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Objective:To investigate the effect of postoperative hypoalbuminemia on acute kidney injury (AKI) after cardiac surgery under cardiopulmonary bypass (CPB).Methods:The clinical data of adult patients undergoing cardiac surgery under CPB were retrospectively analyzed. The difference between preoperative and postoperative serum albumin level was compared. The patients were divided into hypoalbuminemia group (≤35 g/L) and non-hypoalbuminemia group (>35 g/L) according to the lowest serum albumin concentration within 48 hours after surgery. The incidence and severity of postoperative AKI were compared between the two groups. Univariate analysis and binary logistic regression analysis were used to evaluate the effect of postoperative hypoalbuminemia on the incidence of postoperative AKI.Results:Among the 749 patients, the serum albumin level after cardiac surgery was significantly lower than that before surgery ( Z=-15.739, P<0.001), and the proportion of patients with hypoalbuminemia increased from 9.6% to 27.6% ( χ2=83.516, P<0.001). Postoperative AKI occurred in 273 patients, including 109 cases (52.7%) in hypoalbuminemia group and 164 cases (30.3%) in non-hypoalbuminemia group. The incidence of AKI in hypoalbuminemia group was significantly higher than that in non-hypoalbuminemia group ( χ2=32.443, P<0.001), and the severity of AKI in hypoalbuminemia group increased than that in non-hypoalbuminemia group ( Z=-2.098, P=0.036), and the time of hospital stay extended ( Z=-2.442, P=0.015). After adjusted by gender, age, preoperative hypoalbuminemia, comorbidities (hypertension, hyperuricemia, diabetes mellitus, cerebrovascular disease), renal insufficiency, preoperative heart function, coronary angiography, CPB time, aorta blocking time, type of heart surgery and postoperative hypotension, binary logistic regression analysis revealed that postoperative hypoalbuminemia was an independent risk factor for CPB-associated AKI ( OR=2.319, 95% CI 1.586-3.392, P<0.001). Conclusions:AKI is a common complication following cardiac surgery under CPB. Serum albumin after CBP is significantly lower than that before CBP, and postoperative hypoalbuminemia within 48 hours after surgery is an independent risk factor for AKI.
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Objective To investigate the impact of preoperative hyperuricemia on acute kidney injury (AKI) after cardiac surgery with cardiopulmonary bypass (CPB).Methods A total of 567 adult patients undergoing cardiac surgery with CPB were enrolled to conduct a retrospective cohort database analysis.The patients were divided into hyperuricemia group and non-hyperuricemia group according to preoperative serum uric acid,and the incidence of AKI in two groups were compared.Binary logistic regression analysis was used to evaluate the relationship between preoperative hyperuricemia and AKI.Results Among 567 patients after cardiac surgery with CPB,hyperuricemia occurred in 303 cases (53.4％),and AKI occurred in 217 cases (38.3％).There was significantdifference in the incidence of AKI between hyperuricemia group and non-hyperuricemia group (44.6％ vs 31.1％,x2=10.874,P=0.001).The duration of intensive care unit (ICU) stay and the length of stay were longer in hyperuricemia group than those in non-hyperuricemia group (both P ＜ 0.05).After adjusting for age,gender,comorbidities (hypertension,diabetes mellitus,cerebrovascular disease),preoperative renal function,preoperative heart function,CPB time,intraoperative aortic block time,type of cardiac surgery and postoperative hypotension,binary logistic regression analysis showed that preoperative hyperuricemia was an independent risk factor of AKI after cardiac surgery with CPB (OR=1.912,95％ CI 1.270-2.879,P=0.002).Conclusion AKI is a common complication following cardiac surgery with CPB,and hyperuricemia is independently associated with CPB-associated AKI.Hyperuricemia may be involved in the pathogenesis of AKI,and intervention before cardiac surgery may be beneficial to prevent postoperative AKI.