BACKGROUND: A small increase in serum creatinine after cardiac surgery has been associated with increased mortality. However, it is unclear whether this association varies with baseline renal function. METHODS: We retrospectively reviewed data on 1359 patients who underwent cardiac surgery over a 4-year period in two tertiary care hospitals including demographic data, comorbid conditions, and intra- and postoperative complications using a standardized form. We followed patients for 90 days postoperatively and death rates and length of hospital stay were noted. RESULTS: The incidence of acute kidney injury (AKI) after cardiac surgery was 40.2%. Patients were grouped into terciles based on change in serum creatinine. Kaplan-Meier survival analysis and Cox regression analysis showed that the development of AKI with a small increase in serum creatinine of more than 0.3 mg/dL from baseline (tercile 3) was associated with a higher risk of mortality within 90 days and 7 days longer hospitalization following a cardiac surgery. Stratified analysis showed that only patients with baseline eGFR < 60 mL/min/1.73 m (2) had fivefold higher mortality with rise of serum creatinine >0.3 mg/dL. CONCLUSIONS: Patients with baseline eGFR < 60 mL/min/1.73 m(2) had increased risk of mortality after cardiac surgery with a small increase in serum creatinine whereas a similar increase in serum creatinine in those with eGFR ≥ 60 mL/min/1.73 m(2) did not increase mortality.
BACKGROUND: A small increase in serum creatinine after cardiac surgery has been associated with increased mortality. However, it is unclear whether this association varies with baseline renal function. METHODS: We retrospectively reviewed data on 1359 patients who underwent cardiac surgery over a 4-year period in two tertiary care hospitals including demographic data, comorbid conditions, and intra- and postoperative complications using a standardized form. We followed patients for 90 days postoperatively and death rates and length of hospital stay were noted. RESULTS: The incidence of acute kidney injury (AKI) after cardiac surgery was 40.2%. Patients were grouped into terciles based on change in serum creatinine. Kaplan-Meier survival analysis and Cox regression analysis showed that the development of AKI with a small increase in serum creatinine of more than 0.3 mg/dL from baseline (tercile 3) was associated with a higher risk of mortality within 90 days and 7 days longer hospitalization following a cardiac surgery. Stratified analysis showed that only patients with baseline eGFR < 60 mL/min/1.73 m (2) had fivefold higher mortality with rise of serum creatinine >0.3 mg/dL. CONCLUSIONS:Patients with baseline eGFR < 60 mL/min/1.73 m(2) had increased risk of mortality after cardiac surgery with a small increase in serum creatinine whereas a similar increase in serum creatinine in those with eGFR ≥ 60 mL/min/1.73 m(2) did not increase mortality.
Authors: F Perry Wilson; Michael Shashaty; Jeffrey Testani; Iram Aqeel; Yuliya Borovskiy; Susan S Ellenberg; Harold I Feldman; Hilda Fernandez; Yevgeniy Gitelman; Jennie Lin; Dan Negoianu; Chirag R Parikh; Peter P Reese; Richard Urbani; Barry Fuchs Journal: Lancet Date: 2015-02-26 Impact factor: 79.321
Authors: Sidney Le; Angier Allen; Jacob Calvert; Paul M Palevsky; Gregory Braden; Sharad Patel; Emily Pellegrini; Abigail Green-Saxena; Jana Hoffman; Ritankar Das Journal: Kidney Int Rep Date: 2021-02-26
Authors: Rosana G Bruetto; Fernando B Rodrigues; Ulysses S Torres; Ana P Otaviano; Dirce M T Zanetta; Emmanuel A Burdmann Journal: PLoS One Date: 2012-04-23 Impact factor: 3.240
Authors: Amit X Garg; Nadine Shehata; Shay McGuinness; Richard Whitlock; Dean Fergusson; Ron Wald; Chirag Parikh; Sean M Bagshaw; Boris Khanykin; Alex Gregory; Summer Syed; Gregory M T Hare; Meaghan S Cuerden; Kevin E Thorpe; Judith Hall; Subodh Verma; Pavel S Roshanov; Jessica M Sontrop; C David Mazer Journal: Can J Kidney Health Dis Date: 2018-01-03
Authors: Paula Duque-Sosa; Diego Martínez-Urbistondo; Gemma Echarri; Raquel Callejas; María Josefa Iribarren; Gregorio Rábago; Pablo Monedero Journal: PLoS One Date: 2017-02-22 Impact factor: 3.240