Meta-analysis for outcomes of acute kidney injury after cardiac surgery

Shi, Qiankun; Liang, Hong; Mu, Xinwei; Zhang, Cui; Chen, Xin

doi:10.1097/md.0000000000005558

Cited by 11 publications

(10 citation statements)

References 33 publications

(35 reference statements)

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“…AKI after cardiac surgery (CS-AKI) patients have higher mortality rates than those who did not develop AKI [4,5], and the mortality rate of AKI-renal replacement therapy (AKI-RRT) patients has been reported to be 41.4-65% [6,7,8,9]. Current research has found that there are many factors related to the incidence of CS-AKI and its outcome, with body mass index (BMI) being one of these risk factors.…”

Section: Introductionmentioning

confidence: 99%

Role of Body Mass Index in Acute Kidney Injury Patients after Cardiac Surgery

et al. 2017

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Background/Aims: To explore the association of body mass index (BMI) with the risk of developing acute kidney injury after cardiac surgery (CS-AKI) and for AKI requiring renal replacement therapy (AKI-RRT) after cardiac surgery. Methods: Clinical data of 8,455 patients undergoing cardiac surgery, including demographic preoperative, intraoperative, and postoperative data were collected. Patients were divided into underweight (BMI <18.5), normal weight (18.5≤ BMI <24), overweight (24≤ BMI <28), and obese (BMI ≥28) groups. The influence of BMI on CS-AKI incidence, duration of hospital, and intensive care unit (ICU) stays as well as AKI-related mortality was analyzed. Results: The mean age of the patients was 53.2 ± 13.9 years. The overall CS-AKI incidence was 33.8% (n = 2,855) with a hospital mortality of 5.4% (n = 154). The incidence of AKI-RRT was 5.2% (n = 148) with a mortality of 54.1% (n = 80). For underweight, normal weight, overweight, and obese cardiac surgery patients, the AKI incidences were 29.9, 31.0, 36.5, and 46.0%, respectively (p < 0.001). The hospital mortality of AKI patients in the 4 groups was 9.5, 6.0, 3.8, and 4.3%, whereas the hospital mortality of AKI-RRT patients in the 4 groups was 69.2, 60.8, 36.4, and 58.8%, both significantly different (p < 0.05). Hospital and ICU stay durations were not significantly different in the 4 BMI groups. Conclusion: The hospital prognosis of AKI and AKI-RRT patients after cardiac surgery was best when their BMI was in the 24-28 range.

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Section: Introductionmentioning

confidence: 99%

Role of Body Mass Index in Acute Kidney Injury Patients after Cardiac Surgery

et al. 2017

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“…The in‐hospital mortality was 4.3%, with the odds ratio of 4.93 ( P < .001). AKI has also been reported to increase the mortality in several conditions, such as critical illness, acute coronary syndrome, solid organ/hematologic transplantation, cirrhosis, stroke and cardiac surgery 26‐34 . In addition, greater degree of resource utilisation, including renal replacement therapy, invasive/non‐invasive mechanical ventilation support and blood transfusion has been correlated with AKI.…”

Section: Discussionmentioning

confidence: 99%

Acute kidney injury among salicylate intoxication hospitalisations in the United States

et al. 2020

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Background This study aimed to evaluate the risk factors and the association of acute kidney injury (AKI) with outcomes, and resource utilisation in patients hospitalised because of salicylate intoxication in the United States. Methods Hospitalised patients with a primary diagnosis of salicylate intoxication from 2003 to 2014 were identified in the National Inpatient Sample (NIS) database. End‐stage kidney disease patients were excluded. The occurrence of AKI was identified using hospital diagnosis code. Clinical characteristics, in‐hospital treatment, outcomes and resource utilisation were compared between patients with and without AKI. Results A total of 13 787 eligible hospital admissions were included in the analysis. AKI occurred in 1279 (9.3%) admissions. Older age, male sex, more recent year of hospitalisation, anaemia, hypertension, congestive heart failure, chronic kidney disease, volume depletion, sepsis and ventricular arrhythmia/cardiac arrest were significantly associated with increased risk of AKI, whereas Hispanic race was associated with decreased risk. AKI was significantly associated with increased risk of organ failure, and in‐hospital mortality. In addition, the need for ventilation support, blood component transfusion, renal replacement therapy, length of hospital stay and hospitalisation cost were higher in AKI patients. Conclusion Approximately one tenth of salicylate intoxication patients developed AKI during hospitalisation. AKI was associated with higher morbidity, mortality and resource utilisations.

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“…Contributing factors are oxidative stress during renal I/R-injury, inflammation, hemolysis, cholesterol emboli, nephrotoxic drugs and toxins resulting in glomerular and tubular damage, reduced glomerular filtration rates and impaired creatinine clearance, as shown in Figure 5 . AKI is strongly associated with the need for renal replacement therapy, increased hospital- and ICU-LOS, mortality and decreased long-term quality of life [ 3 , 108 , 109 , 110 , 111 , 112 , 113 , 114 ].…”

Section: Influence Of Vitamin C On Organ Systems In Cardiac Surgermentioning

confidence: 99%

Vitamin C to Improve Organ Dysfunction in Cardiac Surgery Patients—Review and Pragmatic Approach

et al. 2018

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The pleiotropic biochemical and antioxidant functions of vitamin C have sparked recent interest in its application in intensive care. Vitamin C protects important organ systems (cardiovascular, neurologic and renal systems) during inflammation and oxidative stress. It also influences coagulation and inflammation; its application might prevent organ damage. The current evidence of vitamin C’s effect on pathophysiological reactions during various acute stress events (such as sepsis, shock, trauma, burn and ischemia-reperfusion injury) questions whether the application of vitamin C might be especially beneficial for cardiac surgery patients who are routinely exposed to ischemia/reperfusion and subsequent inflammation, systematically affecting different organ systems. This review covers current knowledge about the role of vitamin C in cardiac surgery patients with focus on its influence on organ dysfunctions. The relationships between vitamin C and clinical health outcomes are reviewed with special emphasis on its application in cardiac surgery. Additionally, this review pragmatically discusses evidence on the administration of vitamin C in every day clinical practice, tackling the issues of safety, monitoring, dosage, and appropriate application strategy.

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Meta-analysis for outcomes of acute kidney injury after cardiac surgery

Abstract: Supplemental Digital Content is available in the text

Cited by 11 publications

References 33 publications

Role of Body Mass Index in Acute Kidney Injury Patients after Cardiac Surgery

Role of Body Mass Index in Acute Kidney Injury Patients after Cardiac Surgery

Acute kidney injury among salicylate intoxication hospitalisations in the United States

Vitamin C to Improve Organ Dysfunction in Cardiac Surgery Patients—Review and Pragmatic Approach

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