scholarly journals Is Nadir Oxygen Delivery on Cardiopulmonary Bypass an Independent Risk Factor for Acute Kidney Injury After Cardiac Surgery?

2016 ◽  
Vol 101 (4) ◽  
pp. 1631 ◽  
Author(s):  
Fu-Shan Xue ◽  
Gao-Pu Liu ◽  
Chao Sun
Keyword(s):  
Acute Kidney Injury ◽  
Cardiac Surgery ◽  
Risk Factor ◽  
Cardiopulmonary Bypass ◽  
Oxygen Delivery ◽  
Independent Risk Factor ◽  
Kidney Injury

scholarly journals The Albumin-to-Fibrinogen Ratio Independently Predicts Acute Kidney Injury in Infants With Ventricular Septal Defect Undergoing Cardiac Surgery With Cardiopulmonary Bypass

2021 ◽  
Vol 9 ◽  
Author(s):  
Fan Cao ◽  
Xinxin Chen ◽  
Guodong Huang ◽  
Wenhua Liu ◽  
Na Zhou ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Cardiac Surgery ◽  
Risk Factor ◽  
Cardiopulmonary Bypass ◽  
Ventricular Septal Defect ◽  
Independent Risk Factor ◽  
Septal Defect ◽  
Kidney Injury ◽  
Elective Cardiac Surgery

Background: Acute kidney injury (AKI) is a common and serious complication faced by children following ventricular septal defect (VSD) surgery with cardiopulmonary bypass (CPB). The objective of this study was to explore potential predictors inherent to AKI.Methods: VSD infants who were scheduled for elective cardiac surgery with CPB from 2017 to 2020 were enrolled in this study. Based on the Pediatric Risk, Injury, Failure, Loss, End-Stage Renal Disease (pRIFLE) criteria, patients were divided into AKI and non-AKI groups. Univariate and multivariate logistic regression analyses were carried out in order to evaluate potential risk factors for AKI. Receiver operating characteristic (ROC) curves were generated to evaluate the predictive probabilities of risk factors for AKI.Results: Of all the 338 enrolled VSD infants, 49 manifested AKI with an incidence of 14.5% (49/338). The ROC curve indicated that albumin-to-fibrinogen ratio (AFR) during CPB was a significant predictor of AKI [area under the curve (AUC), 0.711; p < 0.001]. Based on the univariate and multivariate logistic analyses, AFR during CPB [odds ratio (OR), 1.89; 95% confidence interval (CI), 1.22–2.76, p = 0.011] was the only independent risk factor for AKI.Conclusions: This study demonstrated that a low AFR (<9.35) during CPB was an independent risk factor for AKI in VSD infants following cardiac surgery with CPB.

scholarly journals Oxygen delivery during cardiopulmonary bypass and acute kidney injury: Preliminary Study

2019 ◽  
pp. 5-11
Author(s):  
Juan Carlos Santos ◽  
Maria Carmen Santos ◽  
Carlos Casado ◽  
Maria Luz Recio ◽  
Antonio Cabrera ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Cardiac Surgery ◽  
Cardiopulmonary Bypass ◽  
Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Oxygen Delivery ◽  
Kidney Injury ◽  
Blood Gases ◽  
Post Cardiopulmonary Bypass ◽  
O2 Delivery

Objective: to assess the relationship between oxygen delivery during cardiopulmonary bypass and the incidende of acute kidney injury in the immediate postoperative period of patients undergoing cardiac surgery, as well as to identify possible risk factors. Methods: A retrospective observational study of patients undergoing cardiac surgery scheduled between May 2016 and February 2018 was carried out in which the M-M4 System was used for online blood gases. Patients with preoperative diagnosis of chronic renal failure were excluded. For the oxigen delivery, the average of all M4 records was made. Results: 133 patients (35.3% women) with a mean age of 64.9 ± 10.9 years were studied. The incidence of acute kidney injury was 18.8% (AKI I: 12%; AKI II: 3%; AKI III: 3.8%). There was no correlation between acute kidney injury and O2 delivery (251 ± 43 vs 247 ± 52, ns), if there was a difference when patients needed renal replacement therapy (251 ± 43 vs 198 ± 18, p = 0.04). There was a significant increase risk in diabetes; HTA; pulmonary arterial hypertension; chronic atrial fibrilation; red blood cell concentrate and blood products administration in the operating room; redo for bleeding; high lactic acid and glycemia post cardiopulmonary bypass; prolonged pump and ischemia times; and combined surgery. Conclusions: There was no direct relationship between O2 delivery and acute kidney injury, although there was a significantly lower O2 delivery in patients who needed postoperative renal replacement therapy.

Pentastarch 10% (250 kDa/0.45) is an independent risk factor of acute kidney injury following cardiac surgery*

2009 ◽  
Vol 37 (4) ◽  
pp. 1293-1298 ◽  
Author(s):  
Jean-Philippe Rioux ◽  
Myriam Lessard ◽  
Bruno De Bortoli ◽  
Patrick Roy ◽  
Martin Albert ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Cardiac Surgery ◽  
Risk Factor ◽  
Independent Risk Factor ◽  
Kidney Injury

scholarly journals Association of Preoperative Diuretic Use With Early Acute Kidney Injury in Infants With Biventricular Hearts Following Cardiac Surgery

2021 ◽  
Author(s):  
Steven L. Rathgeber ◽  
Adrija Chakrabarti ◽  
Eva Kapravelou ◽  
Nicole Hemphill ◽  
Christine Voss ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Cardiac Surgery ◽  
Risk Factor ◽  
Cardiopulmonary Bypass ◽  
Tetralogy Of Fallot ◽  
Odds Ratio ◽  
Congenital Heart ◽  
Kidney Injury ◽  
Stage 1

Background Diuretics are used to manage congestive heart failure in infants with congenital heart disease. Adult data indicate that preoperative diuretic use increases the risk of cardiac surgery associated acute kidney injury (CS‐AKI). We have sought to understand if preoperative diuretics in infants increases the risk of CS‐AKI. Methods and Results This is a single‐center retrospective study of infants (1–12 months) who had CS requiring cardiopulmonary bypass between 2013 and 2018. The diagnosis and severity of CS‐AKI was defined according to the Kidney Disease Improving Global Outcomes guidelines. Three hundred patients were included (mean 6 months, SD 2.4, range 1.2–12.9 months). A total of 149 (49.7%) patients were diagnosed with CS‐AKI (stage 1: 80 [54%], stage 2: 57 [38%], stage 3: 12 [8%]). Logistic regression analysis showed preoperative diuretics were not associated with CS‐AKI (odds ratio [OR], 0.79; 95% CI, 0.43–1.44; P =0.45). A diagnosis of tetralogy of Fallot was an independent risk factor for CS‐AKI (OR, 3.49; 95% CI, 1.33–9.1, P =0.01). A diagnosis of tetralogy of Fallot (OR, 3.6; 95% CI, 1.28–10.22; P =0.02) and longer cardiopulmonary bypass (OR, 1.01; 95% CI, 1.0–1.02; P =0.04) time are risk factors for moderate to severe CS‐AKI. Conclusions Preoperative diuretic use does not contribute to the risk of CS‐AKI in infants early after surgery. A diagnosis of tetralogy of Fallot was the only risk factor for CS‐AKI identified using multivariate analysis in our cohort. Furthermore, a diagnosis of tetralogy of Fallot and longer cardiopulmonary bypass time are risk factors for moderate to severe CS‐AKI.

scholarly journals Effects of hyperuricaemia, with the superposition of being overweight and hyperlipidaemia, on the incidence of acute kidney injury following cardiac surgery: a retrospective cohort study

BMJ Open ◽  
2022 ◽  
Vol 12 (1) ◽  
pp. e047090
Author(s):  
Yiqi Su ◽  
Haoxuan Li ◽  
Yang Li ◽  
Xialian Xu ◽  
Bo Shen ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Uric Acid ◽  
Cardiac Surgery ◽  
Risk Factor ◽  
Independent Risk Factor ◽  
Multivariate Logistic Regression Analysis ◽  
Kidney Injury ◽  
Acid Group ◽  
Tertiary Hospital ◽  
University Teaching

ObjectivesAcute kidney injury (AKI) is a common complication of cardiac surgery. This study aimed to explore the effects of hyperuricaemia, being overweight and hyperlipidaemia as risk factors for AKI in patients following cardiac surgery (cardiac surgery-associated acute kidney injury (CSA-AKI)).DesignRetrospective observational study.SettingUniversity teaching, grade-A tertiary hospital in Shanghai, China.ParticipantsPatients who underwent cardiac surgery from July 2015 to December 2015 in Zhongshan Hospital, Fudan University.Main outcome measuresWe investigated the effect of hyperuricaemia, in combination with being overweight and hyperlipidaemia, on the risk of CSA-AKI.ResultsA total of 1420 patients were enrolled. The AKI incidence in the highest uric acid group was 44.4%, while that in the lowest uric acid group was 28.5% (p<0.001). Patients in the higher uric acid quartiles were more likely to be overweight and hyperlipidaemic at the same time (p<0.001). Multivariate logistic regression analysis showed that hyperuricaemia was an independent risk factor for AKI (OR=1.237, 95% CI 1.095 to 1.885; p=0.009); being overweight or hyperlipidaemia alone was not an independent risk factor, but the combination of being overweight and hyperlipidaemia was (OR=1.544, 95% CI 1.059 to 2.252; p=0.024). In the final model, the OR value increased to 3.126 when hyperuricaemia was combined with being overweight and hyperlipidaemia, and the Hosmer-Lemeshow test showed that all three models fit well (p=0.433, 0.638 and 0.597, respectively).ConclusionsThe combination of being overweight and having hyperlipidaemia was an independent risk factor, but being overweight or having hyperlipidaemia alone was not. The combination of hyperuricaemia, being overweight and hyperlipidaemia further increased the risk of CSA-AKI.

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