R Tjahjono1, M Connellan2, E Granger3. 1. Faculty of Medicine, The University of New South Wales, Sydney, Australia. Electronic address: richardtjahjono@gmail.com. 2. Department of Cardiothoracic Surgery, St. Vincent's Hospital, Sydney, Australia. 3. Faculty of Medicine, The University of New South Wales, Sydney, Australia; Department of Cardiothoracic Surgery, St. Vincent's Hospital, Sydney, Australia.
Abstract
BACKGROUND: Acute kidney injury (AKI) is an outcome that represents a significant increase in morbidity and mortality rates; however, limited information exists about the incidence of AKI after cardiac transplantation. METHODS: This single-center, retrospective study from 2009 to 2014 analyzed pre-, intra-, and post-operative characteristics of 111 patients who underwent orthotopic cardiac transplantation to identify risk factors for AKI and validate findings of existing literature. RESULTS: AKI based on the RIFLE criteria (risk, injury, failure, loss, and end-stage) occurred in 65 patients (58.6%) during the hospitalization period, with 38 patients requiring early dialysis. Risk factors for AKI were longer cardiopulmonary bypass duration (P = .008), higher packed cell (P = .004) and cryoprecipitate (P = .022) transfusions, and post-operative bleeding with subsequent surgical re-exploration (P = .008). The development of AKI was also associated with longer inotropic (P ≤ .001) and ventilation duration (P ≤ .001) as well as higher mortality rates (P = .048). CONCLUSIONS: AKI after cardiac transplantation is prevalent and prognostically significant. Although there is yet to be a strategy that conclusively demonstrated its ability to prevent AKI after cardiac surgery, therapies targeted at modifiable risk factors may offer protection against this outcome.
BACKGROUND:Acute kidney injury (AKI) is an outcome that represents a significant increase in morbidity and mortality rates; however, limited information exists about the incidence of AKI after cardiac transplantation. METHODS: This single-center, retrospective study from 2009 to 2014 analyzed pre-, intra-, and post-operative characteristics of 111 patients who underwent orthotopic cardiac transplantation to identify risk factors for AKI and validate findings of existing literature. RESULTS: AKI based on the RIFLE criteria (risk, injury, failure, loss, and end-stage) occurred in 65 patients (58.6%) during the hospitalization period, with 38 patients requiring early dialysis. Risk factors for AKI were longer cardiopulmonary bypass duration (P = .008), higher packed cell (P = .004) and cryoprecipitate (P = .022) transfusions, and post-operative bleeding with subsequent surgical re-exploration (P = .008). The development of AKI was also associated with longer inotropic (P ≤ .001) and ventilation duration (P ≤ .001) as well as higher mortality rates (P = .048). CONCLUSIONS: AKI after cardiac transplantation is prevalent and prognostically significant. Although there is yet to be a strategy that conclusively demonstrated its ability to prevent AKI after cardiac surgery, therapies targeted at modifiable risk factors may offer protection against this outcome.
Authors: Maaike A Sikma; Claudine C Hunault; Johannes H Kirkels; Marianne C Verhaar; Jozef Kesecioglu; Dylan W de Lange Journal: Eur J Drug Metab Pharmacokinet Date: 2018-06 Impact factor: 2.441
Authors: Maaike A Sikma; Claudine C Hunault; Erik M Van Maarseveen; Alwin D R Huitema; Ed A Van de Graaf; Johannes H Kirkels; Marianne C Verhaar; Jan C Grutters; Jozef Kesecioglu; Dylan W De Lange Journal: Eur J Drug Metab Pharmacokinet Date: 2020-02 Impact factor: 2.441