Preoperative serum h-FABP concentration is associated with postoperative incidence of acute kidney injury in patients undergoing cardiac surgery

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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Faculty Opinions recommendation of Preoperative serum brain natriuretic peptide and risk of acute kidney injury after cardiac surgery.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.14265977.15778084 ◽

2012 ◽

Author(s):

Gad Cotter ◽

Olga Milo

Keyword(s):

Acute Kidney Injury ◽

Cardiac Surgery ◽

Brain Natriuretic Peptide ◽

Natriuretic Peptide ◽

Kidney Injury ◽

Preoperative Serum

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Preoperative hypoalbuminemia was associated with acute kidney injury in high-risk patients following non-cardiac surgery: a retrospective cohort study

10.21203/rs.2.9275/v2 ◽

2019 ◽

Author(s):

Nan Li ◽

Hong Qiao ◽

Jing-Fei Guo ◽

Hong-Yun Yang ◽

Xue-Ying Li ◽

...

Keyword(s):

Acute Kidney Injury ◽

Logistic Regression ◽

Cardiac Surgery ◽

Serum Albumin ◽

Multivariate Logistic Regression Analysis ◽

Kidney Injury ◽

Albumin Concentration ◽

Multivariate Logistic Regression ◽

Preoperative Serum ◽

Postoperative Aki

Abstract Background: Acute kidney injury (AKI) is a common complication following non-cardiac surgery with adverse short- and long- term morbidity and mortality. Evidence shows that hypoalbuminemia is associated with increased AKI risk in patients with infectious diseases and cancer and following cardiac surgery and transplant surgery. However, little evidence is available on non-cardiac surgery population. Thus, we investigated the association between preoperative hypoalbuminemia and AKI following non-cardiac surgery. Methods: We retrospectively assessed perioperative risk factors and preoperative serum albumin concentration in 729 consecutive adult patients who underwent non-cardiac surgery from July 1, 2017, to June 30, 2018. Each patient was categorized according to maximal Kidney Disease Improving Global Outcomes criteria based on creatinine changes and urine output within the first week after surgery. Multivariate Logistic regression models were used to analyze the association between preoperative hypoalbuminemia and postoperative AKI. Results: Of 729 patients, 188 (25.8%) developed AKI. AKI incidence was higher in patients with preoperative serum albumin <37.5 g/L than in those with preoperative serum albumin ≥37.5 g/L [35.9% (98/273) vs. 19.7% (90/456), P<0.001]. Multivariate logistic regression analysis showed that preoperative serum albumin <37.5 g/L (odds ratio 1.892; 95% confidence interval 1.238-2.891; P=0.003) was independently associated with postoperative AKI. Patients with preoperative serum albumin <37.5 g/L tended to have a higher but not significant ratio in AKI stage 2 (2.6% vs 1.1%, P=0.144) and much higher ratio in AKI stage 3 (4.8% vs 0.7%, P<0.001) than those with preoperative serum albumin ≥37.5 g/L. AKI patients had a higher in-hospital mortality rate [6.9% (13/188) vs. 0.2% (1/541), P<0.001]. Kaplan-Meier analysis revealed that the cumulative survival rate decreased with increasing AKI severity (P<0.001). Postoperative AKI was also associated with other worse outcomes, such as prolonged mechanical ventilation [53.4 (33.0, 73.8) vs 14.7 (11.1, 18.3) hours, P<0.001], intensive care unit stay [4.0 (3.1, 4.9) vs 2.0 (1.8, 2.3) days, P<0.001], postoperative hospital stay [17.8 (14.8, 20.9) vs 12.3 (11.3, 13.3) days, P<0.001], and higher total cost [13,453 (8,538, 20,228) vs 11,306 (6,277, 16,400) dollars, P<0.001]. Conclusions: Preoperative hypoalbuminemia was independently associated with AKI after non-cardiac surgery, and postoperative AKI was associated with poor outcomes.

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Preoperative serum ST2 level predicts acute kidney injury after adult cardiac surgery

Journal of Thoracic and Cardiovascular Surgery ◽

10.1016/j.jtcvs.2018.03.149 ◽

2018 ◽

Vol 156 (3) ◽

pp. 1114-1123.e2 ◽

Cited By ~ 7

Author(s):

Kevin W. Lobdell ◽

Devin M. Parker ◽

Donald S. Likosky ◽

Michael Rezaee ◽

Moritz Wyler von Ballmoos ◽

...

Keyword(s):

Acute Kidney Injury ◽

Cardiac Surgery ◽

Kidney Injury ◽

Preoperative Serum ◽

Adult Cardiac Surgery

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Preoperative hypoalbuminemia was associated with acute kidney injury in high risk patients following non-cardiac surgery: a retrospective cohort study

10.21203/rs.2.9275/v1 ◽

2019 ◽

Author(s):

Nan Li ◽

Hong Qiao ◽

Jing-Fei Guo ◽

Hong-Yun Yang ◽

Xue-Ying Li ◽

...

Keyword(s):

Acute Kidney Injury ◽

Logistic Regression ◽

Cardiac Surgery ◽

Serum Albumin ◽

Serum Albumin Level ◽

Kidney Injury ◽

Albumin Level ◽

Multivariate Logistic Regression ◽

Preoperative Serum ◽

Postoperative Aki

Abstract Background Acute kidney injury (AKI) is a common complication following non-cardiac surgery with adverse short and long term prognosis. Current evidence have shown hypoalbuminemia was associated with an increased risk of AKI in patients with infectious diseases, cancer, following cardiac surgery and transplant surgery. However, there were few evidence focusing on non-cardiac surgery population. The purpose of this study was to investigate the association between preoperative hypoalbuminemia and AKI following non-cardiac surgery. Methods We retrospectively assessed perioperative risk factors and preoperative serum albumin in 729 consecutive adult patients who underwent non-cardiac surgery from July 1, 2017 to June 30, 2018. Each patient was categorized by maximal Kidney Disease Improving Global Outcomes criteria based on creatinine changes and urine output within first week after surgery. Multivariate Logistic regression models were used to analyze the association between preoperative hypoalbuminemia and postoperative AKI. Results Of the 729 patients, 188 (25.8%) developed AKI, the AKI incidence was higher in patients with a preoperative serum albumin level < 37.5g/L than those ≥37.5g/L [35.9% (98/273) vs. 19.7% (90/456), P <0.001]. Multivariate Logistic regression analysis showed preoperative serum albumin level < 37.5g/L (OR 1.892; 95% CI 1.238-2.891; P = 0.003) was independently associated with postoperative AKI. Furthermore, AKI in patients with preoperative hypoalbuminemia was more severe with 28.6% vs 18.0% for stage 1 (P=0.001), 2.6% vs 1.1% for stage 2 (P=0.144) and 4.8% vs 0.7% for stage 3 (P<0.001), respectively. Patients with AKI had a higher in-hospital mortality rate [6.9% (13/188) vs. 0.2% (1/541), P <0.001]. By Kaplan-Meier analysis, patients with AKI had lower cumulative survival rate with more severe stage of AKI relating to poorer outcomes (P<0.001). Postoperative AKI was also associated with other worse outcomes, such as prolonged mechanical ventilation [53.4 (33.0, 73.8) vs 14.7 (11.1, 18.3) hours, P<0.001], ICU stay [4.0 (3.1, 4.9) vs 2.0 (1.8, 2.3) days, P<0.001] and postoperative hospital stay [17.8 (14.8, 20.9) vs 12.3 (11.3, 13.3) days, P<0.001], and higher total cost [89,000 (56,000, 132,000) vs 75,000 (42,000, 109,000) yuan, P<0.001]. Conclusions Preoperative hypoalbuminemia was independently associated with AKI after non-cardiac surgery, and postoperative AKI was associated with poor outcomes.

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Preoperative serum cystatin C combined with dipstick proteinuria predicts acute kidney injury after cardiac surgery

Renal Failure ◽

10.3109/0886022x.2014.949759 ◽

2014 ◽

Vol 36 (10) ◽

pp. 1497-1503 ◽

Cited By ~ 9

Author(s):

Xudong Wang ◽

Miaolin Che ◽

Bo Xie ◽

Song Xue ◽

Yucheng Yan

Keyword(s):

Acute Kidney Injury ◽

Cardiac Surgery ◽

Cystatin C ◽

Kidney Injury ◽

Serum Cystatin C ◽

Serum Cystatin ◽

Preoperative Serum

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Preoperative serum uric acid predicts incident acute kidney injury following cardiac surgery

BMC Nephrology ◽

10.1186/s12882-018-0970-x ◽

2018 ◽

Vol 19 (1) ◽

Cited By ~ 4

Author(s):

T. Kaufeld ◽

K. A. Foerster ◽

T. Schilling ◽

J. T. Kielstein ◽

J. Kaufeld ◽

...

Keyword(s):

Acute Kidney Injury ◽

Uric Acid ◽

Cardiac Surgery ◽

Serum Uric Acid ◽

Kidney Injury ◽

Preoperative Serum

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Preoperative hypoalbuminemia was associated with acute kidney injury in high-risk patients following non-cardiac surgery: a retrospective cohort study

10.21203/rs.2.9275/v3 ◽

2019 ◽

Author(s):

Nan Li ◽

Hong Qiao ◽

Jing-Fei Guo ◽

Hong-Yun Yang ◽

Xue-Ying Li ◽

...

Keyword(s):

Acute Kidney Injury ◽

Logistic Regression ◽

Cardiac Surgery ◽

Serum Albumin ◽

Multivariate Logistic Regression Analysis ◽

Kidney Injury ◽

Albumin Concentration ◽

Multivariate Logistic Regression ◽

Preoperative Serum ◽

Postoperative Aki

Abstract Background: Acute kidney injury (AKI) is a common complication following non-cardiac surgery with adverse short- and long- term morbidity and mortality. Evidence shows that hypoalbuminemia is associated with increased AKI risk in patients with infectious diseases and cancer and following cardiac surgery and transplant surgery. However, little evidence is available on non-cardiac surgery population. Thus, we investigated the association between preoperative hypoalbuminemia and AKI following non-cardiac surgery. Methods: We retrospectively assessed perioperative risk factors and preoperative serum albumin concentration in 729 consecutive adult patients who underwent non-cardiac surgery from July 1, 2017, to June 30, 2018. Each patient was categorized according to maximal Kidney Disease Improving Global Outcomes criteria based on creatinine changes and urine output within the first week after surgery. Multivariate Logistic regression models were used to analyze the association between preoperative hypoalbuminemia and postoperative AKI. Results: Of 729 patients, 188 (25.8%) developed AKI. AKI incidence was higher in patients with preoperative serum albumin <37.5 g/L than in those with preoperative serum albumin ≥37.5 g/L [35.9% (98/273) vs. 19.7% (90/456), P<0.001]. Multivariate logistic regression analysis showed that preoperative serum albumin <37.5 g/L (odds ratio 1.892; 95% confidence interval 1.238-2.891; P=0.003) was independently associated with postoperative AKI. Patients with preoperative serum albumin <37.5 g/L tended to have a higher but not significant ratio in AKI stage 2 (2.6% vs 1.1%, P=0.144) and much higher ratio in AKI stage 3 (4.8% vs 0.7%, P<0.001) than those with preoperative serum albumin ≥37.5 g/L. AKI patients had a higher in-hospital mortality rate [6.9% (13/188) vs. 0.2% (1/541), P<0.001]. Kaplan-Meier analysis revealed that the cumulative survival rate decreased with increasing AKI severity (P<0.001). Postoperative AKI was also associated with other worse outcomes, such as prolonged mechanical ventilation [53.4 (33.0, 73.8) vs 14.7 (11.1, 18.3) hours, P<0.001], intensive care unit stay [4.0 (3.1, 4.9) vs 2.0 (1.8, 2.3) days, P<0.001], postoperative hospital stay [17.8 (14.8, 20.9) vs 12.3 (11.3, 13.3) days, P<0.001], and higher total cost [13,453 (8,538, 20,228) vs 11,306 (6,277, 16,400) dollars, P<0.001]. Conclusions Preoperative hypoalbuminemia was independently associated with AKI after non-cardiac surgery, and postoperative AKI was associated with poor outcomes.

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