Preoperative hidden renal dysfunction add an age dependent risk of progressive chronic kidney disease after cardiac surgery

Xu, Jiacheng; Yu, Jun; Xu, Xialian; Shen, Bo; Wang, Yimei; Jiang, Wuhua; Lv, Wenlv; Fang, Yi; Luo, Zhe; Wang, Chunsheng; Teng, Jie; Ding, Xiaoqiang

doi:10.1186/s13019-019-0977-9

Cited by 10 publications

(4 citation statements)

References 19 publications

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“…Like sarcopenia, kidney disease was also an outcome-effected factor in this study. Kidney disease has been reported to worsen many outcomes, such as prolonged LOS in the ICU and the hospital, delayed independence in 100 m walking, and increased mortality, because of high incidence of composite cardiovascular events and difficulty in medical administration, such as fluid balance 23 , 30 , 31 , 32 ) . To achieve early home discharge, not only cardiac rehabilitation, but also the strict kidney management at post-surgery, are important.…”

Section: Discussionmentioning

confidence: 99%

Impact of sarcopenia on the progress of cardiac rehabilitation and discharge destination after cardiovascular surgery

et al. 2021

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To investigate the factors that affect the progress of cardiac rehabilitation, length of stay in the hospital, and discharge destination after cardiovascular surgery. [Participants and Methods] This was a prospective observational study. Sixty-seven patients scheduled to undergo open-heart surgery were included in the study. We evaluated physical and psychiatric functions pre-and post-surgery. Sarcopenia was defined as a short physical performance battery score of <9.5. [Results] Sarcopenia was a significant factor of delay of the day of the first rehabilitation, independence in 100-m walking, and exercise training at the rehabilitation gym. Comparisons between pre-and post-surgery were performed in the sarcopenia group. No significant decreases in physical and psychiatric functions were found. The discharge transfer rate was significantly different between the sarcopenia and non-sarcopenia groups. Sarcopenia and the decline in balance score significantly correlated with discharge transfer. [Conclusion] Cardiac rehabilitation can achieve recovery of physical and psychiatric functions even in patients with sarcopenia; however, the discharge transfer rate among the patients with sarcopenia was high. Improving balance ability may result in early home discharge.

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Section: Discussionmentioning

confidence: 99%

Impact of sarcopenia on the progress of cardiac rehabilitation and discharge destination after cardiovascular surgery

et al. 2021

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“…Baseline serum creatinine has been correlated with renal perfusion [45,46]. Preoperative hidden or slight renal dysfunction, which is widely recognized as a contributing factor to postoperative AKI, is highly prevalent (49.1%) among patients undergoing cardiac surgery with normal Scr levels [47]. Our study indicates that despite the delayed detection of a significant rise in Scr, it remains a reliable predictor of AKI [48].…”

Section: E838mentioning

confidence: 63%

Development and Validation of a Novel Nomogram for Predicting Perioperative Acute Kidney Injury Following Isolated Off-Pump Coronary Artery Bypass Grafting Surgery

Shoulei Chen,

Cheng Luo,

Chen Fang

et al. 2023

HSF

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Background: The aim of this work was to create a novel model for predicting acute kidney injury (AKI) after off-pump coronary artery bypass graft (OPCABG). Methods: The individuals who underwent OPCABG were randomly separated into a derivation group and a validation group, at a 7:3 ratio. The primary outcome was AKI under the Kidney Disease: Improving Global Outcomes (KDIGO) criteria. To optimize feature selection and construct a nomogram, both least absolute shrinkage and selection operator regression (LASSO) and logistic regression analysis were utilized. The nomogram was assessed in various ways: with the C-index, calibration curve, decision curve analysis (DCA), and clinical impact curve analysis (CICA). Results: The use of an intra-aortic balloon pump (IABP), systolic blood pressure, smoking and baseline serum creatinine were identified as independent impact factors. The C-index of the nomogram was 0.733 (95% confidence interval (CI) = 0.669–0.791) and 0.786 (95% CI = 0.693–0.878) in the training and validation groups, respectively. The area under the curve (AUC) of the internal validation was 0.715 using bootstrapping with 1000 replicates. The calibration plot revealed that the predicted outcomes aligned well with the observations. DCA and CICA suggested that the model had clinical benefit. Conclusion: The nomogram that relied on clinical characteristics proved to be a dependable instrument to predict AKI after OPCABG. This model is conveniently applicable in clinical settings and will be a valuable resource for assessing timely medical measures to mitigate risk.

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“…Our study is in line with others that emphasized age as an independent risk factor for AKI postoperatively 14 – 16 . Whereas age is an important predictor of AKI, its role in more chronic forms of kidney disease is debatable 11 , 17 . The ‘natural’ decline of eGFR with aging may overestimate the incidence of CKD or progressive kidney disease occurring in this population.…”

Section: Discussionmentioning

confidence: 99%

A pilot study to explore patterns and predictors of delayed kidney decline after cardiopulmonary bypass

Zaky,

Younan,

Meers

et al. 2024

Sci Rep

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There is no current consensus on the follow up of kidney function in patients undergoing cardiopulmonary bypass (CPB). The main objectives of this pilot study is to collect preliminary data on kidney function decline encountered on the first postoperative visit of patients who have had CPB and to identify predictors of kidney function decline post hospital discharge. Design: Retrospective chart review. Adult patients undergoing open heart procedures utilizing CPB. Patient demographics, type of procedure, pre-, intra-, and postoperative clinical, hemodynamic echocardiographic, and laboratory data were abstracted from electronic medical records. Acute kidney disease (AKD), and chronic kidney disease (CKD) were diagnosed based on standardized criteria. Interval change in medications, hospital admissions, and exposure to contrast, from hospital discharge till first postoperative visit were collected. AKD, and CKD as defined by standardized criteria on first postoperative visit. 83 patients were available for analysis. AKD occurred in 27 (54%) of 50 patients and CKD developed in 12 (42%) out of 28 patients. Older age was associated with the development of both AKD and CKD. Reduction in right ventricular cardiac output at baseline was associated with AKD (OR: 0.5, 95% CI: 0.3, 0.79, P = 0.01). Prolongation of transmitral early diastolic filling wave deceleration time was associated with CKD (OR: 1.02, 95% CI: 1.01, 1.05, P = 0.03). In-hospital acute kidney injury (AKI) was a predictor of neither AKD nor CKD. AKD and CKD occur after CPB and may not be predicted by in-hospital AKI. Older age, right ventricular dysfunction and diastolic dysfunction are important disease predictors. An adequately powered longitudinal study is underway to study more sensitive predictors of delayed forms of kidney decline after CPB.

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Preoperative hidden renal dysfunction add an age dependent risk of progressive chronic kidney disease after cardiac surgery

Cited by 10 publications

References 19 publications

Impact of sarcopenia on the progress of cardiac rehabilitation and discharge destination after cardiovascular surgery

Impact of sarcopenia on the progress of cardiac rehabilitation and discharge destination after cardiovascular surgery

Development and Validation of a Novel Nomogram for Predicting Perioperative Acute Kidney Injury Following Isolated Off-Pump Coronary Artery Bypass Grafting Surgery

A pilot study to explore patterns and predictors of delayed kidney decline after cardiopulmonary bypass

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