scholarly journals Risk factors for acute kidney injury in elderly patients after coronary artery bypass grafting: A Chinese population

2021 ◽  
Author(s):  
Xuejian Hou ◽  
Taoshuai Liu ◽  
shijun xu ◽  
Zhuhui Huang ◽  
Yang Li ◽  
...  
Keyword(s):  
Risk Factors ◽  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Elderly Patients ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Kidney Injury ◽  
Bypass Grafting ◽  
Artery Bypass Grafting ◽  
Intervention Measures

Background and aim of the study: Elderly patients are more likely to have adverse complications after coronary artery bypass grafting (CABG). There are few studies on the risk factors for acute kidney injury (AKI) after surgery in elderly patients, especially in the Asian population. This study retrospectively analysed the risk factors for AKI in Chinese elderly patients after CABG and established a risk prediction model to detect these risk factors early and take active intervention measures. Methods: A total of 432 patients were included in this study from 2018 to 2019. AKI was defined according to the Kidney Disease Improving Global Outcomes (KDIGO) criteria. The patients were divided into an AKI group and a non-AKI group. Multivariate logistic regression analysis was used to screen out the factors with p < 0.05. Results: Out of 432 patients in the study, 119 (27.5%) developed AKI. The estimated glomerular filtration rate (eGFR), ≥3 coronary anastomoses, preoperative intra-aortic balloon pump (IABP) implantation and prolonged ventilation time were independent risk factors for AKI. The area under the ROC curve was 0.702 (95% confidence interval (CI) [0.643-0.761], p < 0.001). Conclusions: The eGFR, ≥3 coronary anastomoses, preoperative IABP implantation and prolonged ventilation time are independent risk factors for AKI in elderly patients undergoing coronary artery bypass grafting. Early discovery of these risk factors and the implementation of appropriate intervention measures are useful to reduce the occurrence of AKI after CABG and improve the prognosis of patients.

scholarly journals Risk factors for acute kidney injury in elderly patients after coronary artery bypass grafting: A Chinese population

2020 ◽  
Author(s):  
Xuejian Hou ◽  
Taoshuai Liu ◽  
Shijun Xu ◽  
Zhuhui Huang ◽  
Yang Li ◽  
...  
Keyword(s):  
Risk Factors ◽  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Elderly Patients ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Kidney Injury ◽  
Bypass Grafting ◽  
Artery Bypass Grafting ◽  
Intervention Measures

Abstract Background: Elderly patients are more likely to have adverse complications after coronary artery bypass grafting (CABG). There are few studies on the risk factors of acute kidney injury (AKI) after surgery in elderly patients, especially in the Asian population. This study retrospectively analyse the risk factors of AKI in Chinese elderly patients after CABG, and establish a risk prediction model to detect these risk factors early and take active intervention measures.Methods: A total of 432 patients were included in this study from 2018 to 2019. AKI was defined according to the Kidney Disease Improving Global Outcomes (KDIGO) criteria. The patients were divided into AKI group and non AKI group. Multivariate logistic regression analysis was used to screen out the factors with P < 0.05. The receiver operating characteristic (ROC) curve was made for the predictive risk model. At the same time, the incidence of complications after CABG was compared between the two groups.Results: Of 432 patients in the study, 119 (27.5%) developed AKI. The estimated glomerular filtration rate (eGFR), ≥ 3 coronary anastomoses, intra-aortic balloon pump (IABP) implantation and ventilation time were independent risk factors for AKI. The area of the ROC curve was (0.702, 95% confidence interval (CI) [0.643-0.761], P < 0.001). There were 7 deaths in the AKI group, which was significantly higher than that in the non AKI group. In addition, in the reoperation and postoperative myocardial infarction, the AKI group was also higher than the non AKI group. Conclusion: The eGFR, ≥ 3 coronary anastomoses, IABP implantation and ventilation time are independent risk factors for AKI in elderly patients undergoing coronary artery bypass grafting. Early discovering these risk factors and taking intervention measures are helpful to reduce the occurrence of AKI after CABG and improve the prognosis of patients.

scholarly journals Preoperative use of furosemide may increase the incidence of acute kidney injury after coronary artery bypass grafting: a propensity score-matched study

2021 ◽  
Author(s):  
Hui Zheng ◽  
Le Liu ◽  
Guoliang Fan ◽  
Zhigang Liu ◽  
Zhengqing Wang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Propensity Score ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Kidney Injury ◽  
Bypass Grafting ◽  
Artery Bypass Grafting

Abstract Objectives Furosemide is usually administered before the Coronary artery bypass grafting (CABG) to improve water–sodium retention. However, no final conclusions are available on the postoperative renal outcome of furosemide. We evaluated the effect of preoperative furosemide on acute kidney injury (AKI) after CABG. Methods We recorded the use of furosemide 14 days before surgery in all patients who underwent CABG from 2016 to 2017. Patients were divided into furosemide (F) group and non-furosemide (NF) group according to preoperative use of furosemide. A 1:1 propensity score matching was performed. Multivariate analyses were conducted to determine risk factors for AKI after CABG. Results Overall, 974 patients were included in the study, of which 82 cases were complicated with postoperative AKI. The incidence of AKI was significantly increased in F group than NF group (28.9% vs. 7.4%, p = 0.000). After adjusting for risk factors, the incidence of AKI in the F group was 5.34 times more than the NF group (95% confidence interval [CI] 2.45–11.64; p = 0.000). The incidence of AKI increased significantly when the cumulative dosage of furosemide exceeded 110 mg (odds ratio [OR] 6.23; 95% CI 2.07–18.74, p = 0.001) and 250 mg (OR 8.31; 95% CI 2.87–24.02, p = 0.000). After the propensity-matching group analysis, same results were obtained. Conclusions The incidence of AKI after CABG was related to the use of preoperative furosemide, and it increased exponentially with the increase of cumulative dose of furosemide. This provides guidance for the dose of preoperative furosemide.

Mortality Risk Factors in Chronic Renal Failure Patients after Coronary Artery Bypass Grafting

Renal Failure ◽  
2007 ◽  
Vol 29 (7) ◽  
pp. 823-828 ◽  
Author(s):  
Beril Akman ◽  
Ayse Bilgic ◽  
Gulsah Sasak ◽  
Siren Sezer ◽  
Atilla Sezgin ◽  
...  
Keyword(s):  
Risk Factors ◽  
Renal Failure ◽  
Coronary Artery ◽  
Chronic Renal Failure ◽  
Coronary Artery Bypass Grafting ◽  
Coronary Artery Bypass ◽  
Mortality Risk ◽  
Artery Bypass ◽  
Bypass Grafting ◽  
Artery Bypass Grafting

scholarly journals Association between preoperative level of hemoglobin A1c and the incidence of acute kindey injury after coronary artery bypass grafting surgery: a cohort study

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Ghada Mohamed Samir ◽  
Omar Mohamed Ali Mohamed Omar ◽  
Madiha Metwally Zidan ◽  
Hazem Abd El Rahman Fawzy ◽  
Marwa Mamdouh Mohamed El Far
Keyword(s):  
Acute Kidney Injury ◽  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Coronary Artery Bypass ◽  
Hemoglobin A1c ◽  
Artery Bypass ◽  
Kidney Injury ◽  
P Value ◽  
Bypass Grafting ◽  
Artery Bypass Grafting

Abstract Background The development of acute kidney injury (AKI) is an important indicator of clinical outcomes after cardiac surgery. Elevated preoperative hemoglobin A1c level may be associated with acute kidney injury in patients undergoing coronary artery bypass grafting. This study will investigate the association of preoperative HbA1c levels with AKI after isolated coronary artery bypass grafting (CABG). Results Forty patients undergoing elective CABG were enrolled in this cohort study. Patients are divided into 2 equal groups who underwent isolated coronary artery bypass grafting (CABG): patients with preoperative HbA1c 5.7–6.4% (group A) (prediabetics) and patients with preoperative HbA1c > or = 6.5% (group B) (diabetics). Acute kidney injury according to the Kidney Disease: Improving Global Outcomes criteria developed in 11 patients (27.5%). There was a significant difference between the two groups as regards postoperative urinary NGAL, creatinine level on the 1st day, creatinine level on the 2nd day, urine output on the 1st day, and urine output on the 2nd day (p value was 0.001, 0.002, 0.006, 0.0002, and 0.012 respectively). Postoperative ICU stay duration was statistically significant in the diabetic group (P value 0.009). The need for renal replacement therapy was higher in the diabetic group, but it was not statistically significant between the two groups. Roc analysis shows AUC 0.922 with a significant p value (< 0.0001) and cut of value (≥ 7) with sensitivity 81.82 and specificity 93.10. Conclusion This study revealed that elevated preoperative HbA1c level above 7% showed an increase in incidence of post CABG acute kidney injury along with increase length of postoperative ICU stay.

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