Incidence, Risk Factors, and Outcomes of Acute Kidney Injury after Cardiac Surgery
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- Category: Vol. 85, September 2017
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Incidence, Risk Factors, and Outcomes of Acute Kidney Injury after Cardiac Surgery, IHAB A. IBRAHIM, USAMA M. MOHAMED, HUSSEIN H. SAMIR, HOSSAM A. SAYED, EHAB A. HASSAN and MOHAMED S. ABD EL-SALAM
Abstract
Introduction: Adult cardiac surgery is significantly asso-ciated with the development of Acute Kidney Injury (AKI). We aimed to determine the incidence, outcome and risk-factors of AKI in patients undergoing cardiac surgery.
Patients and Methods: All adult patients undergoing cardiac surgery, with or without Cardiopulmonary Bypass (CPB), from January 2015, to July 2015 were included. Clinical, biochemical and surgical features were recorded. The primary outcome was AKI diagnosed by the Acute Kidney Injury Network (AKIN) criteria. Secondary outcomes were length of ICU and hospital stays, acute dialysis, and mortality.
Results: 40 patients (male/female ratio, 2.1; mean age, 48±13y) were included, with 25 (62.5%) developing post-operative AKI. Patients who developed post-operative AKI were comparable to the non-AKI group as regards age, gender, body mass indexes, and preoperative serum creatinine, eGFR and LVEF; while showed longer CPB times and Aortic Cross-clamp Time (AXT); and received post-operative vasopressor/ inotropic support more frequently than those without AKI. Multivariate stepwise logistic regression analysis identified AXT (OR=1.06 [95% CI 1.01-1.12], p=0.02), and CPB (OR=4.6 [95% CI 1.3-16.4], p=0.02), as the only independent predictors for AKI. Development of AKI was independently associated with with increased length of hospital and Intensive Care Unit (ICU) stay.
Conclusion: AKI is common after cardiac surgery and is associated with prolonged ICU and hospital stay. CPB time and AXT are independently associated with AKI risk. Reducing CPB time could improve the outcome of patients at high risk of AKI.