BACKGROUND: There is considerable controversy regarding the diagnosis of Acute Kidney Injury (AKI), and there are over 30 different definitions. OBJECTIVE: To evaluate the incidence and risk factors for the development of AKI following cardiac surgery according to the RIFLE, AKIN and KDIGO criteria, and compare the prognostic power of these criteria. METHODS: Cross-sectional study that included 321 consecutively patients (median age 62 [53-71] years; 140 men) undergoing cardiac surgery between June 2011 and January 2012. The patients were followed for up to 30 days, for a composite outcome (mortality, need for dialysis and extended hospitalization). RESULTS: The incidence of AKI ranged from 15% - 51%, accordingly to the diagnostic criterion adopted. While age was associated with risk of AKI in the three criteria, there were variations in the remaining risk factors. During follow-up, 89 patients developed the outcome and all criteria were associated with increased risk in the univariate Cox analysis and after adjustment for age, gender, diabetes, and type of surgery. However, after further adjustment for extracorporeal circulation and the presence of low cardiac output, only AKI diagnosed by the KDIGO criterion maintained this significant association (HR= 1.89 [95% CI: 1.18 - 3.06]). CONCLUSION: The incidence and risk factors for AKI after cardiac surgery vary significantly according to the diagnostic criteria used. In our analysis, AKI the KDIGO criterion was superior to AKIN and RIFLE with regard its prognostic power.
BACKGROUND: There is considerable controversy regarding the diagnosis of Acute Kidney Injury (AKI), and there are over 30 different definitions. OBJECTIVE: To evaluate the incidence and risk factors for the development of AKI following cardiac surgery according to the RIFLE, AKIN and KDIGO criteria, and compare the prognostic power of these criteria. METHODS: Cross-sectional study that included 321 consecutively patients (median age 62 [53-71] years; 140 men) undergoing cardiac surgery between June 2011 and January 2012. The patients were followed for up to 30 days, for a composite outcome (mortality, need for dialysis and extended hospitalization). RESULTS: The incidence of AKI ranged from 15% - 51%, accordingly to the diagnostic criterion adopted. While age was associated with risk of AKI in the three criteria, there were variations in the remaining risk factors. During follow-up, 89 patients developed the outcome and all criteria were associated with increased risk in the univariate Cox analysis and after adjustment for age, gender, diabetes, and type of surgery. However, after further adjustment for extracorporeal circulation and the presence of low cardiac output, only AKI diagnosed by the KDIGO criterion maintained this significant association (HR= 1.89 [95% CI: 1.18 - 3.06]). CONCLUSION: The incidence and risk factors for AKI after cardiac surgery vary significantly according to the diagnostic criteria used. In our analysis, AKI the KDIGO criterion was superior to AKIN and RIFLE with regard its prognostic power.
Authors: Rajendra H Mehta; Joshua D Grab; Sean M O'Brien; Charles R Bridges; James S Gammie; Constance K Haan; T Bruce Ferguson; Eric D Peterson Journal: Circulation Date: 2006-11-06 Impact factor: 29.690
Authors: Dyego José de Araújo Brito; Vinicius José da Silva Nina; Rachel Vilela de Abreu Haickel Nina; José Albuquerque de Figueiredo Neto; Maria Inês Gomes de Oliveira; João Victor Leal Salgado; Joyce Santos Lages; Natalino Salgado Filho Journal: Rev Bras Cir Cardiovasc Date: 2009 Jul-Sep
Authors: Duminda N Wijeysundera; Keyvan Karkouti; Jean-Yves Dupuis; Vivek Rao; Christopher T Chan; John T Granton; W Scott Beattie Journal: JAMA Date: 2007-04-25 Impact factor: 56.272
Authors: Maurício de Nassau Machado; Rafael Carlos Miranda; Isabela Thomaz Takakura; Eduardo Palmegiani; Carlos Alberto dos Santos; Marcos Aurélio Oliveira; Osana M Mouco; Mauro E Hernandes; Maria Angélica Lemos; Lília N Maia Journal: Arq Bras Cardiol Date: 2009-09 Impact factor: 2.000
Authors: Ravindra L Mehta; John A Kellum; Sudhir V Shah; Bruce A Molitoris; Claudio Ronco; David G Warnock; Adeera Levin Journal: Crit Care Date: 2007 Impact factor: 9.097
Authors: Scott M Sutherland; John J Byrnes; Manish Kothari; Christopher A Longhurst; Sanjeev Dutta; Pablo Garcia; Stuart L Goldstein Journal: Clin J Am Soc Nephrol Date: 2015-02-03 Impact factor: 8.237
Authors: Wim Vandenberghe; Sofie Gevaert; John A Kellum; Sean M Bagshaw; Harlinde Peperstraete; Ingrid Herck; Johan Decruyenaere; Eric A J Hoste Journal: Cardiorenal Med Date: 2015-12-19 Impact factor: 2.041
Authors: Isaac Newton Guimarães Andrade; Diego Torres Aladin de Araújo; Fernando Ribeiro de Moraes Neto Journal: Rev Bras Cir Cardiovasc Date: 2015 Jul-Sep