IntroductionAmong patients undergoing cardiac surgery, the occurrence of acute renal
injury appears to be associated with worse prognosis and increased
mortality. The objective of this study was to evaluate risk factors and the
impact this complication on mortality and survival after cardiac surgery
among patients without chronic kidney disease.MethodsIn this retrospective study, we reviewed the medical records of 142 patients
who underwent elective coronary artery bypass grafting, valve replacement
(single or multiple), or both (simultaneously) at a tertiary care
hospital.ResultsAmong the 142 patients evaluated, the mean age was 58.28±13.87 years
and 80 (56.33%) were female. The postoperative incidence of acute renal
injury was 43.66%. Univariate analysis between the groups with and without
acute renal injury revealed no significant differences, whereas multivariate
analysis showed that risk factors for acute renal injury included valve
replacement (OR=4.7, P=0.002, 95% CI=1.76-12.62, age
(OR=1.044, P=0.012, 95% CI=1.01-1.07), previous cardiac
surgery (OR=36.1, P=0.015, 95% CI=1.99-653.85),
postoperative use of the vasoactive drug norepinephrine (OR=3.32,
P=0.013, 95% CI=1.29-8.58) and dobutamine (OR=5.3,
P=0.019, 95% CI=1.32-21.64). In our sample, there were
30 deaths, of which 25 had acute kidney injury. Survival was also lower
among the patients with this complication, especially those who had required
hemodialysis (OR=2.60, P<0.001, 95% CI=1.01-6.70) or had
previously undergone cardiac surgery (OR=3.68, P<0.001,
95% CI=1.09-12.37).ConclusionOur findings underscore the importance of identifying risk factors for
developing acute renal injury after cardiac surgery, which can further the
development of effective renoprotective strategies.