Abstract:The performance of known prediction models for AKI-D was found reasonably well in the prediction of KDIGO-AKI, with the model by Thakar having the highest predictive value in the discrimination of patients with risk for all KDIGO-AKI stages.
“…The incidence of RRT was 10%, which is within the range reported by Kiers et al (9.3%) [11]. Kristovic noted an incidence of 3.5% in a retrospective study, which is much lower than the values assessed in the present study [12]. Finally, from 31,677 patients who underwent open-heart surgery, 555 (1.7%) patients developed severe AKI requiring dialysis [13].…”
Background: Acute kidney injury (AKI) is a frequent and serious complication of cardiac surgery, associated with a high incidence of morbidity and mortality. Although the RIFLE criteria serve as a prominent tool to identify patients at high risk of AKI, an optimized diagnosis model in clinical practice is desired.Methods: Based on the SOP-criteria, 365 patients (10%) developed AKI following surgery and were subjected to RRT. In contrast, the incidence of AKI, defined according to the RIFLE criteria, was only 7% (n=251 patients). Prominent risk factors identified by SOP were patients’ sex, valve and combined valve and bypass surgery, deep hypothermia, use of intra-aortic balloon pump (IABP) and previous coronary interventions. Ischemia, reperfusion, blood loss and surgery time also served as significant risk factors for patient evaluated by SOP.Results: Risk assessment by RIFLE differed in as much as most patients with normothermia and those receiving only cardiovascular bypass developed AKI. However, patients’ sex and valve surgery did not serve as a risk factor.Conclusion: Evaluation of patients by the RIFLE versus SOP criteria yielded different results with more AKI patients detected by SOP. Based on the present data, it is concluded that patients may not prone to AKI when surgery and ischemia time will be kept short, when blood loss is mitigated to a minimum and when surgery is performed under non-hypothermic conditions
“…The incidence of RRT was 10%, which is within the range reported by Kiers et al (9.3%) [11]. Kristovic noted an incidence of 3.5% in a retrospective study, which is much lower than the values assessed in the present study [12]. Finally, from 31,677 patients who underwent open-heart surgery, 555 (1.7%) patients developed severe AKI requiring dialysis [13].…”
Background: Acute kidney injury (AKI) is a frequent and serious complication of cardiac surgery, associated with a high incidence of morbidity and mortality. Although the RIFLE criteria serve as a prominent tool to identify patients at high risk of AKI, an optimized diagnosis model in clinical practice is desired.Methods: Based on the SOP-criteria, 365 patients (10%) developed AKI following surgery and were subjected to RRT. In contrast, the incidence of AKI, defined according to the RIFLE criteria, was only 7% (n=251 patients). Prominent risk factors identified by SOP were patients’ sex, valve and combined valve and bypass surgery, deep hypothermia, use of intra-aortic balloon pump (IABP) and previous coronary interventions. Ischemia, reperfusion, blood loss and surgery time also served as significant risk factors for patient evaluated by SOP.Results: Risk assessment by RIFLE differed in as much as most patients with normothermia and those receiving only cardiovascular bypass developed AKI. However, patients’ sex and valve surgery did not serve as a risk factor.Conclusion: Evaluation of patients by the RIFLE versus SOP criteria yielded different results with more AKI patients detected by SOP. Based on the present data, it is concluded that patients may not prone to AKI when surgery and ischemia time will be kept short, when blood loss is mitigated to a minimum and when surgery is performed under non-hypothermic conditions
“…6 This imposes a considerable economic burden on the health care system. Prior studies have demonstrated prolonged duration of CPB as a risk factor for ARF 3,7,8,[10][11][12] ; however, CPB time is frequently dichotomized at heterogeneous time points.…”
“…Higher preoperative sCr was considered as an independent risk factor for postoperative AKI. [36] The studies of Christenson, [33] Prowle et al [18] and Billings et al [21] did not exclude patients with preoperative renal dysfunction which was diagnosed by elevated sCr and these 3 studies showed no protective effect of PST on renal outcome. Billings et al [21] even found that PST was associated with increased sCr on postoperative day 2 and AKI occurred in more patients with preoperative chronic kidney disease(CKD) randomized to atorvastatin than placebo.…”
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