Acute kidney injury following cardiac surgery

Gude, Dilip; Jha, Ratan

doi:10.4103/0971-9784.101874

Cited by 25 publications

(29 citation statements)

References 65 publications

(77 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Current data is insufficient to confirm the association between these CPB parameters and the risk of CSA-AKI [2,71] . Other more established CPB-related risk factors are duration of CPB (> 100-120 min), perfu- Najafi M. Creatinine, AKI and cardiac surgery outcome sion pressure, hemodilution during CPB, blood transfusion, hemolysis, most commonly due to cardiotomy suction, and embolism [2,95,96] . The role of CPB in inducing systemic inflammatory response syndrome (SIRS) and consequently CSA-AKI has been shown in different cardiac surgery events.…”

Section: Intraoperative Risk Factorsmentioning

confidence: 99%

Serum creatinine role in predicting outcome after cardiac surgery beyond acute kidney injury

Najafi

2014

WJC

View full text Add to dashboard Cite

Serum creatinine is still the most important determinant in the assessment of perioperative renal function and in the prediction of adverse outcome in cardiac surgery. Many biomarkers have been studied to date; still, there is no surrogate for serum creatinine measurement in clinical practice because it is feasible and inexpensive. High levels of serum creatinine and its equivalents have been the most important preoperative risk factor for postoperative renal injury. Moreover, creatinine is the mainstay in predicting risk models and risk factor reduction has enhanced its importance in outcome prediction. The future perspective is the development of new definitions and novel tools for the early diagnosis of acute kidney injury largely based on serum creatinine and a panel of novel biomarkers.

show abstract

Section: Intraoperative Risk Factorsmentioning

confidence: 99%

Serum creatinine role in predicting outcome after cardiac surgery beyond acute kidney injury

Najafi

2014

WJC

View full text Add to dashboard Cite

show abstract

“…Incluso aumentos modestos de la creatinina sérica basal se han vinculado a un incremento significativo de la mortalidad a 30 días (6) . La incidencia de IRA en este trabajo se encuentra dentro de los valores aportados por la bibliografía, haciendo la salvedad de su amplia variación de acuerdo a los criterios considerados.…”

Section: Discussionunclassified

“…Otras variables consideradas habitualmente como factores de riesgo de aparición de IRA como la edad, el sexo femenino, la DM, la FEVI y la utilización de BIAC no pudo demostrarse que lo fueran en nuestro estudio (6,9) .…”

Section: Discussionunclassified

“…Su incidencia es variable en los distintos estudios, oscilando entre 5% y 20% (5)(6)(7) ; 1% a 2% de los pacientes requerirán diálisis (6,8) .…”

Section: Introductionunclassified

“…El desarrollo de IRA, a su vez, se asocia a complicaciones infecciosas de gravedad variable, incremento en la estadía hospitalaria y mal pronóstico a largo plazo con aumento significativo de la mortalidad (1,4,6,9,15,16) . Considerando todo lo previamente expuesto, los objetivos del trabajo fueron determinar la incidencia acumulada de IRA en el POCC en nuestro servicio, evaluar la existencia de predictores de IRA y mortalidad asociada.…”

Section: Introductionunclassified

See 2 more Smart Citations

Incidencia acumulada de insuficiencia renal aguda en el posoperatorio de cirugía cardíaca

2018

Rev.Urug.Cardiol.

View full text Add to dashboard Cite

Introducción: la insuficiencia renal aguda (IRA) constituye una causa frecuente de morbimortalidad en el posoperatorio de cirugía cardíaca, con incidencia variable según la definición utilizada y los factores derivados del paciente y del procedimiento quirúrgico. Objetivo: los objetivos de este artículo fueron determinar la incidencia de IRA en un centro de cirugía cardíaca, la presencia de predictores y su asociación con mortalidad quirúrgica. Métodos: estudio prospectivo y observacional con elementos analíticos. Se incluyeron todos los pacientes con función renal normal y sin antecedentes de enfermedad renal sometidos a cirugía cardíaca en el período julio 2014 -julio 2015. Se determinó la creatininemia basal y a las 24 y 48 horas de la cirugía. La IRA fue definida utilizando el criterio RIFLE. Se valoró mortalidad quirúrgica y se analizaron variables pre e intraoperatorias como predictoras de desarrollo de IRA utilizando análisis uni y multivariado. Resultados: cumplieron los criterios de inclusión 400 pacientes. La incidencia de IRA por criterio RIFLE fue 10,3% (IC95% 8,7-11,8); la mortalidad quirúrgica en este grupo alcanzó 19,5%, mientras que en los controles fue 1,9%. Las variables asociadas al desarrollo de IRA fueron EuroSCORE más elevado, cirugía combinada, uso de circulación extracorpórea (CEC) y clampeo aórtico. La cirugía de revascularización miocárdica (CRM) presentó una asociación inversa con la aparición de IRA y constituyó un predictor independiente en el análisis multivariado. La presencia de IRA fue un predictor independiente de mortalidad quirúrgica. Conclusiones: la incidencia de IRA es frecuente en el posoperatorio de cirugía cardíaca y se encuentra dentro de los valores internacionales. Su presencia implica mayor mortalidad quirúrgica.

show abstract

Transcatheter aortic valve implantation in patients with pre-existing chronic kidney disease

Rahman

Sharma

Brecker

2015

IJC Heart & Vasculature

View full text Add to dashboard Cite

BackgroundWe investigated the effect of chronic kidney disease (CKD) on morbidity and mortality following transcatheter aortic valve implantation (TAVI) including patients on haemodialysis, often excluded from randomised trials.Methods and resultsWe performed a retrospective post hoc analysis of all patients undergoing TAVI at our centre between 2008 and 2012. 118 consecutive patients underwent TAVI; 63 were considered as having (CKD) and 55 not having (No-CKD) significant pre-existing CKD, (defined as estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m2). Chronic haemodialysis patients (n = 4) were excluded from acute kidney injury (AKI) analysis. Following TAVI, in CKD and No-CKD patients respectively, AKI occurred in 23.7% and 14.5% (p = 0.455) and renal replacement therapy (RRT) was necessary in 8.5% and 3.6% (relative risk (RR) [95% CI] = 2.33 [0.47–11.5], p = 0.440); 30-day mortality rates were 6.3% and 1.8% (p = 0.370); and 1-year mortality rates were 17.5% and 18.2% (p = 0.919). Patients who developed AKI had a significantly increased risk of 30-day (12.5% vs. 1.1%, p = 0.029) mortality. We found the presence of diabetes (odds ratio (OR) [95% CI] = 4.58 [1.58–13.3], p = 0.005) and elevated baseline serum creatinine (OR [95% CI] = 1.02 [1.00–1.03], p = 0.026) to independently predict AKI to statistical significance by multivariate analysis.ConclusionTAVI is a safe, acceptable treatment for patients with pre-existing CKD, however caution must be exercised, particularly in patients with pre-existing diabetes mellitus and elevated pre-operative serum creatinine levels as this confers a greater risk of AKI development, which is associated with increased short-term post-operative mortality.

show abstract

Acute kidney injury following cardiac surgery

Cited by 25 publications

References 65 publications

Serum creatinine role in predicting outcome after cardiac surgery beyond acute kidney injury

Serum creatinine role in predicting outcome after cardiac surgery beyond acute kidney injury

Incidencia acumulada de insuficiencia renal aguda en el posoperatorio de cirugía cardíaca

Transcatheter aortic valve implantation in patients with pre-existing chronic kidney disease

Contact Info

Product

Resources

About