Is kidney function altered by the duration of cardiopulmonary bypass?

Boldt, Joachim; Brenner, Torsten; Lehmann, Andreas; Suttner, Stefan; Kumle, Bernhard; Isgro, Frank

doi:10.1016/s0003-4975(02)04559-9

Cited by 112 publications

(70 citation statements)

References 24 publications

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“…Se atribuye un papel determinante en la generación del insulto renal a la hemólisis producida por el uso de rodillos y a la succión del reservorio de cardiotomía, así como a la liberación de hemoglobina y radicales libres. También la hemodilución que se genera durante la CEC sería responsable de isquemia renal medular (9,10,12) . La canulación y el clampeo aórtico se asocian con incremento de fenómenos ateroembólicos renales que exacerban la isquemia e inducen inflamación (26) .…”

Section: Discussionunclassified

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

2018

Rev.Urug.Cardiol.

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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.

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Section: Discussionunclassified

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

2018

Rev.Urug.Cardiol.

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“…[26] Boldt ve ark. [27] çalışmalarında kross klemp süresi 90 dk'yı geçen hastalarda ABY gelişme oranını, kross klemp süresi 70 dk'nın altında olan hastalara göre belirgin yüksek bulmuşlardır. Chertow ve ark.…”

Section: Discussionunclassified

Does serum neutrophil gelatinase-associated lipocalin biomarker detect the early deterioration in renal functions in patients with insulin-dependent diabetes mellitus undergoing coronary artery bypass graft surgery?

Bugra¹

2014

Turk Gogus Kalp Dama

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“…3 Studies have demonstrated that patients with CPB times more than 90 min showed more pronounced kidney damage than patients with CPB times less than 70 min. 13,30 We were unable to determine a cut-off value due to the wide range of clinical data. Contrast-induced nephropathy can occur after angiography, particularly in infants and neonates.…”

Section: Discussionmentioning

confidence: 99%

Early Initiation of Peritoneal Dialysis after Arterial Switch Operations in Newborn Patients

et al. 2012

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Background and aim: We investigated the clinical outcome of early initiated peritoneal dialysis (PD) use in our newborn patients who underwent arterial switch operation (ASO) for transposition of the great arteries (TGA) and had routine intraoperative PD catheter implantation. We determined the risk factors for PD, factors associated with prolonged PD, morbidity, and mortality. The aim of the present study was to describe our experience of using PD in this patient cohort. Materials and Methods: Eighty two patients who were diagnosed with TGA and TGA-ventricular septal defect (VSD) and who had undergone TGA correction operation in Başkent University, Istanbul Medical Research and Training Hospital between 2007 and 2012 were retrospectively investigated. All the patients were under 30 days old. PD catheters were routinely implanted intraoperatively at the end of the operation. PD was initiated in transient renal insufficiency. In the absence of oliguria and increased creatinine level, PD was established in the presence of one of the following: clinical signs of fluid overload, hyperkalemia (>5 mEq/L), persistent metabolic acidosis, lactate level above 8 mmol/L or low cardiac output syndrome. The patients were divided into two groups according to the need for postoperative PD (PD group and non-PD group). PD was initiated in 32 (39%) patients after the operation, whereas 50 (61%) patients did not need dialysis. The clinical outcomes and perioperative data of the two groups were compared. Results: The demographics in the two groups were similar. Cardiopulmonary bypass time was longer in the PD group [non-PD group, 175.24 AE 32.39 min; PD group, 196.22 AE 44.04 min (p < 0.05)]. Coronary anomaly was found to be higher in the PD group [non-PD group, n ¼ 2 patients (4.0%); PD group, n ¼ 7 patients (21.9%); p < 0.05]. There was more need for PD in TGA þ VSD patients [simple TGA patients, n ¼ 14; TGA þ VSD patients, n ¼ 18 (p < 0.05)]. PD rate was higher in patients whose sterna were left open at the end of the operation (p < 0.05).

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Is kidney function altered by the duration of cardiopulmonary bypass?

Cited by 112 publications

References 24 publications

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

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

Does serum neutrophil gelatinase-associated lipocalin biomarker detect the early deterioration in renal functions in patients with insulin-dependent diabetes mellitus undergoing coronary artery bypass graft surgery?

Early Initiation of Peritoneal Dialysis after Arterial Switch Operations in Newborn Patients

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