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Acute kidney injury after heart valve surgery in elderly patients: any risk factors to modify?
Carrascal, Yolanda; Laguna, Gregorio; Blanco, Miriam; Pañeda, Lucia; Segura, Bárbara.
  • Carrascal, Yolanda; Hospital Clínico Universitario de Valladolid. Department of Cardiac Surgery. Valladolid. ES
  • Laguna, Gregorio; Hospital Clínico Universitario de Valladolid. Department of Cardiac Surgery. Valladolid. ES
  • Blanco, Miriam; Hospital Clínico Universitario de Valladolid. Department of Cardiac Surgery. Valladolid. ES
  • Pañeda, Lucia; Hospital Clínico Universitario de Valladolid. Department of Cardiac Surgery. Valladolid. ES
  • Segura, Bárbara; Hospital Clínico Universitario de Valladolid. Department of Cardiac Surgery. Valladolid. ES
Rev. bras. cir. cardiovasc ; 36(1): 1-9, Jan.-Feb. 2021. tab, graf
Article in English | LILACS | ID: biblio-1155799
ABSTRACT
Abstract

Introduction:

Postoperative acute kidney injury contributes to longer hospital stays and increased costs related to cardiac surgery in the elderly. We analyse the influence of the patient's age on risk factors for acute kidney injury after cardiac valve surgery.

Methods:

We evaluated the prevalence and risk factors for acute kidney injury in 939 consecutive patients undergoing valve surgery, between 2013 and 2018.

Results:

The prevalence of acute kidney injury was 19.5%. Hypertension (P=0.017); RR (95% CI) 1.74 (1.10-3.48), age ≥70 years (P=0.006); RR (95% CI) 1.79 (1.17-2.72), preoperative haematocrit <33% (P=0.009); RR (95% CI) 2.04 (1.19-3.48), glomerular filtration rate <60 ml/min/1.73 m2 (P<0.0001); RR (95%) CI 2.36 (1.54-3.62) and cardiac catheterization <8 days before surgery (P=0.021); RR (95% CI) 2.15 (1.12-4.11) were identified as independent risk factors. In patients older than 70 years, with no kidney disease diagnosed preoperatively, glomerular filtration rate <70 ml/min/1.73 m2, male gender, cardiopulmonary bypass time, preoperative haematocrit <36% and preoperative therapy with angiotensin-converting enzyme inhibitors were risk factors for acute kidney injury after valve surgery.

Conclusions:

In elderly patients, postoperative acute kidney injury develops with higher values of preoperative glomerular filtration rate than those observed in a younger population. Preoperative correction of anaemia, discontinuation of angiotensin-converting enzyme inhibitors and surgical techniques reducing cardiopulmonary bypass time would be considered to reduce the prevalence of renal failure.
Subject(s)


Full text: Available Index: LILACS (Americas) Main subject: Acute Kidney Injury / Cardiac Surgical Procedures Type of study: Etiology study / Observational study / Prognostic study / Risk factors Limits: Aged / Female / Humans / Male Language: English Journal: Rev. bras. cir. cardiovasc Journal subject: Cardiology / General Surgery Year: 2021 Type: Article Affiliation country: Spain Institution/Affiliation country: Hospital Clínico Universitario de Valladolid/ES

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Full text: Available Index: LILACS (Americas) Main subject: Acute Kidney Injury / Cardiac Surgical Procedures Type of study: Etiology study / Observational study / Prognostic study / Risk factors Limits: Aged / Female / Humans / Male Language: English Journal: Rev. bras. cir. cardiovasc Journal subject: Cardiology / General Surgery Year: 2021 Type: Article Affiliation country: Spain Institution/Affiliation country: Hospital Clínico Universitario de Valladolid/ES