Acute kidney injury (AKI) outcome, a predictor of long-term major adverse cardiovascular events (MACE)

2016 ◽  
Vol 85 (2016) (01) ◽  
pp. 1-11 ◽  
Author(s):  
Bolanle A. Omotoso ◽  
Emaad M. Abdel-Rahman ◽  
Wenjun Xin ◽  
Jennie Z. Ma ◽  
Kenneth W. Scully ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Cardiovascular Events ◽  
Kidney Injury ◽  
Major Adverse Cardiovascular Events

Dialysis Requirement and Long-Term Major Adverse Cardiovascular Events in Patients with Chronic Kidney Disease and Superimposed Acute Kidney Injury

Nephron ◽  
2017 ◽  
Vol 136 (2) ◽  
pp. 95-102 ◽  
Author(s):  
Bolanle A. Omotoso ◽  
Faruk Turgut ◽  
Emaad M. Abdel-Rahman ◽  
Wenjun Xin ◽  
Jennie Z. Ma ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Acute Kidney Injury ◽  
Kidney Disease ◽  
Cardiovascular Events ◽  
Kidney Injury ◽  
Major Adverse Cardiovascular Events

scholarly journals Preoperative Estimates of Glomerular Filtration Rate as Predictors of Outcome after Surgery

2013 ◽  
Vol 118 (4) ◽  
pp. 809-824 ◽  
Author(s):  
John F. Mooney ◽  
Isuru Ranasinghe ◽  
Clara K. Chow ◽  
Vlado Perkovic ◽  
Federica Barzi ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Glomerular Filtration Rate ◽  
Cardiovascular Events ◽  
Filtration Rate ◽  
Kidney Injury ◽  
Major Adverse Cardiovascular Events ◽  
Increased Risk ◽  
All Cause Mortality ◽  
The Relationship

Abstract Background: Kidney dysfunction is a strong determinant of prognosis in many settings. Methods: A systematic review and meta-analysis was undertaken to explore the relationship between estimated glomerular filtration rate (eGFR) and adverse outcomes after surgery. Cohort studies reporting the relationship between eGFR and major outcomes, including all-cause mortality, major adverse cardiovascular events, and acute kidney injury after cardiac or noncardiac surgery, were included. Results: Forty-six studies were included, of which 44 focused exclusively on cardiac and vascular surgery. Within 30 days of surgery, eGFR less than 60 ml·min·1.73 m−2 was associated with a threefold increased risk of death (multivariable adjusted relative risk [RR] 2.98; 95% confidence interval [CI] 1.95–4.96) and acute kidney injury (adjusted RR 3.13; 95% CI 2.22–4.41). An eGFR less than 60 ml·min·1.73 m−2 was associated with an increased risk of all-cause mortality (adjusted RR 1.61; 95% CI 1.38–1.87) and major adverse cardiovascular events (adjusted RR 1.49; 95% CI 1.32–1.67) during long-term follow-up. There was a nonlinear association between eGFR and the risk of early mortality such that, compared with patients having an eGFR more than 90 ml·min·1.73 m−2 the pooled RR for death at 30 days in those with an eGFR between 30 and 60 ml·min·1.73 m−2 was 1.62 (95% CI 1.43–1.80), rising to 2.85 (95% CI 2.49–3.27) in patients with an eGFR less than 30 ml·min·1.73 m−2 and 3.75 (95% CI 3.44–4.08) in those with an eGFR less than 15 ml·min·1.73 m−2. Conclusion: There is a powerful relationship between eGFR, and both short- and long-term prognosis after, predominantly cardiac and vascular, surgery.

scholarly journals Role of cystatin C as a biomarker of acute kidney injury and as an independent long-term predictor of cardiovascular events, mortality and functional outcome

2012 ◽  
Author(s):  
Carolina Marrani ◽  
Teuta Zenjelaj ◽  
Daniela Bartoli ◽  
Francesco Corradi ◽  
Rinaldo Innocenti
Keyword(s):  
Acute Kidney Injury ◽  
Cystatin C ◽  
Cardiovascular Events ◽  
Cox Regression ◽  
Elevated Serum ◽  
Kidney Injury ◽  
Serum Cystatin C ◽  
Serum Cystatin ◽  
Long Term Mortality

Introduction Serum cystatin C measurements as an early biomarker of acute kidney injury (AKI) is gaining acceptance as studies confirm and define its usefulness. The aim of this study is to determine whether increase in serum cystatin C has an impact on long-term mortality, independently from the presence of the kidney injury itself.Materials and methods A retrospective study (20-month follow-up) was conducted in 173 not selected hospitalized patients. According to serum cystatin C concentrations, patients were stratified in risk classes by quartiles (≥0.55 and <1 mg/L; ≥1 and <1.17 mg/L; ≥1.17 and 1.57 mg/L; ≥1.57 and ≤5.29 mg/L). We compared the association of cystatin C levels with the risk for long-term mortality, after adjustment for age, sex, race and heart failure risk factors.Results A relationship with higher serum levels of cystatin C and mortality was found in patients with and without AKI, being stronger in patients without AKI. After multivariate adjustment, the highest quartile of cystatin C (>1.5 mg/L) was associated with a lower risk for long-term mortality. The statistical analysis (Cox regression) of the independent variables as far as mortality is concerned confirmed the significance of our result (RR 3.60; IC 1.73–7.48; p = 0.001).Conclusions In summary, elevated serum cystatin C level (>1.5 mg/L) was strongly and independently associated with negative clinical outcomes such as mortality and cardiovascular events, independently from the kidney injury itself. The dosage of cystatin C might play an important role in clinical practice for the assessment of cardiovascular risk stratification.

Acute Kidney Injury and Long-term Risk of Cardiovascular Events After Cardiac Surgery: A Population-Based Cohort Study

2015 ◽  
Vol 29 (3) ◽  
pp. 617-625 ◽  
Author(s):  
Malene Kærslund Hansen ◽  
Henrik Gammelager ◽  
Carl-Johan Jacobsen ◽  
Vibeke Elisabeth Hjortdal ◽  
J. Bradley Layton ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Cardiac Surgery ◽  
Cohort Study ◽  
Cardiovascular Events ◽  
Kidney Injury ◽  
Population Based

scholarly journals Effect of remote ischaemic preconditioning on mortality and morbidity after non-cardiac surgery: meta-analysis

BJS Open ◽  
2021 ◽  
Vol 5 (2) ◽  
Author(s):  
K L Wahlstrøm ◽  
E Bjerrum ◽  
I Gögenur ◽  
J Burcharth ◽  
S Ekeloef
Keyword(s):  
Acute Kidney Injury ◽  
Cardiac Surgery ◽  
Cardiovascular Events ◽  
Meta Analysis ◽  
Kidney Injury ◽  
Non Invasive ◽  
Remote Ischaemic Preconditioning ◽  
Meta Analyses ◽  
Long Term Mortality

Abstract Background Remote ischaemic preconditioning (RIPC) has been shown to have a protective role on vital organs exposed to reperfusion injury. The aim of this systematic review was to evaluate the effects of non-invasive RIPC on clinical and biochemical outcomes in patients undergoing non-cardiac surgery Methods A systematic literature search of PubMed, EMBASE, Scopus, and Cochrane databases was carried out in February 2020. RCTs investigating the effect of non-invasive RIPC in adults undergoing non-cardiac surgery were included. Meta-analyses and trial sequential analyses (TSAs) were performed on cardiovascular events, acute kidney injury, and short- and long-term mortality. Results Some 43 RCTs including 3660 patients were included. The surgical areas comprised orthopaedic, vascular, abdominal, pulmonary, neurological, and urological surgery. Meta-analysis showed RIPC to be associated with fewer cardiovascular events in non-cardiac surgery (13 trials, 1968 patients, 421 events; odds ratio (OR) 0.68, 95 per cent c.i. 0.47 to 0.96; P = 0.03). Meta-analyses of the effect of RIPC on acute kidney injury (12 trials, 1208 patients, 211 events; OR 1.14, 0.78 to 1.69; P = 0.50; I2 = 9 per cent), short-term mortality (7 trials, 1239 patients, 65 events; OR 0.65, 0.37 to 1.12; P = 0.12; I2 = 0 per cent), and long-term mortality (4 trials, 1167 patients, 9 events; OR 0.67, 0.18 to 2.55; P = 0.56; I2 = 0 per cent) showed no significant differences for RIPC compared with standard perioperative care in non-cardiac surgery. However, TSAs showed that the required information sizes have not yet been reached. Conclusion Application of RIPC to non-cardiac surgery might reduce cardiovascular events, but not acute kidney injury or all-cause mortality, but currently available data are inadequate to confirm or reject an assumed intervention effect.

scholarly journals Management of Acute Kidney Injury Following Major Abdominal Surgery: A Contemporary Review

2020 ◽  
Vol 9 (8) ◽  
pp. 2679
Author(s):  
Joana Gameiro ◽  
José Agapito Fonseca ◽  
Filipe Marques ◽  
José António Lopes
Keyword(s):  
Acute Kidney Injury ◽  
Abdominal Surgery ◽  
Cardiovascular Events ◽  
Kidney Injury ◽  
Patient Characteristics ◽  
Major Abdominal Surgery ◽  
Comprehensive Review ◽  
Postoperative Aki ◽  
Long Term Mortality

Acute kidney injury (AKI) is a frequent occurrence following major abdominal surgery and is independently associated with both in-hospital and long-term mortality, as well as with a higher risk of progressing to chronic kidney disease (CKD) and cardiovascular events. Postoperative AKI can account for up to 40% of in-hospital AKI cases. Given the differences in patient characteristics and the pathophysiology of postoperative AKI, it is inappropriate to assume that the management after noncardiac and nonvascular surgery are the same as those after cardiac and vascular surgery. This article provides a comprehensive review on the available evidence on the management of postoperative AKI in the setting of major abdominal surgery.

Sign in / Sign up

Export Citation Format

Share Document