Risk Factors for Perioperative Acute Kidney Injury After Adult Cardiac Surgery: Role of Perioperative Management

Parolari, Alessandro; Pesce, Lorenzo L.; Pacini, Davide; Mazzanti, Valeria; Salis, Stefano; Sciacovelli, Chiarangela; Rossi, Fabiana; Alamanni, Francesco

doi:10.1016/j.athoracsur.2011.09.073

Cited by 227 publications

(197 citation statements)

References 19 publications

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“…The risk factors for CABG-associated AKI revealed by our study are mostly consistent with those in previous studies, which have reported that decreased LVEF, 6,7 poor baseline renal function, 7,19 hypoalbuminemia, 20,21 and large-volume intraoperative transfusion 19 are associated with postoperative AKI.…”

Section: Discussionsupporting

confidence: 81%

Association Between Elevated Echocardiographic Index of Left Ventricular Filling Pressure and Acute Kidney Injury After Off-Pump Coronary Artery Surgery

Hur

Nam

et al. 2018

Circ J

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and mortality. 4,9 Hemodynamic disturbance during OPCAB has been reported to have a biventricular contribution, and the major cause is believed to be diastolic dysfunction and abnormal filling of both ventricles. 10,11 As such, it is possible that an underlying increased LVFP may aggravate the intraoperative hemodynamic disturbance, resulting in a higher rate of postoperative AKI. Although previous studies have reported the effect of diastolic dysfunction on postoperative outcomes, including death or major adverse cardiac events (MACE), 4,12 postoperative renal dysfunction was evaluated only as a secondary outcome and the association between increased LVFP in patients with normal LV systolic function and postoperative AKI has not been fully evaluated.The ratio of the early transmitral blood flow velocity to early diastolic velocity of the mitral annulus (E/e′) has been reported to have good predictive power for mean LV diastolic pressure or mean LVFP and has been used to estimate the diastolic function of the heart. 13,14 E/e′ >15 is P erioperative acute kidney injury (AKI) has been reported to be an important contributor to postoperative morbidity and mortality especially after cardiovascular surgery, including coronary artery bypass graft (CABG). 1,2 Off-pump coronary artery bypass surgery (OPCAB) has been associated with less severe and a lower incidence of AKI compared with on-pump CABG. 3 Nonetheless, there is still a substantial incidence of AKI after OPCAB and it is caused by transient circulatory arrest, global hypoperfusion, myocardial ischemia-reperfusion injury, and inflammatory response. 3 The incidence of diastolic dysfunction in patients who undergo CABG has been reported as high. 4,5 Although many studies have reported systolic dysfunction of the heart as a risk factor for postoperative AKI, 6,7 the association between preoperative diastolic dysfunction and postoperative AKI has not been investigated. A stiff left ventricle with low compliance would lead to an elevated LV filling pressure (LVFP), 8 which is associated with higher morbidity Background: The ratio of the early transmitral flow velocity to early diastolic velocity of the mitral annulus (E/e′) is an echocardiographic index of mean left ventricular (LV) filling pressure. We investigated the association between the preoperative E/e′ ratio and postoperative acute kidney injury (AKI) during off-pump coronary artery bypass surgery (OPCAB).

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Section: Discussionsupporting

confidence: 81%

Association Between Elevated Echocardiographic Index of Left Ventricular Filling Pressure and Acute Kidney Injury After Off-Pump Coronary Artery Surgery

Hur

Nam

et al. 2018

Circ J

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“…Previous reports have also indicated that patients with a history of cardiovascular disease are at high risk for AKI [8,9,10]. A history of diabetes mellitus has also been demonstrated to be one of the risk factors of AKI in some clinical studies [11,12]. As these diseases promote arteriosclerosis and glomerular sclerosis, such damage may influence the occurrence of CIA.…”

Section: Discussionmentioning

confidence: 99%

The Risk Factors of Severe Acute Kidney Injury Induced by Cisplatin

Mizuno¹,

Ishikawa

Sato

et al. 2013

Oncology

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Objectives: We reported that the KDIGO (Kidney Disease: Improving Global Outcomes) criteria could stratify the risk of mortality in acute kidney injury (AKI) caused by cisplatin. The purpose of this study was to investigate risk factors of severe cisplatin-induced AKI (CIA). Methods: From January 2006 to December 2012, we identified Japanese cancer patients who were treated with cisplatin as a first-line chemotherapy at Nagoya University Hospital. Serum creatinine levels were used to define CIA. Results: We evaluated 1,721 patients treated with cisplatin. In multivariable analysis, cisplatin dosages/m² [odds ratio (OR) 1.019] or diagnosis of cancer stage 4 (OR 1.797) were risk factors of moderate CIA. History of diabetes mellitus (OR 3.454), history of cardiovascular disease (OR 3.612) or diagnosis of cancer stage 4 (OR 2.610) were risk factors of severe CIA. Conclusions: Diabetes mellitus, cardiovascular disease and advanced cancer increased the risk of severe CIA. As severe CIA shortens the survival period, we should consider whether the use of cisplatin benefits these patients.

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“…[8,24] Given that advanced age is not a preventable risk factor, the management of preventable factors becomes more important in elderly patients in order to protect renal functions following cardiac surgery. Currently, various tests are being used to accomplish this.…”

Section: Discussionmentioning

confidence: 99%

An evaluation of renal functions in pulsatile and non-pulsatile cardiopulmonary bypass in the elderly

Hökenek¹

2013

Turk Gogus Kalp Dama

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Risk Factors for Perioperative Acute Kidney Injury After Adult Cardiac Surgery: Role of Perioperative Management

Cited by 227 publications

References 19 publications

Association Between Elevated Echocardiographic Index of Left Ventricular Filling Pressure and Acute Kidney Injury After Off-Pump Coronary Artery Surgery

Association Between Elevated Echocardiographic Index of Left Ventricular Filling Pressure and Acute Kidney Injury After Off-Pump Coronary Artery Surgery

The Risk Factors of Severe Acute Kidney Injury Induced by Cisplatin

An evaluation of renal functions in pulsatile and non-pulsatile cardiopulmonary bypass in the elderly

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