Risk Factors and Outcome of Acute Kidney Injury after Isolated CABG Surgery: a Prospective Cohort Study

• Published in: Revista brasileira de cirurgia cardiovascular Vol. 34; no. 1; pp. 70 - 75
• Main Authors: Amini, Shahram, Najafi, Mona Najaf, Karrari, Seyedeh Parissa, Mashhadi, Mohammadghasem Etemadi, Mirzaei, Sahereh, Tashnizi, Mohammad Abbasi, Moeinipour, Ali Asghar, Hoseinikhah, Hamid, Aazami, Mathias Hossain, Jafari, Mahdieh
• Format: Journal Article
• Language: English; Portuguese
• Published: Brazil Sociedade Brasileira de Cirurgia Cardiovascular 01.01.2019
• Subjects: Acute Kidney Injury; Acute Kidney Injury - etiology; Acute Kidney Injury - mortality; Age; Aged; Anesthesiology; CARDIAC & CARDIOVASCULAR SYSTEMS; Cardiology; Cohort analysis; Coronary Artery Bypass; Coronary Artery Bypass - adverse effects; Coronary Artery Bypass - mortality; Coronary vessels; Diabetes; Female; Heart surgery; Hemoglobin; Hospital Mortality; Humans; Intensive care; Intensive Care Units - statistics & numerical data; Kidneys; Length of Stay - statistics & numerical data; Male; Medical imaging; Middle Aged; Mortality; Multivariate Analysis; Original; Pregnancy; Prospective Studies; Reference Values; Respiration, Artificial - adverse effects; Respiration, Artificial - mortality; Risk Assessment - methods; Risk Factors; Statistical analysis; Statistics, Nonparametric; SURGERY; Teaching hospitals; Time Factors; Treatment Outcome; Variables; Veins & arteries; Ventilators; Coronary Artery Bypass; Treatment Outcome; Acute Kidney Injury
• ISSN: 1678-9741; 0102-7638; 1678-9741
• DOI: 10.21470/1678-9741-2017-0209

Acute kidney injury (AKI) is a frequent event after cardiac surgery with increased mortality and morbidity. We explored frequency, risk factors, and associated morbidity and mortality of AKI after isolated coronary artery bypass grafting (CABG) surgery at a single institution. All consecutive adults undergoing CABG surgery from March 2013 to October 2016 were assessed for development and severity of AKI based on Acute Kidney Injury Network (AKIN) criteria. The patients were also investigated regarding their need for renal replacement therapy (RRT), predictive risk factors, and associated outcomes, including duration of mechanical ventilation, mortality, intensive care unit (ICU) and hospital length of stay. Of 1737 patients in the study, 275 (15.8%) developed AKI. Twenty-five (12.8%) cases required RRT. Patients with AKI had longer ventilation time, ICU and hospital length of stay (P<0.001). Mortality rates were 28 (10.2%) and 22 (1.5%) in patients with and without AKI, respectively (P<0.001). There was a strong association between advanced age (aOR=1.016, 95% CI=1.002-1.030, P=0.028), diabetes (aOR=1.36, 95% CI=1.022-1.809, P=0.035), on-pump surgery (aOR=2.63, 95% CI=1.543-4.483, P<0.001), transfusion of more than 1 unit of red blood cells (aOR=2.154, 95% CI=1.237-3.753, P=0.007), and prolonged mechanical ventilation and development of AKI (aOR=2.697, 95% CI=1.02407.071, P<0.001). AKI was seen less frequently in those with opium abuse (aOR=0.613, 95% CI=0.409-0.921, P=0.018). We demonstrated that advanced age, diabetes, on-pump surgery, red blood cell transfusion, and prolonged mechanical ventilation were independent positive risk factors for the development of AKI after isolated CABG while opium abuse was a protective factor.