Incidence, risk factors, and prognosis of a moderate increase in plasma creatinine early after cardiac surgery*

Ryckwaert, F.; Boccara, Gilles; Frappier, J. M.; Colson, P

doi:10.1097/00003246-200207000-00016

Cited by 136 publications

(89 citation statements)

References 14 publications

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“…3,7,11,20 Conlon et al showed an increase in Cr by 1.0 (mg/dL) and new onset of renal failure was associated with mortality. 4 We chose rather to calculate the %⌬Cr, categorize patients into 4 groups and assessed 90-day mortality.…”

Section: Discussionmentioning

confidence: 99%

“…However, many methods have been used to characterize ARF including preoperative Cr, 9,10 postoperative Cr, the absolute increase from preoperative Cr to the highest postoperative level, or the relative percent increase from preoperative to postoperative Cr (%⌬Cr). The definition of ARF has varied widely, ie, %⌬Crϭ20%, 6,11 25%, 8,12 30%, 7 or 50%. 3,7 Studies demonstrated their definition of ARF (ie, %⌬Cr) was associated with in-hospital mortality after CABG.…”

mentioning

confidence: 99%

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Perioperative Increases in Serum Creatinine Are Predictive of Increased 90-Day Mortality After Coronary Artery Bypass Graft Surgery

Brown¹,

Cochran²,

Dacey³

et al. 2006

Circulation

122

100

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Background-Impaired renal function after coronary artery bypass graft (CABG) surgery is a key risk factor for in-hospital mortality. However, perioperative increases in serum creatinine and the association with mortality has not been well-studied.We assessed the hypothesis that perioperative increases in creatinine are associated with increased 90-day mortality. Methods and Results-We studied 1391 patients in northern New England undergoing CABG in 2001 and evaluated preoperative and postoperative creatinine. Patients with preoperative dialysis were excluded. Data were linked to the National Death Index to assess 90-day survival. Kaplan-Meier and log-rank techniques were used. Patients were stratified by percent increase in creatinine from baseline: Ͻ25%, 25% to 49%, 50% to 99%, Ն100%. We assessed 90-day survival and calculated adjusted hazard ratios (HR) and 95% confidence intervals (95% CI) for creatinine groups, adjusting for age and sex. Patients with the largest creatinine increases (50% to 99% or Ն100%) had significantly higher 90-day mortality compared with patients with a smaller increase (Ͻ50%; PϽ0.001). Adjusted HR and 95% CI confirmed patients in the higher 2 groups had an increased risk of mortality compared with the Ͻ25% (referent); however, the 25% to 49% group was not different from the referent: 1.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Perioperative Increases in Serum Creatinine Are Predictive of Increased 90-Day Mortality After Coronary Artery Bypass Graft Surgery

Brown¹,

Cochran²,

Dacey³

et al. 2006

Circulation

122

100

View full text Add to dashboard Cite

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“…1 However, studies reporting the association of small changes in sCr with adverse short-term outcomes are emerging in the literature. [2][3][4] …”

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confidence: 99%

Acute Kidney Injury Is Associated With Increased Long-Term Mortality After Cardiothoracic Surgery

et al. 2009

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Background-Long-term survival after acute kidney injury (AKI) is poorly studied. We report the relationship between long-term mortality and AKI with small changes in serum creatinine during hospitalization after various cardiothoracic surgery procedures. Methods and Results-This was a retrospective study of 2973 patients with no history of chronic kidney disease who were discharged from the hospital after cardiothoracic surgery between 1992 and 2002. AKI was defined by the RIFLE classification (Risk, Injury, Failure, Loss, and End stage), which requires at least a 50% increase in serum creatinine and stratifies patients into 3 grades of AKI: Risk, injury, and failure. Patient survival was determined through the National Social Security Death Index. Long-term survival was analyzed with a risk-adjusted Cox proportional hazards regression model. Survival was worse among patients with AKI and was proportional to its severity, with an adjusted hazard ratio of 1.23 (95% CI 1.06 to 1.42) for the least severe RIFLE risk class and 2.14 (95% CI 1.73 to 2.66) for the RIFLE failure class compared with patients without AKI. Survival was worse among all subgroups of cardiothoracic surgery with AKI except for valve surgery. Patients with complete renal recovery after AKI still had an increased adjusted hazard ratio for death of 1.28 (95% CI 1.11 to 1.48) compared with patients without AKI. Conclusions-The

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“…[4] Preoperative comorbidities and intraoperative factors are of utmost importance and they may be modifiable factors for developing AKI. [5] Karkouti et al [16] described major risk factors of AKI as follows: intraoperative mean arterial pressure, pre-and intraoperative anemia, need for intraoperative red blood cell transfusion, and pre-and intraoperative proinflammatory activity due to other organic diseases. Considering the comorbidities, there is a number of studies showing that diabetes mellitus, chronic obstructive pulmonary disease, high body mass index, congestive heart failure, and cardiopulmonary bypass time are important factors for AKI development.…”

Section: Discussionmentioning

confidence: 99%

“…Currently, many studies have shown that mild changes in sCr levels can be associated with high morbidity and mortality rates in the early and late postoperative period, and even after discharge from hospital with cardiac and renal recovery. [3,5] In recent years, several studies have addressed to the definition of AKI and certain criteria have been developed to define AKI and to monitor the severity of the disease, including Renal Risk, Injury, Failure, Loss of Kidney Function, End-stage Renal Disease (RIFLE) and the latest Acute Kidney Injury Network Criteria (AKIN), which focuses on mild sCr changes, have been shown to be more sensitive and specific, compared to the RIFLE. [6][7][8] Although coronary artery bypass grafting (CABG) is a risk factor for AKI, cardiac valve surgery has a higher risk for postoperative AKI.…”

mentioning

confidence: 99%

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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Incidence, risk factors, and prognosis of a moderate increase in plasma creatinine early after cardiac surgery*

Cited by 136 publications

References 14 publications

Perioperative Increases in Serum Creatinine Are Predictive of Increased 90-Day Mortality After Coronary Artery Bypass Graft Surgery

Perioperative Increases in Serum Creatinine Are Predictive of Increased 90-Day Mortality After Coronary Artery Bypass Graft Surgery

Acute Kidney Injury Is Associated With Increased Long-Term Mortality After Cardiothoracic Surgery

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

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