Jiachang Hu1, Rongyi Chen1, Shaopeng Liu1, Xiaofang Yu1, Jianzhou Zou1, Xiaoqiang Ding2. 1. Department of Nephrology, Zhongshan Hospital, Shanghai Medical College, Fudan University, Shanghai, China; Shanghai Institute of Kidney and Dialysis, Shanghai, China. 2. Department of Nephrology, Zhongshan Hospital, Shanghai Medical College, Fudan University, Shanghai, China; Shanghai Institute of Kidney and Dialysis, Shanghai, China. Electronic address: ding.xiaoqiang@zs-hospital.sh.cn.
Abstract
OBJECTIVES: To estimate the global incidence and outcomes of acute kidney injury (AKI) after cardiac surgery in adult patients. DESIGN: A systematic review and meta-analysis. SETTING: Cardiac surgery wards. PARTICIPANTS: Adult patients after cardiac surgery INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: The authors searched PubMed, Web of Science, Cochrane Library, OVID, and EMBASE databases for all articles on cardiac surgery patients published during 2004 to 2014. Meta-analyses were conducted to generate pooled incidence, mortality, ICU length of stay, and length of hospital stay. The authors also described the variations according to study design, criteria of AKI, surgical methods, countries, continents, and their economies. After a primary and secondary screen, 91 observational studies with 320,086 patients were identified. The pooled incidence rates of AKI were 22.3% (95% confidence interval [CI], 19.8 to 25.1) in total and 13.6%, 3.8%, and 2.7% at stages 1, 2, and 3, respectively, whereas 2.3% of patients received renal replacement therapy. The pooled short-term and long-term mortality were 10.7% and 30%, respectively, and increased along with the severity of stages. The pooled unadjusted odds ratio for short-term and long-term mortality in patients with AKI relative to patients without AKI was 0.144 (95% CI, 0.108 to 0.192, p<0.001) and 0.342 (95% CI 0.287-0.407, p<0.001), respectively. The pooled average ICU length of stay and length of hospital stay in the AKI group were 5.4 and 15 days, respectively, while they were 2.2 and 10.5 days in the no-AKI group. CONCLUSIONS: AKI is a great burden for patients undergoing cardiac surgery and can affect short-term and long-term prognoses of these patients.
OBJECTIVES: To estimate the global incidence and outcomes of acute kidney injury (AKI) after cardiac surgery in adult patients. DESIGN: A systematic review and meta-analysis. SETTING: Cardiac surgery wards. PARTICIPANTS: Adult patients after cardiac surgery INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: The authors searched PubMed, Web of Science, Cochrane Library, OVID, and EMBASE databases for all articles on cardiac surgery patients published during 2004 to 2014. Meta-analyses were conducted to generate pooled incidence, mortality, ICU length of stay, and length of hospital stay. The authors also described the variations according to study design, criteria of AKI, surgical methods, countries, continents, and their economies. After a primary and secondary screen, 91 observational studies with 320,086 patients were identified. The pooled incidence rates of AKI were 22.3% (95% confidence interval [CI], 19.8 to 25.1) in total and 13.6%, 3.8%, and 2.7% at stages 1, 2, and 3, respectively, whereas 2.3% of patients received renal replacement therapy. The pooled short-term and long-term mortality were 10.7% and 30%, respectively, and increased along with the severity of stages. The pooled unadjusted odds ratio for short-term and long-term mortality in patients with AKI relative to patients without AKI was 0.144 (95% CI, 0.108 to 0.192, p<0.001) and 0.342 (95% CI 0.287-0.407, p<0.001), respectively. The pooled average ICU length of stay and length of hospital stay in the AKI group were 5.4 and 15 days, respectively, while they were 2.2 and 10.5 days in the no-AKI group. CONCLUSIONS: AKI is a great burden for patients undergoing cardiac surgery and can affect short-term and long-term prognoses of these patients.
Authors: Marilyn Schallom; Donna Prentice; Carrie Sona; Kara Vyers; Cassandra Arroyo; Brian Wessman; Enyo Ablordeppey Journal: Am J Crit Care Date: 2020-11-01 Impact factor: 2.228
Authors: Roger G Evans; Naoya Iguchi; Andrew D Cochrane; Bruno Marino; Sally G Hood; Rinaldo Bellomo; Peter R McCall; Clive N May; Yugeesh R Lankadeva Journal: Am J Physiol Regul Integr Comp Physiol Date: 2019-12-11 Impact factor: 3.619