Acute kidney injury after cardiac surgery in patients without chronic kidney disease
Rev. bras. cir. cardiovasc
;
33(5): 454-461, Sept.-Oct. 2018. tab, graf
Artigo
em Inglês
| LILACS
| ID: biblio-977449
ABSTRACT
Abstract Introduction:
Among patients undergoing cardiac surgery, the occurrence of acute renal injury appears to be associated with worse prognosis and increased mortality. The objective of this study was to evaluate risk factors and the impact this complication on mortality and survival after cardiac surgery among patients without chronic kidney disease.Methods:
In this retrospective study, we reviewed the medical records of 142 patients who underwent elective coronary artery bypass grafting, valve replacement (single or multiple), or both (simultaneously) at a tertiary care hospital.Results:
Among the 142 patients evaluated, the mean age was 58.28±13.87 years and 80 (56.33%) were female. The postoperative incidence of acute renal injury was 43.66%. Univariate analysis between the groups with and without acute renal injury revealed no significant differences, whereas multivariate analysis showed that risk factors for acute renal injury included valve replacement (OR=4.7, P=0.002, 95% CI=1.76-12.62, age (OR=1.044, P=0.012, 95% CI=1.01-1.07), previous cardiac surgery (OR=36.1, P=0.015, 95% CI=1.99-653.85), postoperative use of the vasoactive drug norepinephrine (OR=3.32, P=0.013, 95% CI=1.29-8.58) and dobutamine (OR=5.3, P=0.019, 95% CI=1.32-21.64). In our sample, there were 30 deaths, of which 25 had acute kidney injury. Survival was also lower among the patients with this complication, especially those who had required hemodialysis (OR=2.60, P<0.001, 95% CI=1.01-6.70) or had previously undergone cardiac surgery (OR=3.68, P<0.001, 95% CI=1.09-12.37).Conclusion:
Our findings underscore the importance of identifying risk factors for developing acute renal injury after cardiac surgery, which can further the development of effective renoprotective strategies.
Texto completo:
DisponíveL
Índice:
LILACS (Américas)
Assunto principal:
Complicações Pós-Operatórias
/
Injúria Renal Aguda
/
Procedimentos Cirúrgicos Cardíacos
Tipo de estudo:
Estudo de etiologia
/
Estudo observacional
/
Estudo prognóstico
/
Fatores de risco
Limite:
Adulto
/
Idoso
/
Aged80
/
Feminino
/
Humanos
/
Masculino
Idioma:
Inglês
Revista:
Rev. bras. cir. cardiovasc
Assunto da revista:
Cardiologia
/
Cirurgia Geral
Ano de publicação:
2018
Tipo de documento:
Artigo
País de afiliação:
Brasil
Instituição/País de afiliação:
Centro Universitário Patos de Minas/BR
/
Instituto de Assistência Médica do Servidor Público de São Paulo/BR
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