Acute kidney injury in a patient with metabolic syndrome

Background: Finding patients at risk of developing contrast-induced acute kidney injury (CI-AKI) is important because of its associated complications. In the present study, the contribution of different variables, such as the presence of metabolic syndrome (MetS), the volume creatinine clearance (V/CrCl) ratio, the iodine-dose (I-dose)/CrCl ratio, or hypertension, to CI-AKI was evaluated. Methods: A total of 255 patients undergoing elective coronary angiography with or without intervention were enrolled and divided into a MetS and a control group. All patients were assessed for the development of CI-AKI after the procedures. Results: CI-AKI occurred in 39.23% (51 of 130) of the MetS patients and 14.4% (18 of 125) of the control group (p < 0.001). The multivariable regression model showed that male sex and the use of statins decreased the risk of CI-AKI, and high triglyceride levels, I-dose/CrCl > 0.52, MetS, CrCl ≤60 mL/min, and age ≥70 years increased the risk of CI-AKI, independent of confounding factors. The difference in the mean V/CrCl ratio was statistically significant between patients who developed CI-AKI and those who did not show renal impairment (2.36 ± 1.35 vs. 1.43 ± 0.89, respectively; p < 0.001). The ROC curve analysis of I-dose/CrCl determined the best cutoff value for patients with and those without MetS as 0.51 and 0.63, with a sensitivity value of 68 and 72% and a specificity value of 73 and 74%, respectively. Conclusions: We showed that MetS is a strong risk factor for CI-AKI in nondiabetic patients undergoing elective coronary interventions; and the I-dose/CrCl ratio is a strong predictor of CI-AKI in these patients. We suggest that clinicians identify MetS patients and calculate their I-dose/CrCl ratio before coronary interventions.

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Risk of acute kidney injury in patients with ischemic heart disease and concomitant metabolic syndrome after on-pump coronary bypass grafting

Yakut Medical Journal ◽

10.25789/ymj.2021.73.07 ◽

2021 ◽

pp. 25-29

Author(s):

A.S. Korostelev ◽

A.F. Potapov ◽

A.A. Ivanova ◽

P.I. Zakharov ◽

A.V. Bulatov

Keyword(s):

Metabolic Syndrome ◽

Acute Kidney Injury ◽

Heart Disease ◽

Ischemic Heart Disease ◽

Kidney Injury ◽

Coronary Bypass ◽

Ischemic Heart ◽

Bypass Grafting ◽

Coronary Bypass Grafting

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

The Heart Surgery Forum ◽

10.1532/hsf.1400 ◽

2016 ◽

Vol 19 (3) ◽

pp. 099 ◽

Cited By ~ 1

Author(s):

Atike Tekeli Kunt ◽

Hakan Parlar ◽

Orhan Findik ◽

Cagri Duzyol ◽

Ozgur Baris ◽

...

Keyword(s):

Metabolic Syndrome ◽

Acute Kidney Injury ◽

Logistic Regression ◽

Regression Analysis ◽

Cardiac Surgery ◽

Artery Bypass ◽

Kidney Injury ◽

Bypass Grafting ◽

Group I ◽

Postoperative Aki

Background: Metabolic syndrome (MetS) is defined as a cluster of systemic abnormalities: hyperglycemia, dyslipidemia, abdominal obesity, and hypertension. Acute kidney injury (AKI) is one of the devastating complications after cardiac surgery. Age, DM, preexisting renal dysfunction, hypertension, impaired left ventricular function, and severe arteriosclerosis of the aorta are the major risk factors for the development of AKI. The purpose of the current study was to analyze the influence of MetS on AKI occurring after coronary artery bypass grafting (CABG).Methods: We retrospectively reviewed the prospectively collected data of 500 adult patients who underwent isolated CABG surgery with normal renal function (baseline serum creatinine value <1.4 mg/dL) from January 2011 to January 2015. The patients were divided into two groups either having the diagnosis of MetS (Group I) or not (Group II). MetS was diagnosed based on International Diabetes Federation definition. Kidney injury was interpreted according to RIFLE classification. The effect of MetS on AKI after CABG was determined using logistic regression analysis and the results were expressed as odds ratio (OR) with a 95% confidence interval (CI). A P value <.05 was considered statistically significant.Results: Metabolic syndrome was diagnosed in 16.4% of all patients. Postoperative AKI occurred in 26 patients (31.7%) in Group I whereas there were 53 patients (12.7%) in Group II. On logistic regression analysis, the presence of MetS was shown to be associated with increased incidence of postoperative AKI (OR, 3.197; 95% CI, 1.850-5.526; P = .000).Conclusion: 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.

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