ISSN 1006-298X      CN 32-1425/R

Chinese Journal of Nephrology, Dialysis & Transplantation ›› 2019, Vol. 28 ›› Issue (4): 324-329.DOI: 10.3969/j.issn.1006-298X.2019.04.005

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Characteristic of cardiac surgery patients with acute kidney injury

  

  • Online:2019-08-31 Published:2019-10-11

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