Logistic risk model predicting postoperative renal failure requiring dialysis in cardiac surgery patients☆

Rahmanian, Parwis B.; Kwiecień, Grzegorz; Langebartels, Georg; Madershahian, Navid; Wittwer, Thorsten; Wahlers, Thorsten

doi:10.1016/j.ejcts.2010.12.051

Cited by 30 publications

(52 citation statements)

References 25 publications

(24 reference statements)

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“…[4] Prior studies have largely investigated clinical risk factors for new onset of dialysis-dependent renal failure occurring during the post-operative period after cardiac surgery. Clinical risk factors have included older age,[7, 13] sex,[11] race,[7] diabetes,[7–9, 13, 20, 21] peripheral vascular disease,[21, 22] baseline eGFR[9, 22] (or baseline SCr),[6–8, 13, 20, 21] poor ejection fraction,[6, 8, 9, 22] New York Heart Association class,[6–8, 13, 21, 22] congestive heart failure,[11, 20] prior acute myocardial infarction,[7, 11, 21] atrial fibrillation,[21] lung disease or chronic obstructive pulmonary disease,[6–8, 22] pre-operative intra-aortic balloon pump,[6, 8, 9, 22] emergent surgery,[8, 9] type of surgery,[6–9, 13] reoperation,[6–8, 20, 22] and low cardiac output failure or use of more than two inotropes. [11, 13] Only three studies investigated perfusion characteristics such as cardiopulmonary bypass time >120 or >180 minutes.…”

Section: Commentmentioning

confidence: 99%

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Determinants of Acute Kidney Injury Duration After Cardiac Surgery: An Externally Validated Tool

Brown

Kramer

MacKenzie³

et al. 2012

The Annals of Thoracic Surgery

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Background Acute kidney injury (AKI) duration following cardiac surgery is associated with poor survival in a dose-dependent manner. However, it is not known what peri-operative risk factors contribute to prolonged AKI and delayed recovery. We sought to identify peri-operative risk factors that predict duration of AKI, a complication that effects short and long term survival. Methods We studied 4,987 consecutive cardiac surgery patients from 2002 through 2007. AKI was defined as a ≥0.3 (mg/dL) or ≥50% increase in SCr from baseline. Duration of AKI was defined by the number of days AKI was present. Step-wise multivariable negative binomial regression analysis was conducted using peri-operative risk factors for AKI duration. C-index was estimated by Kendall’s tau. Results AKI developed in 39% of patients with a median duration of AKI at 3 days and ranged from 1 to 108 days. Patients without AKI had duration of zero days. Independent predictors of AKI duration included baseline patient and disease characteristics, operative and post-operative factors. Prediction for mean duration of AKI was developed using coefficients from the regression model and externally validated the model on 1,219 cardiac surgery patients in a separate cardiac surgery cohort (TRIBE-AKI). The C-index was 0.65 (p<0.001) for the derivation cohort and 0.62 (p<0.001) for the validation cohort. Conclusion We identified and externally validated peri-operative predictors of AKI duration. These risk-factors will be useful to evaluate a patient’s risk for the tempo of recovery from AKI after cardiac surgery and subsequent short and long term survival. The level of awareness created by working with these risk factors have implications regarding positive changes in processes of care that have the potential to decrease the incidence and mitigate AKI.

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Section: Commentmentioning

confidence: 99%

“…[11, 13] Only three studies investigated perfusion characteristics such as cardiopulmonary bypass time >120 or >180 minutes. [11, 13, 20, 21]…”

Section: Commentmentioning

confidence: 99%

Determinants of Acute Kidney Injury Duration After Cardiac Surgery: An Externally Validated Tool

Brown

Kramer

MacKenzie³

et al. 2012

The Annals of Thoracic Surgery

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“…Rahamanian and colleagues and Aronson S et al described congestive heart failure as a risk factor for the development of post-surgery ARF. 15,8 Lohr et al found that both "congestive heart failure" (CHF) and systolic blood pressure less than 110 mmHg were associated with mortality. 16 Lien and Chan found that "heart failure" influenced survival in a retrospective analysis of 58 patients in case of ARF.…”

Section: Discussionmentioning

confidence: 99%

“…16 According to Chertow GM, Thakar CV, Wijeysundra DN and Rahmanian PB and colleauges low ejection fraction is a risk factor for post cardiac surgery acute renal failure. 2,[13][14][15] The effects of diabetes mellitus on postoperative renal failure may be the result of renal parenchymal disease, such as glomerulonephritis. Out of 50 patients, only 2 patients were diabetic and post operatively acute renal failure was not seen in either of them.…”

Section: Discussionmentioning

confidence: 99%

Pre-operative and peri operative predictors of acute renal failure after cardiac surgery

Dhaulta

Panwar

2019

Int J Adv Med

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Background: Acute kidney injury (AKI) is one of the most serious complications during the postoperative period of cardiac surgery. Multiple variables predict the ARF after cardiac surgery. Objective of this study was to evaluate the significance of pre and peri-operative variables which may help in predicting the chances of developing ARF after cardiac surgery.Methods: This study was an observational, prospective study conducted among patients who were scheduled to undergo open heart surgery under cardiopulmonary bypass.Results: In total, 50 patients who underwent open-heart surgery, ARF was seen in 5 patients, with the incidence rate of 10%. Acute renal failure was present in one patient with ejection fraction <35, 2 patients had ejection fraction between 35 to 50 and 2 patients with ejection fraction >50. It was seen in 4 patients with 1-2 hrs of cardiopulmonary bypass and in 1 patient with >2 hrs of cardiopulmonary bypass. ARF was also seen in 4 patients with hematocrit between 22-26% and in 1 patient with >26%.Conclusions: The study provided a clinical variable score that can predict ARF after open-heart surgery. The score enhances the accuracy of prediction by accounting for the effect of all major risk factors of ARF.

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“…AKI associated with a cardiac operation is known to confer increased risk for both early and late death [4][5][6][7][8]. Among those who develop AKI, renal replacement therapy is required in 1% to 5% of patients [1,4,9,10] and carries an associated mortality of 25% to 50% [10][11][12]. Patients who experience recovery of renal function after AKI associated with a cardiac operation are still vulnerable to significantly increased rates of long-term mortality and progression to chronic kidney disease [5].…”

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confidence: 99%

Renal Failure After Cardiac Operations: Not All Acute Kidney Injury Is the Same

Crawford

Magruder

Grimm

et al. 2017

The Annals of Thoracic Surgery

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Logistic risk model predicting postoperative renal failure requiring dialysis in cardiac surgery patients☆

Cited by 30 publications

References 25 publications

Determinants of Acute Kidney Injury Duration After Cardiac Surgery: An Externally Validated Tool

Determinants of Acute Kidney Injury Duration After Cardiac Surgery: An Externally Validated Tool

Pre-operative and peri operative predictors of acute renal failure after cardiac surgery

Renal Failure After Cardiac Operations: Not All Acute Kidney Injury Is the Same

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