Renal Dysfunction After Cardiac Surgery with Normothermic Cardiopulmonary Bypass: Incidence, Risk Factors, and Effect on Clinical Outcome

Abstract

We found that postoperative renal dysfunction was a frequent and severe complication after normothermic cardiac surgery, independently associated with poor outcome. Independent predictors of this complication were advanced age, active endocarditis, and recent (within 48 h) radiocontrast agent administration (the only preoperative modifiable factor), as well as postoperative hemodynamic dysfunction.

Nadir Oxygen Delivery on Bypass and Hypotension Increase Acute Kidney Injury Risk After Cardiac Operations

“…Using our definition of AKI as an increase in serum creatinine of greater than 50%, one group reported an associated inhospital mortality rate of nearly 30% [2]. Patients who progress to dialysis have an associated mortality rate of up to 60% [2,17].…”

“…Postoperative hypotension on POD0 or POD1 and low DO 2 on CPB both independently increase the AKI risk in cardiac surgical patients. D epending on the definition used, acute kidney injury (AKI) affects 20% to 40% of all cardiac surgical patients [1][2][3][4]. The onset of AKI is universally associated with poor outcomes [5,6], and even small decreases in the glomerular filtration rate (GFR) have been demonstrated to confer an increased risk of morbidity and death in this demographic [7].…”

Effects of Mannitol and Dopamine on Renal Function in Coronary Artery Bypass Surgery

“…Kalp cerrahisini takiben ortaya çıkan renal disfonksiyon multifaktöriyeldir ve perioperatif düşük kalp debisi ya da KPB'a bağlanmak-tadır (5)(6)(7) . Spesifik olarak ilişkili diğer daha fazla tartışılan baypas işlemi ile ilgili risk faktörleri ise, kros-klemp zamanı, özellikle 70 dk.…”

“…Spesifik olarak ilişkili diğer daha fazla tartışılan baypas işlemi ile ilgili risk faktörleri ise, kros-klemp zamanı, özellikle 70 dk. 'dan daha uzun olan KPB süresi (8) , pulsatil veya nonpulsatil baypas akımı (5) , normotermik veya hipotermik baypas (6) ve pompalı veya pompasız koroner arter baypas cerrahisi olarak belirlenmiştir (9) . KPB boyunca serbest plazma hemoglobini, elastaz, endotelin, serbest radikaller (süperok-sit, hidrojen peroksit) ve hidroksil radikalleri oluşup renal hasara neden olabilir (10,11) .…”

The eNOS 786C/T polymorphism in cardiac surgical patients with cardiopulmonary bypass is associated with renal dysfunction

“…It is a frequent complication in the postoperative period of cardiac surgery with cardiopulmonary bypass, with a reported incidence of between 1% and 31% [2][3][4][5][6]. When renal failure develops following cardiac surgery, and is served and associated with the need for haemodiaylsis support, it is associated with an increased mortality and hospital stay [7,2].…”