Predictors of ARF after cardiac surgical procedures

Perfil clínico da resposta inflamatória sistêmica após cirurgia cardíaca pediátrica com circulação extracorpórea

“…In adults, Tuttle et al 28 , in 2003, assessed a group of patients submitted to CPB with a renal failure criterion similar to the one herein stated (increase of 25% in creatinine) and observed a 42% incidence. In the present study, a 22.8% frequency was registered, which is an important criterion for SIRS-CPB score, because 81% of the patients with renal failure presented SIRS-CPB and only 7% of the group which had normal renal function were diagnosed with SIRS-CPB.…”

Fatores de risco pré-operatórios para o desenvolvimento de Insuficiência Renal Aguda em cirurgia cardíaca

“…Several authors utilize the term "renal dysfunction" for non-dialytic ARF, defining it as the presence of serum creatinine increases of around 25 to 50% of the preoperative value and the term "renal failure" for patients with dialytic ARF [5][6][7][8][9]18,19]. Although it seems more objective, the definition of ARF based on dialysis also depends on the experience of the nephrology team, although defined classical criteria are followed.…”

“…Thus, the incidence and risk factors of this disease after heart surgery show much variability. In this work, ARF was defined as a 30% increase in the basal value on the first or second postoperative day, which occurred in 34% of the patients; an incidence higher than in published works that report variations between 1% and 30% [5][6][7][8][9]18,20].…”

“…Tuttle et al [18] showed that patients submitted to valve surgeries presented a 2.5 times higher risk of developing ARF compared to patients submitted to other types of surgery. According to these authors, perhaps the greatest occurrence of ARF is associated with the presence of microthrombi released by the renal tissue during this type of operation.…”

Renal Failure and Heart Surgery

“…Many authors have attempted to identify risk factors for AKI after cardiac surgery. These have been reported to include age [13,14], preoperative renal impairment [14,15], diabetes [16], cerebrovascular disease [16], prolonged cardiopulmonary bypass (CPB) time [13][14][15]17], valve procedures [13][14][15]17,18], postoperative hypotension [14], or hemolysis and ensuing pigment nephropathy [19].…”