The incidence and risk of acute renal failure after cardiac surgery

Bove, Tiziana; Calabrò, Maria Grazia; Landoni, Giovanni; Aletti, Giacomo; Marino, Giovanni; Crescenzi, Giuseppe; Rosica, Concetta; Zangrillo, Alberto

doi:10.1053/j.jvca.2004.05.021

Cited by 253 publications

(189 citation statements)

References 20 publications

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“…19 The RIFLE criteria 19 and subsequent AKIN definition 11 have addressed this methodological deficiency. Acute kidney injury following cardiac, vascular surgery, and major noncardiac surgery has been well studied; 5,16,[20][21][22][23] however, AKI following joint arthroplasty has received less attention. 6,7,24 Though our study was not designed to determine the incidence of postoperative AKI, the percentage of cases (1.8%) that experienced postoperative AKI is higher than previous estimates (0.4-0.55%), likely reflecting increased sensitivity of our modified AKIN criteria compared with RIFLE criteria, 11,19 which may introduce an ascertainment bias.…”

Section: Discussionmentioning

confidence: 99%

Acute kidney injury following total joint arthroplasty: retrospective analysis

Weingarten

Gurrieri

Jarett

et al. 2012

Can J Anesth/J Can Anesth

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Introduction Postoperative acute kidney injury (AKI) following arthroplasty has not been well studied. Our aim was to identify factors associated with increased risk of AKI. Methods The medical records for adult patients who underwent elective total joint arthroplasty during June 1, 2007 to May 31, 2010 at the Mayo Clinic were reviewed to identify patients with normal preoperative kidney function who experienced perioperative AKI, defined as an increase in serum creatinine (sCr) by 26.4 lmolÁL -1 . For each AKI case, two controls were identified and matched for age, sex, and type of operation. Medical records were abstracted for demographics, comorbid conditions, and preoperative, intraoperative, and postoperative variables. Conditional logistic regression analyses were performed to identify risk factors for AKI. Results Of the 9,171 patients who underwent joint replacement operations, 167 with normal preoperative renal function developed AKI with a median [25 th , 75 th ] increase in sCr of 35.4 [26.4, 44.2] lmolÁL -1 . No patient required dialysis. A higher than normal body mass index, diabetes mellitus, the number of baseline antihypertensive medications, cerebral or peripheral vascular disease, use of general anesthesia, and perioperative blood transfusions were independently associated with risk for AKI. Hospital length of stay and intensive care admissions were greater in AKI patients, and in 12.0% of patients, sCr remained at least 26.4 lmolÁL -1 higher than preoperative baseline at least three months after surgery. Conclusion In this case-control investigation, we identified several factors associated with the development of postoperative AKI. Recognition of these risk factors could allow for the adoption of perioperative renal protective strategies in patients undergoing arthroplasty.

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Section: Discussionmentioning

confidence: 99%

Acute kidney injury following total joint arthroplasty: retrospective analysis

Weingarten

Gurrieri

Jarett

et al. 2012

Can J Anesth/J Can Anesth

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“…The inflammatory process after CPB has its final lesion characterized by an increase of diffuse capillary permeability with significant liquid extravasation towards the interstitial tissue [7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25] . This finding could be partially explained by the presence of what is currently called endothelial dysfunction.…”

Section: Discussionmentioning

confidence: 99%

“…In this context, there is a stimulation of leukocytes, monocytes, macrophages, basophils, endothelial cells, myocytes and hepatocytes. There is an increase in the circulation of complement fractions (mainly C3a, C4a and C5a) 5,6 , citokynes (mainly tumor necrosis factoralpha, class 1, 6, 8 and 10 interleukins) [7][8][9] , histamine 10 and adhesion molecules 11. The inflammatory cascade is then amplified and may be associated with clinical manifestations by fever occurrences 12,13 , myocardial dysfunction (due to mechanical, ischemic and immunological injury) 14,15 and/or vasoplegy 16,17 , with occurrence of hypotension; signs of low cardiac output with hyperperfusion and tissular hypoxia; acute renal insufficiency 18,19 ; acute pulmonary lesion 20 , acute respiratory distress syndrome 21 ; blood dyscrasia 22 , neurological symptoms 23,24 and liquid retention with weight gain down to endothelial lesion 25 . When present, these manifestations may prolong the period of stay in ICU and in general hospital due to aggregated morbidity.…”

Section: Introductionmentioning

confidence: 99%

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

Soares¹,

Ribas²,

Spring³

et al. 2010

Arq. Bras. Cardiol.

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“…The incidence of hospital-acquired AKI varies from 5% in patients with normal preoperative renal function to 25% in intensive care unit (ICU) patients (2)(3)(4). Mortality rates of patients with postoperative AKI range from 40 to 60% among ICU patients who require a renal replacement therapy (5)(6)(7). Dialysis remains the only U.S. Food and Drug Administration approved treatment option for established AKI.…”

mentioning

confidence: 99%