The duration of acute kidney injury after cardiac surgery increases the risk of long-term chronic kidney disease

Abstract

Patients developing AKI after cardiac surgery presented high prevalence of long-term incident CKD. The duration of AKI was a strong independent risk factor for this late CKD development. Recognition of predictive factors for CKD development following cardiac surgery-associated AKI may help to develop strategies to prevent or halt CKD progression in this population.

Effect of Cardiac Surgery-Associated Acute Kidney Injury on Long-Term Outcomes of Chinese Patients: A Historical Cohort Study

“…Our results showed that the risk of CKD increased with the severity of CSA-AKI regardless if renal function was restored at discharge, which was in accordance with the findings of previous studies [7,17]. Notably, the cumulative incidence of CKD stages 3-5 was relatively low (9.9%) in the AKI group, as compared to other studies [7,16], which may be explained by the relatively younger age and lower rate (4.8%) of aortic surgery, which had a great impact on the progression of kidney function [18]. In addition, the signs of CKD may not be detected by routine methods, such as eGFR, proteinuria, and blood pressure measurements [19].…”

“…Palomba et al [16] reported that the 12-month prevalence of CKD was 9% in the non-AKI patients versus 25% in the AKI group in a total 350 of patients who underwent elective cardiac surgery. Our results showed that the risk of CKD increased with the severity of CSA-AKI regardless if renal function was restored at discharge, which was in accordance with the findings of previous studies [7,17].…”

IL-17A blockade or deficiency does not affect progressive renal fibrosis following renal ischaemia reperfusion injury in mice

“…However, more recently AKI and CKD were found to be interconnected syndromes with similar risk factors (i.e. older age, pre‐existing renal function impairment, diabetes mellitus, hypertension) . A substantial group of AKI patients develop CKD and even proceed to end‐stage renal disease (ESRD) after severe AKI.…”

AKI on CKD: heightened injury, suppressed repair, and the underlying mechanisms

“…More recently, Kim et al reported that persistent AKI (defined as incomplete reduction of serum creatinine at 7 days) after gastric surgery was associated with CKD progression 1 year later 12 . Similarly, the duration of AKI after cardiac surgery was also regarded as a strong independent risk factor for CKD development 13 . In addition, a recent retrospective study indicated that 29% of patients with elective cardiac surgery and cardiopulmonary bypass experienced AKI and notably, half of these AKI patient developed CKD 14 .…”