关键词: 急性肾损伤, 危险因素, 发病率, 心脏外科手术, 体外循环

Abstract:

Ｏｂｊｅｃｔｉｖｅ：To observe the incidence,clinical characteristics and risk factors of acute kidney injury (AKI) after cardiac surgery in our hospital,and provide evidence for better understanding and early intervention.
Ｍｅｔｈｏｄｏｌｏｇｙ：Retrospective analysis of patients with cardiac surgery from July 2017 to June 2018 in the First Affiliated Hospital of Xi′an Jiaotong University,screening patients with AKI and nonAKI recording their clinical data and analyzing risk factors.
Ｒｅｓｕｌｔｓ：Five hundred seventyfive patients were involved,AKI developed in 177 (3078%) patients,whereas 417% of them received renal replacement therapy.Patients with AKI had significant higher mortality than patients without AKI (1017% vs 05%,P<0001). The incidence of AKI stage 1,2,and 3 was 1913%(110/575),522%(30/575),and 643%(37/575) respectively,and the mortality was 272%(3/110),10%(3/30) and 3243%(12/37).There was a statistically significant difference in mortality between three groups(P<0001). Multivariate Logistic regression analysis showed that cardiopulmonary bypass (OR=1436,95%CI 1168～1765),advanced age(OR=7807,95%CI 1338～45563),previous cardiac surgery (OR=7807,95%CI 1338～45536),high level of preoperative blood Cystatin C (OR=3576,95%CI 139～9197),perioperative infection (OR=1436,95%CI 1168～1765) and intraoperative cardiopulmonary bypass time (OR=1457,95%CI 1077～1971)were the independent risk factors of AKI after cardiac surgery. The occurrence of AKI after cardiac surgery was mainly within 24 hours after surgery,accounting for 8023% of AKI patients.
Ｃｏｎｃｌｕｓｉｏｎ：
AKI can occur early after cardiac surgery  in 3078% of patients.AKI has a significantly increased mortality compared with nonAKI patients.It should be alert to its risk factors and early intervention.

Key words: acute kidney injury, risk factors, morbidity, cardiac surgery, cardiopulmonary bypass