Renal Dysfunction and Cardiac Surgery: How Can We Study an Undefined Entity?

Dhawan, Richa; Chaney, Mark A.

doi:10.1053/j.jvca.2022.07.027

Cited by 2 publications

(4 citation statements)

References 21 publications

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“…The diagnostic tools used to identify acute kidney injury are questioned. The current criteria based on pCr elevation and urine output are not optimal [ 45 ]. Whilst it appears to be promising that novel and more specific biomarkers may be able to predict AKI [ 7 – 9 ] it is however unclear whether some of the commercially available biomarker kits adequately indicate physiological or morphological kidney injury [ 46 , 47 ].…”

Section: Discussionmentioning

confidence: 99%

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Concentrated urine, low urine flow, and postoperative elevation of plasma creatinine: A retrospective analysis of pooled data

Hahn,

Weinberg,

et al. 2023

PLoS ONE

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Elevations of plasma creatinine are common after major surgery, but their pathophysiology is poorly understood. To identify possible contributing mechanisms, we pooled data from eight prospective studies performed in four different countries to study circumstances during which elevation of plasma creatinine occurs. We included 642 patients undergoing mixed major surgeries, mostly open gastrointestinal. Plasma and urinary creatinine and a composite index for renal fluid conservation (Fluid Retention Index, FRI) were measured just before surgery and on the first postoperative morning. Urine flow was measured during the surgery. The results show that patients with a postoperative increase in plasma creatinine by >25% had a high urinary creatinine concentration (11.0±5.9 vs. 8.3±5.6 mmol/L; P< 0001) and higher FRI value (3.2±1.0 vs. 2.9±1.1; P< 0.04) already before surgery was initiated. Progressive increase of plasma creatinine was associated with a gradually lower urine flow and larger blood loss during the surgery (Kruskal-Wallis test, P< 0.001). The patients with an elevation > 25% also showed higher creatinine and a higher FRI value on the first postoperative morning (P< 0.001). Elevations to > 50% of baseline were associated with slightly lower mean arterial pressure (73 ± 10 vs. 80 ± 12 mmHg; P< 0.005). We conclude that elevation of plasma creatinine in the perioperative period was associated with low urine flow and greater blood loss during surgery and with concentrated urine both before and after the surgery. Renal water conservation-related mechanisms seem to contribute to the development of increased plasma creatinine after surgery.

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Section: Discussionmentioning

confidence: 99%

Section: Limitations and Strengthsmentioning

confidence: 98%

Concentrated urine, low urine flow, and postoperative elevation of plasma creatinine: A retrospective analysis of pooled data

Hahn,

Weinberg,

et al. 2023

PLoS ONE

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“…A injúria renal aguda (IRA) é uma complicação grave e comumente relatada em pacientes submetidos à cirurgia cardíaca, sendo considerada fator de risco para o aumento da morbidade e mortalidade pós-operatória. (SCHURLE;KOYNER, 2021;STOKFISZ et al, 2020;DHAWAN;CHANEY, 2022) Sua incidência é relatada de forma muito variável entre os autores, encontrando-se valores de 1,5% a 42% das cirurgias, dependendo do estudo.…”

Section: Introductionunclassified

“…(SCHURLE; KOYNER, 2021;STOKFISZ et al, 2020;NASCIMENTO et al, 2015;NEYRA et al, 2019;DHAWAN;CHANEY, 2022). É caracterizada pela perda rápida da função renal, resultando na incapacidade dos rins de filtrar adequadamente os resíduos metabólicos do sangue.…”

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Clinical-Epidemiological Profile and Acute Kidney Injury in Patient Undergoing Cardiac Surgery

Oliveira,

Briancini,

Linden

et al. 2024

REASE

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Este estudo retrospectivo analisou o perfil clínico-epidemiológico, a taxa de mortalidade e os fatores associados à lesão renal aguda (LRA) em pacientes submetidos a cirurgias cardíacas no Hospital São Lucas/FAG de Cascavel, Paraná. Investigando 144 prontuários (de junho de 2022 a abril de 2023), a taxa de mortalidade foi de 11,8%, e as cirurgias de a revascularização do miocárdio e troca valvar foram as mais prevalentes. Fatores de risco pessoais, idade e tipo de cirurgia foram importantes variáveis estudadas, evidenciando a necessidade de uma abordagem personalizada. O tempo médio de CEC foi 80,7 minutos, variando também de acordo com cada grupo analisado. Seu uso mais prolongado esteve associado a complicações, especialmente nos procedimentos mais complexos. Em paralelo, foi apresentado o perfil do grupo de pacientes que evoluíram com IRA, a qual evidenciou um percentual elevado dos pacientes em pós-operatório de cirurgia cardíaca apresentou essa complicação, com taxa de mortalidade elevada quando comparados com os que não a desenvolveram.

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Renal Dysfunction and Cardiac Surgery: How Can We Study an Undefined Entity?

Cited by 2 publications

References 21 publications

Concentrated urine, low urine flow, and postoperative elevation of plasma creatinine: A retrospective analysis of pooled data

Concentrated urine, low urine flow, and postoperative elevation of plasma creatinine: A retrospective analysis of pooled data

Clinical-Epidemiological Profile and Acute Kidney Injury in Patient Undergoing Cardiac Surgery

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