OBJECTIVES: Acute kidney injury (AKI) occurs frequently after cardiac surgery and is associated with increased mortality. The Kidney Disease: Improving Global Outcomes (KDIGO) criteria for diagnosing AKI include creatinine and urine output values. However, the value of the latter is debated. The authors aimed to evaluate the incidence of AKI after cardiac surgery and the independent association of KDIGO criteria, especially the urine output criterion, and 2.5-year mortality. DESIGN: Prospective, observational, cohort study. SETTING: Single-center study in a university hospital. PARTICIPANTS: The study comprised 638 cardiac surgical patients from September 1, 2011, to June 20, 2012. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Hourly urine output, daily plasma creatinine, risk factors for AKI, and variables for EuroSCORE II were recorded. AKI occurred in 183 (28.7%) patients. Patients with AKI diagnosed using only urine output had higher 2.5-year mortality than did patients without AKI (9/53 [17.0%] v 23/455 [5.1%], p = 0.001). AKI was associated with mortality (hazard ratios [95% confidence intervals]: 3.3 [1.8-6.1] for KDIGO 1; 5.8 [2.7-12.1] for KDIGO 2; and 7.9 [3.5-17.6]) for KDIGO 3. KDIGO stages and AKI diagnosed using urine output were associated with mortality even after adjusting for mortality risk assessed using EuroSCORE II and risk factors for AKI. CONCLUSIONS: AKI diagnosed using only the urine output criterion without fulfilling the creatinine criterion and all stages of AKI were associated with long-term mortality. Preoperatively assessed mortality risk using EuroSCORE II did not predict this AKI-associated mortality.
OBJECTIVES:Acute kidney injury (AKI) occurs frequently after cardiac surgery and is associated with increased mortality. The Kidney Disease: Improving Global Outcomes (KDIGO) criteria for diagnosing AKI include creatinine and urine output values. However, the value of the latter is debated. The authors aimed to evaluate the incidence of AKI after cardiac surgery and the independent association of KDIGO criteria, especially the urine output criterion, and 2.5-year mortality. DESIGN: Prospective, observational, cohort study. SETTING: Single-center study in a university hospital. PARTICIPANTS: The study comprised 638 cardiac surgical patients from September 1, 2011, to June 20, 2012. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Hourly urine output, daily plasma creatinine, risk factors for AKI, and variables for EuroSCORE II were recorded. AKI occurred in 183 (28.7%) patients. Patients with AKI diagnosed using only urine output had higher 2.5-year mortality than did patients without AKI (9/53 [17.0%] v 23/455 [5.1%], p = 0.001). AKI was associated with mortality (hazard ratios [95% confidence intervals]: 3.3 [1.8-6.1] for KDIGO 1; 5.8 [2.7-12.1] for KDIGO 2; and 7.9 [3.5-17.6]) for KDIGO 3. KDIGO stages and AKI diagnosed using urine output were associated with mortality even after adjusting for mortality risk assessed using EuroSCORE II and risk factors for AKI. CONCLUSIONS: AKI diagnosed using only the urine output criterion without fulfilling the creatinine criterion and all stages of AKI were associated with long-term mortality. Preoperatively assessed mortality risk using EuroSCORE II did not predict this AKI-associated mortality.
Authors: Eero Pesonen; Hanna Vlasov; Raili Suojaranta; Seppo Hiippala; Alexey Schramko; Erika Wilkman; Tiina Eränen; Kaapo Arvonen; Maxim Mazanikov; Ulla-Stina Salminen; Mihkel Meinberg; Tommi Vähäsilta; Liisa Petäjä; Peter Raivio; Tatu Juvonen; Ville Pettilä Journal: JAMA Date: 2022-07-19 Impact factor: 157.335
Authors: Jennifer Palermo; Allison B Dart; Alanna De Mello; Prasad Devarajan; Ronald Gottesman; Gonzalo Garcia Guerra; Greg Hansen; Ari R Joffe; Cherry Mammen; Nick Majesic; Catherine Morgan; Peter Skippen; Michael Pizzi; Ana Palijan; Michael Zappitelli Journal: Pediatr Crit Care Med Date: 2017-06 Impact factor: 3.624
Authors: Natalie A Silverton; Isaac E Hall; Natalia P Melendez; Brad Harris; Jackson S Harley; Samuel R Parry; Lars R Lofgren; Gregory J Stoddard; Guillaume L Hoareau; Kai Kuck Journal: J Cardiothorac Vasc Anesth Date: 2021-02-04 Impact factor: 2.894
Authors: Mitra K Nadim; Lui G Forni; Azra Bihorac; Charles Hobson; Jay L Koyner; Andrew Shaw; George J Arnaoutakis; Xiaoqiang Ding; Daniel T Engelman; Hrvoje Gasparovic; Vladimir Gasparovic; Charles A Herzog; Kianoush Kashani; Nevin Katz; Kathleen D Liu; Ravindra L Mehta; Marlies Ostermann; Neesh Pannu; Peter Pickkers; Susanna Price; Zaccaria Ricci; Jeffrey B Rich; Lokeswara R Sajja; Fred A Weaver; Alexander Zarbock; Claudio Ronco; John A Kellum Journal: J Am Heart Assoc Date: 2018-06-01 Impact factor: 5.501
Authors: Samuel H Howitt; Stuart W Grant; Camila Caiado; Eric Carlson; Dowan Kwon; Ioannis Dimarakis; Ignacio Malagon; Charles McCollum Journal: BMC Nephrol Date: 2018-06-25 Impact factor: 2.388
Authors: Natalie A Silverton; Lars R Lofgren; Isaac E Hall; Gregory J Stoddard; Natalia P Melendez; Michael Van Tienderen; Spencer Shumway; Bradley J Stringer; Woon-Seok Kang; Carter Lybbert; Kai Kuck Journal: Anesthesiology Date: 2021-09-01 Impact factor: 8.986