Acute Kidney Injury Associated with Cardiac Surgery: a Comprehensive Literature Review

Harky, Amer; Joshi, Mihika; Gupta, Shubhi; Teoh, Wan Yi; Gatta, Francesca; Snosi, Mostafa

doi:10.21470/1678-9741-2019-0122

Cited by 49 publications

(59 citation statements)

References 75 publications

(102 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Although novel biomarkers, such as neutrophil gelatinase-associated lipocalin and cystatin C, have been identified as independent predictors of AKI and are superior to conventional biomarkers, sCr continues to be a more valuable and accepted tool for AKI diagnosis [ 18 ]. During surgery and CPB, the kidneys may suffer from an imbalance between oxygen supply and oxygen needs that is associated with lactate production [ 19 ]. Higher serum lactate values, which are a surrogate marker of tissue hypoperfusion and imbalance of renal oxygen metabolism, were associated with the occurrence of postoperative AKI.…”

Section: Discussionmentioning

confidence: 99%

Impact of autologous platelet rich plasma use on postoperative acute kidney injury in type A acute aortic dissection repair: a retrospective cohort analysis

Tong

Cao

Liu

et al. 2021

J Cardiothorac Surg

View full text Add to dashboard Cite

Background Perioperative coagulopathy and blood transfusion are common in patients undergoing Stanford type A acute aortic dissection (AAD) repair. The autologous platelet-rich plasmapheresis (aPRP) technique is a blood conservation approach to reduce blood transfusions and morbidity in patients at high risk of bleeding. The purpose of this study was to analyze the effect of aPRP on outcomes, especially in postoperative acute kidney injury (post-AKI), in patients undergoing AAD surgery. Methods Six hundred sixty patients were divided into aPRP and non-aPRP groups according to aPRP use. The primary endpoint was the difference in the incidence of post-AKI between two groups. The secondary endpoints were risk factors for post-AKI and to assess clinical outcomes. The risk factors associated with post-AKI were calculated, and all outcomes were adjusted by propensity-score matching analysis. Results A total of 272 patients (41.2%) received aPRP, whereas 388 were in the non-aPRP group. Compared to non-aPRP group, the occurrence of post-AKI increased by 14.1% (p = 0.002) and 11.1% (p = 0.010) with and without propensity adjustment in the aPRP group, respectively. The aPRP group required fewer intraoperative transfusions (p < 0.05) and shortened the duration of mechanical ventilation (p < 0.05) than those in the non-aPRP group. Multiple regression analyses showed that aPRP (odds ratio: 1.729, 95% confidence interval: 1.225–2.440; p < 0.001) was one of the independent risk factors for post-AKI. Conclusions The use of aPRP significantly reduced intraoperative blood transfusions and decreased postoperative mortality-adjusted mechanical ventilation. However, aPRP use was independently associated with an increased hazard of post-AKI after adjusting for confounding factors.

show abstract

Section: Discussionmentioning

confidence: 99%

Impact of autologous platelet rich plasma use on postoperative acute kidney injury in type A acute aortic dissection repair: a retrospective cohort analysis

Tong

Cao

Liu

et al. 2021

J Cardiothorac Surg

View full text Add to dashboard Cite

show abstract

“…These include hypoperfusion, renal artheroemobolism, activation of complement and inflammatory mediators due to surgical stress and neurohormonal factors. Meanwhile, preoperatively, females are more susceptible to develop AKI post-cardiac surgery compared to men [ 15 ]. In our study, gender was not further studied due to the relatively low number of cases.…”

Section: Discussionmentioning

confidence: 99%

Renal Impairment After Cardiac Surgery: Risk Factors, Outcome and Cost Effectiveness

Elghoneimy

Qahtani

Almontasheri

et al. 2020

Cureus

View full text Add to dashboard Cite

Introduction Acute kidney injury (AKI) is considered one of the serious complications in the medical field. It has a large impact on patients' life medically, socially and economically. It also has a financial burden on governments and hospitals regardless of which part of the world is considered. On the other hand, AKI is a common complication of cardiac surgery, which alone has a tremendous burden and implications on patients and governments. In this study, we will discuss the various risk factors, outcomes and financial burden of renal impairment associated with cardiac surgery. Methods This is a retrospective case-control study, which included 144 adult patients who underwent open cardiac surgical procedures at King Fahad University Hospital in the Eastern Province of Saudi Arabia over a period of five years from January 2015 till the end of December 2019. We included all types of cardiac surgeries performed such as coronary artery bypass grafting (CABG), valve surgery and aortic dissection repair and excluded patients with end-stage renal disease (ESRD) requiring dialysis preoperatively and pediatric patients. Two control groups were defined, those who developed renal impairment (group A) and those who did not develop it (group B). Results The mean age of the patients was 58.59 ± 12.6 years (range: 42 to 77 years). Mean serum creatinine level in the postoperative period was 1.95 ± 1.5 mg/dL in group A compared to group B of 1.0 ± 0.32 mg/dL (P-value<0.01). Mean serum blood urea nitrogen (BUN) in group A was 26.45 ± 19.9 mg/dL compared to group B of 16.79 ± 16.2 mg/dL in group B (P-value < 0.01). Diabetic were more likely to develop renal impairment than non-diabetic (P-value = 0.049, OR 2.73; 95% CI: 0.97-7.66). Obese patients were two times more likely to develop renal impairment than non-obese (P-value = 0.056, OR 2.6; 95% CI: 0.94-7.1). The average cost for each patient with renal impairment who required dialysis was 110,000 Saudi Riyal (~ 29,000 $) compared to other patients. Conclusion Serum creatinine, BUN, diabetes and obesity are strong indicators in developing AKI in cardiac surgery. In addition, the financial burden was almost doubled in patients developing AKI.

show abstract

“…Acute kidney injury following cardiac surgery is a frequent and serious complication, it is considered to be independently associated with worse outcomes, increased mortality rate, prolonged ICU, and hospital stay (Harky et al 2020 ).…”

Section: Discussionmentioning

confidence: 99%

Neutrophil gelatinase-associated lipocalin as a biomarker for predicting acute kidney injury after coronary artery bypass grafting

Othman

Hassan

Elsersi

et al. 2021

Ain-Shams J Anesthesiol

View full text Add to dashboard Cite

Background Early and precocious determination of acute kidney injury (AKI) is essential to prevent morbidity and mortality following coronary artery bypass grafting (CABG). Evaluation of the perioperative renal function is substantial using novel biomarkers other than the late traditional method of using serum creatinine. Plasma neutrophil gelatinase-associated lipocalin (NGAL) is a biomarker investigated for early detection of AKI in patients undergoing coronary artery bypass grafting, and its role has to be determined in this study. Results Twenty-five patients undergoing elective CABG were enrolled in this cohort study and were assigned into two groups: group I include the patients that did not develop AKI (no AKI group) and group II include the patients that developed AKI (AKI group). Acute kidney injury based on Kidney Disease: Improving Global Outcomes (KDIGO) classification had been developed in 7 patients (28%). Plasma NGAL levels at 6 h were higher in patients who developed AKI compared with those who did not (302 ± 88.02 vs. 116.50 ± 17.33 ng/m, p value < 0.001). The cut-off value of plasma NGAL levels measured 6 h postoperatively was 145 ng/ml and the area under the receiver-operating characteristic (ROC) curve was 0.965. Results of this study showed that plasma NGAL is a robust early biomarker of AKI, which preceded the rise in serum creatinine by many hours. Conclusion This study revealed that earlier diagnosis of acute kidney injury in patients undergoing CABG can be achieved by measuring postoperative plasma NGAL concentration at 6 h.

show abstract

Acute Kidney Injury Associated with Cardiac Surgery: a Comprehensive Literature Review

Cited by 49 publications

References 75 publications

Impact of autologous platelet rich plasma use on postoperative acute kidney injury in type A acute aortic dissection repair: a retrospective cohort analysis

Impact of autologous platelet rich plasma use on postoperative acute kidney injury in type A acute aortic dissection repair: a retrospective cohort analysis

Renal Impairment After Cardiac Surgery: Risk Factors, Outcome and Cost Effectiveness

Neutrophil gelatinase-associated lipocalin as a biomarker for predicting acute kidney injury after coronary artery bypass grafting

Contact Info

Product

Resources

About