Post-surgical acute kidney injury

Bansal, Shyam Bihari

doi:10.1016/s2211-9477(11)70008-5

Cited by 4 publications

(5 citation statements)

References 124 publications

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“…Typical coronary artery bypass surgery (CABG) has a low incidence of ARI (∼2.5%) and ARF (∼1%), followed by valvular surgery with an incidence of 2.8% and 1.7%, respectively. Highest risk is observed in patients that undergo CABG + valvular surgery, which has ARI and ARI incidences of 4.6 and 3.3%, respectively . In the present meta‐analysis, all included studies were performed in CABG.…”

Section: Discussionmentioning

confidence: 99%

“…The incidence of postcardiac surgery ARI depends on the type of procedure . Typical coronary artery bypass surgery (CABG) has a low incidence of ARI (∼2.5%) and ARF (∼1%), followed by valvular surgery with an incidence of 2.8% and 1.7%, respectively.…”

Section: Discussionmentioning

confidence: 99%

“…In the present meta‐analysis, all included studies were performed in CABG. In addition, reported incidences of ARI and ARF depend on the definitions used . Fortunately, studies included in the present meta‐analysis used uniform definitions for ARI and ARF; ARI was defined as a 50% increase over the preoperative Cr value within 48–72 h after kidney injury, and ARF was defined as any postoperative renal insufficiency requiring first‐time hemofiltration, dialysis, or any other renal replacement therapy.…”

Section: Discussionmentioning

confidence: 99%

“…Acute kidney injury after cardiac surgery is an important cause of mortality and morbidity (1). The pathophysiology of this injury is believed to be related to systemic inflammatory response and renal hypoperfusion during the period of extracorporeal circulation, but the issue has yet to be resolved (2)(3)(4)(5)(6)(7)(8)(9)(10).…”

mentioning

confidence: 99%

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A Meta-Analysis of Renal Function After Adult Cardiac Surgery With Pulsatile Perfusion

et al. 2015

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The aim of this meta-analysis was to determine whether pulsatile perfusion during cardiac surgery has a lesser effect on renal dysfunction than nonpulsatile perfusion after cardiac surgery in randomized controlled trials. MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials were used to identify available articles published before April 25, 2014. Meta-analysis was conducted to determine the effects of pulsatile perfusion on postoperative renal functions, as determined by creatinine clearance (CrCl), serum creatinine (Cr), urinary neutrophil gelatinase-associated lipocalin (NGAL), and the incidences of acute renal insufficiency (ARI) and acute renal failure (ARF). Nine studies involving 674 patients that received pulsatile perfusion and 698 patients that received nonpulsatile perfusion during cardiopulmonary bypass (CPB) were considered in the meta-analysis. Stratified analysis was performed according to effective pulsatility or unclear pulsatility of the pulsatile perfusion method in the presence of heterogeneity. NGAL levels were not significantly different between the pulsatile and nonpulsatile groups. However, patients in the pulsatile group had a significantly higher CrCl and lower Cr levels when the analysis was restricted to studies on effective pulsatile flow (P < 0.00001, respectively). The incidence of ARI was significantly lower in the pulsatile group (P < 0.00001), but incidences of ARF were similar. In conclusion, the meta-analysis suggests that the use of pulsatile flow during CPB results in better postoperative renal function.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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A Meta-Analysis of Renal Function After Adult Cardiac Surgery With Pulsatile Perfusion

et al. 2015

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“…Acute kidney injury (AKI) is a serious post-operation complication in cardiac surgery patients [ 1 ]; its incidence ranges from 3 to 42 % [ 2 – 10 ], and 1 to 5 % of AKI patients require dialysis therapy [ 1 , 2 , 4 , 9 , 11 ]. The mortality of AKI patients has been reported to be as high as 40–80 % [ 1 , 7 , 9 ]. Although this clinical problem is gaining increased attention, there are still no efficient methods to prevent AKI after cardiac and vascular interventions [ 5 , 6 , 12 – 14 ].…”

Section: Introductionmentioning

confidence: 99%

Effect of remote ischemic preconditioning on postoperative acute kidney injury among patients undergoing cardiac and vascular interventions: a meta-analysis

Lang

Cao

et al. 2016

J Nephrol

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It is currently controversial whether remote ischemic preconditioning (RIPC) reduces the incidence of acute kidney injury (AKI) in patients undergoing cardiovascular interventions. The main objective of this meta-analysis was to investigate whether RIPC provides renal protection for patients undergoing cardiac or vascular surgery. We searched the PubMed database (1966-Oct 2015), Embase database (1966-Oct 2015), Google Scholar, Cochrane Library, ClinicalTrials Database and Open Grey. Then we conducted a meta-analysis of the randomized controlled trials that met the inclusion criteria of our study. The interventions included use of an inflatable tourniquet around the limbs or cross-clamping of the iliac arteries before surgery (RIPC groups) and general cardiovascular intervention (control groups). The main outcomes examined included the incidence of AKI; changes in acute kidney injury biomarkers; and use of renal replacement therapy. Other outcomes examined included in-hospital mortality and the lengths of hospital stay and intensive care unit (ICU) stay. Finally, we screened 26 eligible studies containing 6699 patients who underwent cardiac or vascular interventions with RIPC (n = 3343) or without RIPC (n = 3356). The AKI incidence was decreased in the RIPC group as was the length of ICU stay. There were no differences in the changes in AKI biomarkers, use of renal replacement therapy or in-hospital mortality between the two groups. Remote ischemic preconditioning may decrease the occurrence of AKI in cardiovascular surgery patients. Since studies included have a significant heterogeneity, meta-analyses using a stricter inclusion criteria are needed to clarify the renoprotection effect of RIPC.

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A Preoperative Multimarker Approach to Evaluate Acute Kidney Injury After Cardiac Surgery

Enger

Pleym

Stenseth

et al. 2017

Journal of Cardiothoracic and Vascular Anesthesia

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Post-surgical acute kidney injury

Cited by 4 publications

References 124 publications

A Meta-Analysis of Renal Function After Adult Cardiac Surgery With Pulsatile Perfusion

A Meta-Analysis of Renal Function After Adult Cardiac Surgery With Pulsatile Perfusion

Effect of remote ischemic preconditioning on postoperative acute kidney injury among patients undergoing cardiac and vascular interventions: a meta-analysis

A Preoperative Multimarker Approach to Evaluate Acute Kidney Injury After Cardiac Surgery

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