Development of model to predict end-stage renal disease after coronary artery bypass grafting

Lee, Yeonhee; Park, Ji Won; Jang, Mijung; Moon, Hong Ran; Oh, Kook Hwan; Joo, Kwon Wook; Lim, Chun Soo; Kim, Yon Su; Na, Ki Young; Han, Seung Seok

doi:10.1097/md.0000000000015789

Cited by 5 publications

(8 citation statements)

References 39 publications

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“…However, type of surgery was not a significant predictor in our study, which may be due to the small number of aortic surgery included in our data. Old age and baseline renal function were also significant in our study [2,17]. In addition, body mass index and history of diabetes mellitus were also significant in our study; both are known risk factors of CKD in the general population [25,26].…”

Section: Discussionsupporting

confidence: 61%

“…To our knowledge, only a few previous studies investigated the risk factors of new-onset CKD after cardiac or thoracic aortic surgery [ 2 , 17 , 37 ]. A previous retrospective cohort study also reported that AKI is a significant predictor of CKD after cardiac surgery [ 17 ].…”

Section: Discussionmentioning

confidence: 99%

“…In addition, body mass index and history of diabetes mellitus were also significant in our study; both are known risk factors of CKD in the general population [ 25 , 26 ]. Another retrospective study also reported a prediction model for the end-stage renal disease after coronary artery bypass surgery [ 2 ]. In their multicenter retrospective cohort with a median follow-up of six years, they did not exclude the patients with baseline CKD and reported that both baseline postoperative AKI and preoperative CKD were significant predictors of CKD.…”

Section: Discussionmentioning

confidence: 99%

“…Chronic kidney disease may develop after open cardiac surgery [ 1 ] or coronary artery bypass graft [ 2 ]. End-stage renal disease contributes to increased hospitalization, poor quality of life, and the development of comorbidities, including ischemic heart disease, cerebrovascular accident, and frailty [ 3 , 4 , 5 ].…”

Section: Introductionmentioning

confidence: 99%

“…The incidence of AKI after cardiovascular surgery is as high as 55% [ 7 , 9 , 10 , 11 , 12 , 13 ], and temporary deterioration of renal function after aortic surgery is related to higher long-term mortality [ 14 ]. Although the associations between AKI and CKD were reported in various medical and surgical populations [ 15 , 16 ], this relationship has been rarely reported after cardiac surgery [ 2 , 17 ]. Particularly, the association between the severity of postoperative AKI and the risk of the occurrence of new-onset CKD after cardiovascular surgery has been rarely reported.…”

Section: Introductionmentioning

confidence: 99%

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Severity and Duration of Acute Kidney Injury and Chronic Kidney Disease after Cardiac Surgery

Choe

Cho

Bae

et al. 2021

JCM

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We aimed to evaluate whether the duration and stage of acute kidney injury (AKI) are associated with the occurrence of chronic kidney disease (CKD) in patients undergoing cardiac or thoracic aortic surgery. A total of 2009 cases were reviewed. The patients with postoperative AKI stage 1 and higher stage were divided into transient (serum creatinine elevation ≤48 h) or persistent (>48 h) AKI, respectively. Estimated glomerular filtration rate (eGFR) values during three years after surgery were collected. Occurrence of new-onset CKD stage 3 or higher or all-cause mortality was determined as the primary outcome. Multivariable Cox regression and Kaplan–Meier survival analysis were performed. The Median follow-up of renal function after surgery was 32 months. The cumulative incidences of our primary outcome at one, two, and three years after surgery were 19.8, 23.7, and 26.1%. There was a graded significant association of AKI with new-onset CKD during three years after surgery, except for transient stage 1 AKI (persistent stage 1: HR 3.11, 95% CI 2.62–4.91; transient higher stage: HR 4.07, 95% CI 2.98–6.11; persistent higher stage: HR 13.36, 95% CI 8.22–18.72). There was a significant difference in survival between transient and persistent AKI at the same stage. During three years after cardiac surgery, there was a significant and graded association between AKI stages and the development of new-onset CKD, except for transient stage 1 AKI. This association was stronger when AKI lasted more than 48 h at the same stage. Both duration and severity of AKI provide prognostic value to predict the development of CKD.

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Section: Discussionsupporting

confidence: 61%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Severity and Duration of Acute Kidney Injury and Chronic Kidney Disease after Cardiac Surgery

Choe

Cho

Bae

et al. 2021

JCM

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The Impact of Acute Kidney Injury on Chronic Kidney Disease After Cardiac Surgery: A Systematic Review and Meta-analysis

Lindhardt,

Rasmussen,

Riber

et al. 2024

Journal of Cardiothoracic and Vascular Anesthesia

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A novel nomogram for predicting 3-year mortality in critically ill patients after coronary artery bypass grafting

2021

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Background The long-term outcomes for patients after coronary artery bypass grafting (CABG) have been received more and more concern. The existing prediction models are mostly focused on in-hospital operative mortality after CABG, but there is still little research on long-term mortality prediction model for patients after CABG. Objective To develop and validate a novel nomogram for predicting 3-year mortality in critically ill patients after CABG. Methods Data for developing novel predictive model were extracted from Medical Information Mart for Intensive cart III (MIMIC-III), of which 2929 critically ill patients who underwent CABG at the first admission were enrolled. Results A novel prognostic nomogram for 3-year mortality was constructed with the seven independent prognostic factors, including age, congestive heart failure, white blood cell, creatinine, SpO2, anion gap, and continuous renal replacement treatment derived from the multivariable logistic regression. The nomogram indicated accurate discrimination in primary (AUC: 0.81) and validation cohort (AUC: 0.802), which were better than traditional severity scores. And good consistency between the predictive and observed outcome was showed by the calibration curve for 3-year mortality. The decision curve analysis also showed higher clinical net benefit than traditional severity scores. Conclusion The novel nomogram had well performance to predict 3-year mortality in critically ill patients after CABG. The prediction model provided valuable information for treatment strategy and postdischarge management, which may be helpful in improving the long-term prognosis in critically ill patients after CABG.

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Development of model to predict end-stage renal disease after coronary artery bypass grafting

Abstract: Supplemental Digital Content is available in the text

Cited by 5 publications

References 39 publications

Severity and Duration of Acute Kidney Injury and Chronic Kidney Disease after Cardiac Surgery

Severity and Duration of Acute Kidney Injury and Chronic Kidney Disease after Cardiac Surgery

The Impact of Acute Kidney Injury on Chronic Kidney Disease After Cardiac Surgery: A Systematic Review and Meta-analysis

A novel nomogram for predicting 3-year mortality in critically ill patients after coronary artery bypass grafting

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