OBJECTIVE To investigate the eff ects of
hypoalbuminemia and
human albumin supplementation on
patients with
acute kidney injury (AKI)after
off-pump coronary artery bypass grafting (OPCABG).
METHODS From December 2018 to January 2020,clinical information of 484
patients with coronary atherosclerotic
heart disease who underwent selective OPCABG in Tianjin
Chest Hospital were analyzed retrospectively. The basic data ,American Society of
Anesthesiologists (ASA)grading,the number of
coronary artery bypass grafting ,amount of intraoperative
bleeding ,use of artificial
colloid ,minimum value of
hemoglobin within 7 days after operation ,
hypoalbuminemia occurred after operation ,
monitoring time in postoperative
intensive care unit ,
drainage volume of thoracic
catheterization ,perioperative
blood transfusion ,amount of
human albumin after operation were summarized. All
patients were divided into non-AKI group (414 cases)and AKI group (70 cases)according to the occurrence of AKI. The differences of the above indexes between the two groups were compared. Multiple
Logistic regression analysis was performed to analyze the
risk factor of AKI when selecting the indexes with P<0.1. According to whether
hypoalbuminemia occurred after operation ,all
patients were divided into normal
protein group (347 cases)and
hypoalbuminemia group (137 cases). Hierarchical
analysis was carried out to explore the correlation between
human albumin supplementation and AKI. RESULTS The results of multiple
Logistic regression analysis showed that there was no significant effect on AKI in postoperative
hypoalbuminemia (P>0.05),but there were significant effect in
body mass index and the
dosage of postoperative
human serum albumin (P<0.05). The
risk of AKI would increase by 12.7% every
time the
body mass index increases by 1 unit;the
risk of AKI increased by 17.3% for every 10 g increase in the
dosage of
human albumin . Stratified
analysis showed that the
risk of AKI would increased by 26.9% for every 10 g increase in postoperative
human albumin supplementation in normal
protein group and 14.0% for every 10 g increase in postoperative
human albumin supplementation in
hypoalbuminemia group. CONCLUSIONS
Hypoalbuminemia is not a
risk factor fo r the development of AKI after OPCABG ,but
human albumin supplementation is a
risk factor for AKI after OPCABG.