Impact of a new definition of acute kidney injury based on creatinine kinetics in cardiac surgery patients: a comparison with the RIFLE classification

Background Cardiac surgery-associated acute kidney injury (CSA-AKI) is an important and serious complication that affects morbidity and mortality. We studied both pediatric and adults using the definition of the Acute Kidney Injury Network (AKIN). Methods This is an observational retrospective cohort study done at King Abdulaziz University Hospital in Jeddah, Saudi Arabia approved by ethical committee. The exclusion criteria were baseline serum creatinine (SCr) ≥ 4 mg/dL or preexisting renal failure requiring dialysis, reoperation, death within 24 hours postoperatively, and operative mortality or missing data. 941 patients were included in the analysis using the statistical software SPSS, version 15.0. Results 28.68% in the adult group and 20.07% in the pediatric group developed CSA-AKI. Adult risk factors included age group of 60-69 years, cardiopulmonary bypass (CPB), number of grafts and hypertension. In the pediatric group, CPB, aortic cross-clamping (ACX) and the lower preoperative SCr are the main risk factors Conclusion Conventional conservative management and preoperative Identification of predictor risk factors are essential for prevention of CSA-AKI which constitute the main strategy for optimal management.

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Safety of Argatroban in critically ill patients with acute kidney injury and renal replacement therapy after cardiac surgery

The Thoracic and Cardiovascular Surgeon ◽

10.1055/s-0030-1269141 ◽

2011 ◽

Vol 59 (S 01) ◽

Author(s):

M Klingele ◽

A Lerner-Gräber ◽

D Fliser ◽

HJ Schäfers ◽

H Groesdonk

Keyword(s):

Acute Kidney Injury ◽

Cardiac Surgery ◽

Renal Replacement Therapy ◽

Replacement Therapy ◽

Critically Ill ◽

Critically Ill Patients ◽

Kidney Injury

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Increase of Neutrophil gelatinase-associated Lipocalin and Cystatin C after cardiac surgery – new options for detecting acute kidney injury

The Thoracic and Cardiovascular Surgeon ◽

10.1055/s-0031-1297556 ◽

2012 ◽

Vol 60 (S 01) ◽

Author(s):

H Baumgarten ◽

C Liebetrau ◽

A Van Linden ◽

B Njezic ◽

T Walther ◽

...

Keyword(s):

Acute Kidney Injury ◽

Cardiac Surgery ◽

Cystatin C ◽

Kidney Injury ◽

Neutrophil Gelatinase Associated Lipocalin ◽

Neutrophil Gelatinase

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Preoperative Low Serum Albumin Levels Increase the Requirement of Renal Replacement Therapy after Cardiac Surgery

The Heart Surgery Forum ◽

10.1532/hsf.1577 ◽

2016 ◽

Vol 19 (3) ◽

pp. 123 ◽

Cited By ~ 7

Author(s):

Orhan Findik ◽

Ufuk Aydin ◽

Ozgur Baris ◽

Hakan Parlar ◽

Gokcen Atilboz Alagoz ◽

...

Keyword(s):

Acute Kidney Injury ◽

Regression Analysis ◽

Cardiac Surgery ◽

Renal Replacement Therapy ◽

Serum Albumin ◽

Replacement Therapy ◽

Kidney Injury ◽

Preoperative Serum ◽

Group I ◽

Group Ii

Background: Acute kidney injury is a common complication of cardiac surgery that increases morbidity and mortality. The aim of the present study is to analyze the association of preoperative serum albumin levels with acute kidney injury and the requirement of renal replacement therapy after isolated coronary artery bypass graft surgery (CABG). Methods: We retrospectively reviewed the prospectively collected data of 530 adult patients who underwent isolated CABG surgery with normal renal function. The perioperative clinical data of the patients included demographic data, laboratory data, length of stay, in-hospital complications and mortality. The patient population was divided into two groups: group I patients with preoperative serum albumin levels <3.5 mg/dL; and group II pateints with preoperative serum albumin levels ≥3.5 mg/dL. Results: There were 413 patients in group I and 117 patients in group II. Postoperative acute kidney injury (AKI) occured in 33 patients (28.2%) in group I and in 79 patients (19.1%) in group II. Renal replacement therapy was required in 17 patients (3.2%) (8 patients from group I; 9 patients from group II; P = .018). 30-day mortality occurred in 18 patients (3.4%) (10 patients from group I; 8 patients from group II; P = .037). Fourteen of these patients required renal replacement therapy. Logistic regression analysis revealing the presence of lower serum albumin levels preoperatively was shown to be associated with increased incidence of postoperative AKI (OR: 1.661; 95% CI: 1.037-2.661; P = .035). Logistic regression analysis also revealed that DM (OR: 3.325; 95% CI: 2.162-5.114; P = .000) was another independent risk factor for AKI after isolated CABG. Conclusion: Low preoperative serum albumin levels result in severe acute kidney injury and increase the rate of renal replacement therapy and mortality after isolated CABG.

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