Qian Yi1, Ke Li2, Zhao Jian1, Ying-Bin Xiao1, Lin Chen1, Yao Zhang3, Rui-Yan Ma1. 1. Department of Cardiovascular Surgery, Xinqiao Hospital, Chongqing, PR China. 2. Department of Urologic Surgery, Daping Hospital, Chongqing, PR China. 3. Department of Epidemiology, Third Military Medical University, Chongqing, PR China; Evidence-Based Medicine and Clinical Epidemiology Center, Third Military Medical University, Chongqing, PR China.
Abstract
PURPOSE: Cardiovascular surgery-associated acute kidney injury (AKI-CS) contributes to mortality and morbidity. However, risk factors accelerating its development are unclear. We identified risk factors for AKI-CS in patients with cardiopulmonary bypass in the hospital surgical intensive care unit to predict and minimize renal complication in future cardiac surgery. METHODS: We analyzed data from 14 case-control studies published prior to June 2014 and indexed in Science Citation Index, PubMed, and other databases to determine the major risk factors for AKI-CS. RESULTS: Analyzed risk factors were divided into three groups: preoperative, intraoperative and postoperative. Preoperative factors included: age (OR, 4.87; 95% CI, 3.50-6.24), NYHA class III/IV (OR, 2.53; 95% CI, 1.32-4.86), hypertension (OR, 1.68; 95% CI, 1.44-1.97), preoperative creatinine (OR, 0.66; 95% CI, 0.18-1.14), peripheral vascular disease (OR, 1.31 95% CI, 1.09-1.57), respiratory system disease (OR, 1.29; 95% CI, 1.10-1.50), diabetes mellitus (OR, 1.52; 95% CI, 1.07-2.16), and cerebrovascular disease (OR, 2.13; 95% CI, 1.11-4.09). Intraoperative factors were: cardiopulmonary bypass time (OR, 33.78; 95% CI, 23.15-44.41), aortic clamping time (OR, 13.24; 95% CI, 7.78-18.69), use of intra-aortic balloon pump (OR, 4.44; 95% CI, 2.37-8.30), and type of surgery (OR, 1.01; 95% CI, 0.43-2.39). Postoperative factors were: infection (OR, 3.58; 95% CI, 1.43-8.97), redo operation (OR, 2.57; 95% CI, 1.75-3.78), emergency surgery (OR, 4.76; 95% CI, 3.05-7.43), and low cardiac output (OR, 2.30; 95% CI, 1.05-5.04). CONCLUSIONS: Our results support that preoperative, intraoperative, and postoperative factors are associated with AKI-CS. Ejection fraction, BMI, acute myocardial infarction, type of surgery, and congestive heart failure were not absolutely associated with AKI.
PURPOSE: Cardiovascular surgery-associated acute kidney injury (AKI-CS) contributes to mortality and morbidity. However, risk factors accelerating its development are unclear. We identified risk factors for AKI-CS in patients with cardiopulmonary bypass in the hospital surgical intensive care unit to predict and minimize renal complication in future cardiac surgery. METHODS: We analyzed data from 14 case-control studies published prior to June 2014 and indexed in Science Citation Index, PubMed, and other databases to determine the major risk factors for AKI-CS. RESULTS: Analyzed risk factors were divided into three groups: preoperative, intraoperative and postoperative. Preoperative factors included: age (OR, 4.87; 95% CI, 3.50-6.24), NYHA class III/IV (OR, 2.53; 95% CI, 1.32-4.86), hypertension (OR, 1.68; 95% CI, 1.44-1.97), preoperative creatinine (OR, 0.66; 95% CI, 0.18-1.14), peripheral vascular disease (OR, 1.31 95% CI, 1.09-1.57), respiratory system disease (OR, 1.29; 95% CI, 1.10-1.50), diabetes mellitus (OR, 1.52; 95% CI, 1.07-2.16), and cerebrovascular disease (OR, 2.13; 95% CI, 1.11-4.09). Intraoperative factors were: cardiopulmonary bypass time (OR, 33.78; 95% CI, 23.15-44.41), aortic clamping time (OR, 13.24; 95% CI, 7.78-18.69), use of intra-aortic balloon pump (OR, 4.44; 95% CI, 2.37-8.30), and type of surgery (OR, 1.01; 95% CI, 0.43-2.39). Postoperative factors were: infection (OR, 3.58; 95% CI, 1.43-8.97), redo operation (OR, 2.57; 95% CI, 1.75-3.78), emergency surgery (OR, 4.76; 95% CI, 3.05-7.43), and low cardiac output (OR, 2.30; 95% CI, 1.05-5.04). CONCLUSIONS: Our results support that preoperative, intraoperative, and postoperative factors are associated with AKI-CS. Ejection fraction, BMI, acute myocardial infarction, type of surgery, and congestive heart failure were not absolutely associated with AKI.
Authors: P Bent; H K Tan; R Bellomo; J Buckmaster; L Doolan; G Hart; W Silvester; G Gutteridge; G Matalanis; J Raman; A Rosalion; B F Buxton Journal: Ann Thorac Surg Date: 2001-03 Impact factor: 4.330
Authors: G Landoni; T Bove; M Crivellari; D Poli; O Fochi; C Marchetti; A Romano; G Marino; A Zangrillo Journal: Minerva Anestesiol Date: 2007-11 Impact factor: 3.051
Authors: E Sirvinskas; J Andrejaitiene; L Raliene; L Nasvytis; A Karbonskiene; V Pilvinis; J Sakalauskas Journal: Perfusion Date: 2008-11 Impact factor: 1.972
Authors: Lars Englberger; Rakesh M Suri; Zhuo Li; Edward T Casey; Richard C Daly; Joseph A Dearani; Hartzell V Schaff Journal: Crit Care Date: 2011-01-13 Impact factor: 9.097
Authors: Yaron Arbel; Valentin Fuster; Usman Baber; Taye H Hamza; F S Siami; Michael E Farkouh Journal: Int J Cardiol Date: 2019-06-13 Impact factor: 4.164
Authors: Thomas Wittlinger; Martin Maus; Ingo Kutschka; Hassina Baraki; Martin G Friedrich Journal: J Cardiothorac Surg Date: 2021-01-06 Impact factor: 1.637