Relation between Prolonged Cardiopulmonary Bypass Time in Cardiac Surgery in Adult Patients and Post-Operative Acute Kidney Injury

Abstract

Background Cardiac-surgery associated acute kidney injury (CSA-AKI) remains an important and frequent complication in patients undergoing cardiac surgery and is associated with a poor short- and long-term prognosis. The incidence for CSA-AKI according to Acute Kidney Injury Network criteria (AKIN) varies between 3% and 50%. CSA-AKI requiring temporary renal replacement therapy (RRT) occurs in 5% to 20% of these patients and is associated with a high mortality rate. Objective To detect the relation between prolonged cardiopulmonary bypass time in cardiac surgery and the incidence of post-operative acute kidney injury. Patients and Methods This is an observational retrospective study conducted on (80) adult patients who underwent elective cardiac surgery at Aswan Heart Centre (Magdi Yacoub Foundation) after the approval of the Ethical Medical Committee of Aswan Heart Centre. Results Results of the statistical analysis of the present study showed that mean CPB duration was prolonged in the AKI group of patients (155 min) than the non-AKI group of patients (129 min). Conclusion Prolonged cardiopulmonary bypass duration may be an independent risk factor for acute kidney injury post cardiac surgery in adult patients.

Microvascular dysfunction following cardiopulmonary bypass plays a central role in postoperative organ dysfunction

“…The incidence of AKI following cardiac surgery has been reported to be as low as 3.4% and as high as 40% ( 74 – 76 ). Indeed, longer duration of CPB is related to increased likelihood of postoperative AKI and acute renal failure requiring renal replacement therapy ( 77 – 80 ). Many factors have been shown to contribute to this, including hypotension and hemodynamic disturbances, inflammation, and nephrotoxins; Figure 3 provides an overview of factors influencing AKI after cardiac surgery.…”