Acute Kidney Injury and Long-term Risk of Cardiovascular Events After Cardiac Surgery: A Population-Based Cohort Study

Hansen, Malene; Gammelager, Henrik; Jacobsen, Carl-Johan; Hjortdal, Vibeke E.; Layton, J. Bradley; Rasmussen, Bodil Steen; Andreasen, Jan Jesper; Johnsen, Søren Paaske; Christiansen, Christian Fynbo

doi:10.1053/j.jvca.2014.08.020

Cited by 69 publications

(56 citation statements)

References 34 publications

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“…[3] Patients with AKI in the postoperative period have a higher infection and sepsis rate with longer intensive care unit stay and higher mortality rate, while they need more intra-aortic balloon pump and inotropic support. [19,[22][23][24][25] Consistent with the previous findings, we found higher sepsis and postoperative atrial fibrillation rates in AKI (+) patients. Our patients with AKI also needed more intra-aortic balloon pump and renal replacement therapy during the postoperative course.…”

Section: Discussionsupporting

confidence: 88%

Mitral and aortic valve surgery-related acute kidney injury: affecting factors and its one year follow-up

İşcan¹

2017

Turk Gogus Kalp Dama

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ÖZAmaç: Bu çalışmada izole kalp kapak cerrahisi sonrası akut böbrek hasarının prevalansı araştırıldı ve risk faktörleri ve bir yıllık takip sonuçları belirlendi.Ça lış ma pla nı: Ocak 2008 -Aralık 2014 tarihleri arasında aort ve mitral kapak cerrahisi yapılan toplam 220 hasta (106 erkek, 114 kadın; ort. yaş 50.6±14.7 yıl; dağılım 14-79 yıl) retrospektif olarak incelendi. Hastaların başlangıç özellikleri, eşlik eden hastalıkları, cerrahi parametreleri ve cerrahi sonrası sonuçları kaydedildi. Hastalar Akut Böbrek Hasarı Ağı Kriterleri kullanılarak cerrahi öncesi ve sonrası kreatinin değerleri ile değerlendirildiği üzere, akut böbrek hasarı olanlar ve olmayanlar olarak iki gruba ayrıldı. Bul gu lar:Tüm hastaların 57'sinde akut böbrek hasarı gelişti. Bu hastaların 12'sinde hemodiyaliz ihtiyacı oldu (evre 1, n=40; evre 2, n=12; evre 3, n=5). Akut böbrek hasarı gelişen hastalar, daha yüksek diabetes mellitus oranı ile daha yaşlı olma eğilimindeydi. Bu hastalarda cerrahi sonrası sepsis, kanama revizyonu, atriyal fibrilasyon ve intraaortik balon pompası ihtiyacı oranları daha yüksek ve yoğun bakım ünitesinde ve hastanede kalış süresi daha uzundu. Akut böbrek hasarı gelişmeyen hastalara kıyasla, gelişen hastalarda, daha fazla eritrosit transfüzyonu gerekli oldu.So nuç: Çalışma sonuçlarımız, Akut Böbrek Hasarı Ağı kriterlerine göre cerrahi sonrası hafif düzeyde kreatinin değişiklikleri ile tanılanan akut böbrek hasarının prognoz açısından önemli bir komplikasyon olduğunu göstermektedir. Yaş, diabetes mellitus ve kan transfüzyonu cerrahi sonrası akut böbrek hasarının başlıca risk faktörleridir. Kalp cerrahisi ile ilişkili akut böbrek hasarının erken ve geç dönem sonuçlarının önlenmesi için hastalar cerrahi öncesinde dikkatlice değerlendirilmelidir.Anah tar söz cük ler: Akut böbrek hasarı; kalp kapak cerrahisi; cerrahi sonrası morbidite. ABSTRACTBackground:This study aims to investigate the prevalence of acute kidney injury after isolated cardiac valve surgery, and to identify risk factors and one-year follow-up results.

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Section: Discussionsupporting

confidence: 88%

Mitral and aortic valve surgery-related acute kidney injury: affecting factors and its one year follow-up

İşcan¹

2017

Turk Gogus Kalp Dama

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“…Elements of the modified ACEF score are: advanced age, left ventricle dysfunction and decreased creatinine clearance, which are well-known risk factors for the occurrence of renal impairment [26]. In our study, the modified ACEF and SYNTAX scores failed in the prediction of AKI in both groups separately.…”

Section: Discussionmentioning

confidence: 49%

Clinical SYNTAX Score Can Predict Acute Kidney Injury following On-Pump but Not Off-Pump Coronary Artery Bypass Surgery

et al. 2015

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Background: The complexity of coronary artery disease is usually a neglected factor in risk stratification systems. We aimed to analyze the discriminative ability of the clinical SYNTAX score (CSS) for acute kidney injury (AKI) following on- and off-pump coronary artery surgery. Methods: A total of 193 patients were reviewed in this study. Patients were divided into two groups according to the surgical procedure (group I: off-pump coronary artery bypass grafting, n = 89; group II: on-pump coronary artery bypass grafting, n = 104). Preoperative demographic data, the CSS and postoperative renal functions were evaluated. The postoperative AKI classification was made using the RIFLE (Risk, Injury, Failure, Loss of function, and End-stage renal disease) criteria. Results: Postoperative AKI occurred in 14 of 89 patients (15.7%) in group I and in 29 of 104 patients in group II (27.8%; p = 0.046). The CSS did not vary much between the groups (31.52 ± 13.08 vs. 29.89 ± 15.70; p = 0.638). In group I, the CSS was not different between patients with AKI and those without AKI (30.167 ± 3.93 vs. 31.91± 14.75; p = 0.78). In group II, the CSS was 36.85 ± 18.33 in patients with AKI and 28.02 ± 12.32 in those without, and the difference was significant (p = 0.02). The discriminative ability of the CSS for postoperative AKI using the AUC analysis was 0.500 in group I and 0.840 in group II. Conclusion: The CSSmay be a simple and successful means of risk prediction of postoperative AKI in on-pump coronary artery surgery.

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“…For example, in a population-based cohort study of 4,742 cardiovascular surgery patients with a 5-year follow-up, Hansen et al [13] found that CSA-AKI was associated with an increased risk of death (HR 1.37). In a prospective study of 2,940 consecutive cardiovascular surgery patients followed up for 6.9 years, Lopez-Delgado et al [14] used the RIFLE (an acronym comprising Risk, Injury, Failure, Loss, and End-stage kidney disease) criteria to diagnose the stage of AKI and found that the cumulative survival rate in the non-AKI group was higher than that in the AKI group (87.2 vs. 55.7%, respectively).…”

Section: Discussionmentioning

confidence: 99%

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

Wu¹,

Ma²,

Shao³

et al. 2017

Blood Purif

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Background/Aims: To evaluate the long-term outcomes of Chinese patients with cardiac surgery-associated acute kidney injury (CSA-AKI). Methods: Patients who underwent cardiac surgery with a median 3-year follow-up were enrolled. The long-term survival rate and the incidence of chronic kidney disease (CKD) were recorded, and related risk factors were analyzed. Results: Of all 1,363 patients, 457 (33.5%) developed CSA-AKI. The AKI patients had a lower 3-year survival rate (88.8 vs. 97.2%, respectively, p < 0.001) and a higher incidence of CKD stages 3-5 (9.9 vs. 2.3%, respectively, p < 0.001) than the non-AKI patients. Cox regression analysis showed that AKI, atrial fibrillation, chronic cardiac insufficiency, longer surgical duration, respiratory failure after surgery, and longer mechanical ventilation time were associated with long-term mortality, while AKI, older age, and lower baseline kidney function were associated with incident CKD stages 3-5. Conclusion: CSA-AKI increased the risk of 3-year mortality and incident CKD stages 3-5.

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Acute Kidney Injury and Long-term Risk of Cardiovascular Events After Cardiac Surgery: A Population-Based Cohort Study

Cited by 69 publications

References 34 publications

Mitral and aortic valve surgery-related acute kidney injury: affecting factors and its one year follow-up

Mitral and aortic valve surgery-related acute kidney injury: affecting factors and its one year follow-up

Clinical SYNTAX Score Can Predict Acute Kidney Injury following On-Pump but Not Off-Pump Coronary Artery Bypass Surgery

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

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