The Influence of Metabolic Syndrome on Acute Kidney Injury Occurrence after Coronary Artery Bypass Grafting

Kunt, Atike Tekeli; Parlar, Hakan; Findik, Orhan; Düzyol, Çağrı; Barış, Özgür; Balcı, Canan

doi:10.1532/hsf.1400

Cited by 9 publications

(6 citation statements)

References 22 publications

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“…The same result was obtained by Hertzberg D et al, they reported both type 1 and 2 DM were associated with an increased risk of AKI after CABG [21]. A Tekeli Kunt et al reported the presence of metabolic syndrome (hyperglycemia, dyslipidemia, abdominal obesity, and hypertension) seemed to be associated with increased incidence of AKI after CABG [22]. Oezkur et al concluded that chronic hyperglycemia defined on a single measurement of hemoglobin A1c ≥ 6.0% was also associated with the incidence of AKI after CABG.…”

Section: Discussionsupporting

confidence: 68%

The impact of diabetes mellitus on acute kidney injury after coronary artery bypass grafting

Zhang

Zhu

et al. 2020

J Cardiothorac Surg

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Background Diabetes mellitus(DM) is an indicator affects postoperative mortality and morbidity after coronary artery bypass grafting (CABG). Acute kidney injury (AKI) is one of the frequent postoperative complications after CABG. This multi-centre register study designed to investigate the impact of DM on postoperative AKI in primary isolated CABG patients. Methods We included all patients (n = 4325) from Jiangsu Province CABG register who underwent primary isolated CABG from September 2017 to August 2019. The patients were divided into 3 groups: No-DM group(n = 3067), DM-oral group (DM with oral hypoglycemic agents, n = 706) and DM-insulin group (DM with insulin treatment, n = 552). The development and severity of AKI were based on Acute Kidney Injury Network (AKIN) criteria. Results There were totally 338, 108 and 145 patients developed AKI in No-DM, DM-oral and DM-insulin group respectively. Comparing with No-DM group, DM-oral group had a higher rate of AKI(χ2 = 10.071, p = 0.002), DM-insulin group had a higher rate(χ2 = 94.042, p<0.001) and severity of AKI(χ2 = 10.649, p = 0.005). The adjusted odds ratio for AKI was 1.26 (95% CI 1.03–1.57) in DM-oral group and 3.92 (95% CI 3.27–5.16) in DM-insulin group, in comparison with No-DM group. Conclusions Independent of baseline renal function or cardiac function, DM was associated with an increased risk of AKI after CABG, especially in patients with insulin treatment, who also had a higher severity of AKI.

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Section: Discussionsupporting

confidence: 68%

The impact of diabetes mellitus on acute kidney injury after coronary artery bypass grafting

Zhang

Zhu

et al. 2020

J Cardiothorac Surg

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“…The same result was obtained by Hertzberg D et al, they reported both type 1 and 2 DM were associated with an increased risk of AKI after CABG [21] . A Tekeli Kunt et al reported the presence of metabolic syndrome (hyperglycemia, dyslipidemia, abdominal obesity, and hypertension) seemed to be associated with increased incidence of AKI after CABG [22] . Oezkur et al concluded that chronic hyperglycemia de ned on a single measurement of hemoglobin A1c ≥ 6.0% was also associated with the incidence of AKI after CABG.…”

Section: Discussionmentioning

confidence: 99%

The Impact of Diabetes Mellitus on Acute Kidney Injury after Coronary Artery Bypass Grafting

Wang¹,

Zhang²,

Zhu³

et al. 2020

Preprint

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Abstract Background: Diabetes mellitus(DM) is an indicator affects postoperative mortality and morbidity after coronary artery bypass grafting (CABG). Acute kidney injury (AKI) is one of the frequent postoperative complications after CABG. This multi-centre register study designed to investigate the impact of DM on postoperative AKI in primary isolated CABG patients. Methods: We included all patients (n =4325) from Jiangsu Province CABG register who underwent primary isolated CABG from September 2017 to August 2019. The patients were divided into 3 groups: A group(non-DM, n=3067), B group(DM with oral hypoglycemic agents, n=706) and C group(DM with insulin treatment, n=552). The development and severity of AKI were based on Acute Kidney Injury Network (AKIN) criteria. Results: There were totally 338, 108 and 145 patients developed AKI in A,B and C group respectively. Comparing with A group , B group had a higher rate of AKI(c2=10.071, p=0.002), C group had a higher rate(c2=94.042, p＜0.001) and severity of AKI(c2=10.649, p=0.005). The adjusted odds ratio for AKI was 1.26 (95% CI 1.03-1.57) in B group and 3.92 (95% CI 3.27-5.16) in C group, in comparison with A group. Conclusions: Independent of baseline renal function or cardiac function, DM was associated with an increased risk of AKI after CABG, especially in patients with insulin treatment, who also had a higher severity of AKI.

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“…Included Studies). Most studies reported North America data ( n =40) 4 – 6 , 15 , 23 , 27 , 30 – 35 , 38 – 40 , 43 , 46 – 49 , 52 , 53 , 55 – 62 , 65 – 67 , 70 , 73 , 75 – 78 , 80 , with the remaining spanning Europe 19 , 21 , 22 , 24 , 28 , 42 , 44 , 50 , 51 , 64 , 68 , 81 , the Middle East 20 , Asia 37 , 41 , 45 , 71 , 72 , 74 , 82 , 83 , Africa 63 , and South America 54 . The assessed risk of bias of the included studies ranged from 5 to 8 (fair to good) out of a possible 9 stars when assessed using the NOS.…”

Section: Resultsmentioning

confidence: 99%

“…Across these studies, a total of 333 488 patients with MetS underwent surgery versus 1 449 817 surgical patients without MetS. We found fifteen of 44 studies reported an increased risk of mortality across a range of surgical types including bariatric 39 , 43 , 57 , cardiac 19 , 42 , ear, nose, and throat (ENT) 35 , emergency 31 , endocrine 59 , 84 , gastrointestinal 40 , hepatobiliary 23 , 33 , 34 , neurosurgery 49 , and orthopaedic 47 . Twenty-five studies considered for meta-analysis found no association with 30-day mortality between MetS and non-MetS patients across a wide range of surgical types.…”

Section: Resultsmentioning

confidence: 99%

“…Across these studies, a total of 109 910 patients with MetS underwent surgery versus 650 525 surgical patients without MetS. In the studies considered for meta-analysis, 14 out of 22 were statistically associated with an increase in hospital readmission across a range of surgeries including bariatric 39 , endocrine 32 , 59 , ENT 35 , emergency general surgery 31 , gastrointestinal 40 , orthopaedic 6 , 46 , 47 , 67 , 73 , 78 , and plastics 56 , 77 . The remaining eight studies included for meta-analysis found no association with hospital readmission between MetS and non-MetS patients.…”

Section: Resultsmentioning

confidence: 99%

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Metabolic syndrome and surgical complications: a systematic review and meta-analysis of 13 million individuals

Norris,

Gow,

Arthur

et al. 2023

International Journal of Surgery

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Background: Metabolic syndrome is characterised by the presence of at least three of the five following components: insulin resistance, obesity, chronic hypertension, elevated serum triglycerides and decreased high-density lipoprotein cholesterol concentrations. It is estimated to affect 1 in 3 people around the globe and reported to affect 46% of surgical patients. For people with metabolic syndrome who undergo surgery, an emerging body of literature points to significantly poorer postoperative outcomes compared with non-affected populations. The aim of this study is to review the current evidence on risks of surgical complications in patients with metabolic syndrome compared to those without metabolic syndrome. Methods: Systematic review and meta-analysis using PRISMA and AMSTAR reporting guidelines. Results: The meta-analysis included 63 studies involving 1,919,347 patients with metabolic syndrome and 11,248,114 patients without metabolic syndrome. Compared to individuals without the condition, individuals with metabolic syndrome were at an increased risk of mortality (OR 1.75 95% CIs [1.36-2.24]; P <0.01); all surgical site infection types as well as dehiscence (OR 1.64 95% CIs [1.52 -1.77]; P <0.01); cardiovascular complications (OR 1.56 95% CIs [1.41 -1.73]; P <0.01) including myocardial infarction, stroke, cardiac arrest, cardiac arrythmias and deep vein thrombosis; increased length of hospital stay (MD 0.65 95% CIs [0.39-0.9]; P <0.01); and hospital readmission (OR 1.55 95% CIs [1.41-1.71]; P <0.01). Conclusion: Metabolic syndrome is associated with a significantly increased risk of surgical complications including mortality, surgical site infection, cardiovascular complications, increased length of stay and hospital readmission. Despite these risks and the high prevalence of metabolic syndrome in surgical populations there is a lack of evidence on interventions for reducing surgical complications in patients with metabolic syndrome. The authors suggest prioritising interventions across the surgical continuum that include (1) preoperative screening for metabolic syndrome; (2) surgical prehabilitation; (3) intraoperative monitoring and management; and (4) postoperative rehabilitation and follow-up.

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The Influence of Metabolic Syndrome on Acute Kidney Injury Occurrence after Coronary Artery Bypass Grafting

Abstract: The presence of MetS seems to be associated with increased incidence of AKI after cardiac surgery. MetS is a modifiable issue; if its components are well controlled its dreadful effects after cardiac surgery might be controlled as well.

Cited by 9 publications

References 22 publications

The impact of diabetes mellitus on acute kidney injury after coronary artery bypass grafting

The impact of diabetes mellitus on acute kidney injury after coronary artery bypass grafting

The Impact of Diabetes Mellitus on Acute Kidney Injury after Coronary Artery Bypass Grafting

Metabolic syndrome and surgical complications: a systematic review and meta-analysis of 13 million individuals

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