scholarly journals Perioperative evaluation of kidney function for patients with complicated forms of coronary artery disease

2020 ◽  
pp. 52-58
Author(s):  
O. Gogayeva ◽  
V. Lazoryshynets ◽  
A. Rudenko ◽  
L. Dzakhoieva ◽  
O. Yuvchyk
Keyword(s):  
Coronary Artery Disease ◽  
Acute Kidney Injury ◽  
Coronary Artery ◽  
Kidney Function ◽  
Postoperative Period ◽  
Kidney Injury ◽  
Perioperative Period ◽  
Early Postoperative Period ◽  
Chronic Obstructive ◽  
Artery Disease

The study aimed to analyze kidney function for patients with complicated forms of coronary artery disease (CAD) in the perioperative period. Methods. It was a retrospective analysis of 110 high-risk patients with complicated forms of CAD, who were operated on and discharged from the National M. Amosov Institute for the period from 2009 till 2019 years. Kidney function was evaluated by glomerular filtration rate (GFR), calculated online with СKD-EPI formula. Results. Among the included patients there were 86 (78.1%) patients with metabolic syndrome, 81 (73.59%) patients with disorders of glucose metabolism, 82 (74.5%) subjects with chronic obstructive pulmonary disease and 38 (34.5%) patients had chronic kidney disease (CKD) 3-5 stage. Preoperative risk stratification with EuroScore II scale was 9.4%. All operations performed in cardiopulmonary bypass; Custodial cardioplegia was used in 53 (48.1%) patients. The average perfusion time was 111 minutes, average cross-clamping time was 73.9 minutes. Acute kidney injury in the early postoperative period had 9 (8.1%) patients. Conclusions. At the admittance 38 (34.5%) patients with complicated forms of CAD had CKD 3-5 st. Analysis of the GFR dynamic in the early postoperative period shown a decrease in GFR in 71.05% of patients. Transient acute kidney injury with 50% sCr growth had 9 (8.1%) patients but didn’t require hemodialysis.

scholarly journals Anemia as a risk factor of contrast-associated acute kidney injury

2020 ◽  
Vol 92 (12) ◽  
pp. 48-52
Author(s):  
O. Iu. Mironova ◽  
A. D. Deev ◽  
P. G. Lakotka ◽  
V. V. Fomin
Keyword(s):  
Coronary Artery Disease ◽  
Acute Kidney Injury ◽  
Risk Factor ◽  
Coronary Artery ◽  
Serum Creatinine ◽  
Statistical Significance ◽  
Kidney Injury ◽  
Chronic Coronary Artery Disease ◽  
Absolute Increase ◽  
Artery Disease

Aim.The aim of our study was to assess the role of anemia as a risk factor of contrast-associated acute kidney injury (CA-AKI) in patients with stable coronary artery disease. Materials and methods.1023 patients with chronic coronary artery disease were enrolled in a prospective, open, cohort study (ClinicalTrials.gov ID NCT04014153). 83 patients had anemia. CA-AKI was defined as an increase of 25% or more, or an absolute increase of 0.5 mg/dl or more in serum creatinine from baseline value, assessed at 48 hours following the administration of the contrast. The primary endpoint of the study was the development of CA-AKI according to KDIGO criteria. Results.CA-AKI developed in 12 (14.5%) patients with anemia according to the relative increase of the level of serum creatinine (25% and more from the baseline). With using the absolute increase of the level of serum creatinine the prevalence of CA-AKI was 2 (2.4%) patients. Patients with anemia had higher rate of CA-AKI than the overall population of the study (14.4% versus 12.7%). Although our results were not statistically significant (р=0.61, odds ratio 1.19, 95% confidence interval 0.632.24). Conclusion.The prevalence of CA-AKI was higher in the group of patients with anemia, but didnt meet statistical significance and needs further evaluation in larger studies.

scholarly journals Heart failure and contrast-induced acute kidney injury in patients with coronary artery disease

2020 ◽  
Vol 22 (10) ◽  
pp. 61-63
Author(s):  
Olga Iu. Mironova ◽  
◽  
Olga A. Sivakova ◽  
Aleksandr D. Deev ◽  
Viktor V. Fomin ◽  
...  
Keyword(s):  
Heart Failure ◽  
Coronary Artery Disease ◽  
Acute Kidney Injury ◽  
Coronary Artery ◽  
Serum Creatinine ◽  
Contrast Media ◽  
Kidney Injury ◽  
Baseline Serum ◽  
Artery Disease ◽  
Contrast Media Administration

Aim. To assess the influence of heart failure on the risk of contrast-induced acute kidney injury (CI-AKI) in patients with stable coronary artery disease (CAD) with indications to diagnostic procedures requiring intra-arterial administration of contrast media. Materials and methods. 1023 patients, who were receiving optimal medical therapy and had indications to coronary angiography and possible coronary angio-plasty, with stable CAD were included in the study. We conducted an observational open prospective cohort study, which was registered in clinicaltrials.gov with ID NCT04014153. CI-AKI was defined as 25% or more increase of baseline serum creatinine, or more than 0.5 mg/dl and was assessed 48 hours after contrast media administration. The primary endpoint was the CI-AKI development according to KDIGO criteria. Most of the patients, included in the study, were males aged 66.3±10 years with arterial hypertension and overweight (BMI 29.14±5 kg/m2). Results. The study included 1023 patients, 76 suffered from heart failure. The rate of CI-AKI in this group was 13.2% (10 patients). The rate of CI-AKI using the absolute creatinine rise definition was 4% cases (3 cases). Conclusion. Female patients suffering from heart failure with higher levels of serum creatinine and low glomerular filtration rate need more attention, less amount of contrast and adequate preventive measures before contrast media administration in order to lower the risk of CI-AKI development.

scholarly journals Acute Kidney Injury in High-Risk Patients in Cardiac Surgery of Coronary Artery Disease

2021 ◽  
pp. 15-19
Author(s):  
Olena Gogayeva ◽  
Anatoliy V. Rudenko ◽  
Vasyl V. Lazoryshynets
Keyword(s):  
Coronary Artery Disease ◽  
Acute Kidney Injury ◽  
Coronary Artery ◽  
High Risk ◽  
Myocardial Revascularization ◽  
Kidney Injury ◽  
Ischemic Time ◽  
High Risk Patients ◽  
Risk Patients ◽  
Artery Disease

The aim. To analyze the features of the perioperative period in high-risk patients with coronary artery disease (CAD) and postoperative acute kidney injury (AKI). Materials and methods. A post-hoc analysis of 354 high-risk patients with various forms of CAD who were operated and discharged from the National Amosov Institute of Cardiovascular Surgery of the NAMS of Ukraine from January 2009 till December 2019. All the patients underwent clinical and laboratory tests, ECG, echocardiography, coronary angiography, ventriculography and surgical myocardial revascularization with correction of concomitant cardiac pathology. Based on serum creatinine, the glomerular filtration rate (GFR) was calculated based on CKD-EPI equation on admission, on day 1 after surgery and at discharge. Results. On admission, 132 (37.2%) patients had chronic kidney disease (CKD) with GFR <60 ml/min/1.73 m2. Postoperative AKI occurred in 10 (2.8%) patients, with a predominance of patients with complicated forms of CAD (p = 0.0249), type 2 diabetes mellitus (p = 0.0109). There was no dependence of the occurrence of AKI on age (p = 0.6755), the initial stage of CKD (p = 0.4601) and the Charlson comorbidity index (p = 1.0000). However, AKI more often developed during on-pump operations (p = 0.0333) using cardioplegia (p = 0.0164) and was associated with longer duration (p = 0.0007) and higher blood loss (p = 0.0001). In the early postoperative period, patients with AKI more often developed acute heart failure (p = 0.0051), anemia (p = 0.0176) and were characterized by a longer length of stay in the intensive care unit (p = 0.0010) and at the Institute after surgery (p = 0.0363). Conclusions. Perioperative prevention of nephrological complications involves limitation of the use of nephrotoxic drugs, compensation of comorbid conditions and reduction of intraoperative ischemic time.

Sign in / Sign up

Export Citation Format

Share Document