determined using the KDIGO criteria. We performed logistic regression analysis to investigate the association between preoperative nutritional status and postoperative AKI, as well as the predictive value of nutritional scores for postoperative AKI. Results: A total of 2775 patients were included in the study, of which 707 (25.5%), 291 (10.5%), and 517 (18.6%) had moderate to severe malnutrition according to GNRI, PNI, and CONUT calculations. After surgery, 144 (5.2%) patients developed AKI, 86.1% at stage 1, 11.1% at stage 2, and 2.8% at stage 3 as determined by KDIGO criteria. After adjustment for traditional risk factors, worse nutritional scores were associated with a higher AKI risk. In addition to traditional risk factors, these nutritional indices improved the predictive ability of AKI prediction models, as demonstrated by significant improvements in integrated discrimination and net reclassification. Conclusions: Poor preoperative nutritional status, as assessed by GNRI, PNI and CONUT scores, was associated with an increased risk of postoperative AKI. Incorporating these scores into AKI prediction models improved their performance. These findings emphasize the need for screening surgical patients for malnutrition risk. Further research is needed to determine whether preoperative malnutrition assessment and intervention can reduce postoperative AKI incidence.

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Poor nutritional status and frailty associated with acute kidney injury after cardiac surgery: A retrospective observational study

Cited by 6 publications

References 32 publications

Association of Preoperative Prognostic Nutritional Index with Risk of Postoperative Acute Kidney Injury: A Meta-Analysis of Observational Studies

Association of Preoperative Prognostic Nutritional Index with Risk of Postoperative Acute Kidney Injury: A Meta-Analysis of Observational Studies

Prognostic value of preoperative nutritional status for postoperative moderate to severe acute kidney injury among older patients undergoing coronary artery bypass graft surgery: a retrospective study based on the MIMIC-IV database

Prognostic significance of preoperative nutritional status for postoperative acute kidney injury in older patients undergoing major abdominal surgery: a retrospective cohort study

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