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Predictors of renal replacement therapy following isolated coronary artery surgery - a retrospective case controlled study.
Krauchuk, Alena; Hrapkowicz, Tomasz; Suwalski, Piotr; Perek, Bartlomiej; Jasinski, Marek; Hirnle, Tomasz; Nadziakiewicz, Pawel; Knapik, Piotr.
Afiliación
  • Krauchuk A; Department of Anesthesiology and Intensive Therapy, Silesian Centre for Heart Diseases, Medical University of Silesia, Zabrze, Poland.
  • Hrapkowicz T; Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Silesian Centre for Heart Diseases, Medical University of Silesia, Zabrze, Poland.
  • Suwalski P; Department of Cardiac Surgery, Central Clinical Hospital of the Ministry of Interior and Administration, Warsaw and Centre of Postgraduate Medical Education, Warsaw, Poland.
  • Perek B; Department of Cardiac Surgery and Transplantology, Poznan University of Medical Sciences, Poznan, Poland.
  • Jasinski M; Department and Clinic of Cardiac Surgery, Wroclaw Medical University, Wroclaw, Poland.
  • Hirnle T; Department of Cardiosurgery, Medical University of Bialystok, Bialystok, Poland.
  • Nadziakiewicz P; Department of Anesthesiology and Intensive Therapy, Silesian Centre for Heart Diseases, Medical University of Silesia, Zabrze, Poland.
  • Knapik P; Department of Anesthesiology and Intensive Therapy, Silesian Centre for Heart Diseases, Medical University of Silesia, Zabrze, Poland.
Int J Surg ; 2024 Jun 26.
Article en En | MEDLINE | ID: mdl-38920325
ABSTRACT

OBJECTIVES:

Severe acute kidney injury (AKI) requiring postoperative renal replacement therapy (RRT) is associated with increased morbidity and mortality rate following cardiac surgery. Our study was aimed to analyze patients requiring postoperative RRT in a population undergoing isolated coronary artery surgery.

METHODS:

Following exclusions, we analyzed 124,944 consecutive patients in the Polish National Registry of Cardiac Surgical Procedures (KROK Registry), scheduled for isolated coronary artery surgery between January 2010 and December 2019. Patients who underwent preoperative chronic dialysis were excluded from the study. Data of patients requiring postoperative RRT and patients without postoperative RRT were compared.

RESULTS:

In the analyzed population, 1,668 patients (1.3%) developed AKI requiring RRT. In-hospital mortality among patients with and without postoperative RRT were 40.1% and 1.6%, respectively (P<0.001). Patients requiring postoperative RRT had significantly more preoperative co-morbidities and more frequent postoperative complications. Preoperative chronic renal failure and cardiogenic shock were the two most prominent independent risk factors for postoperative RRT in these patients (OR 5.0, 95%CI 3.9-6.4, P<0.001 and OR 3.9, 95%CI 2.8-5.6, P<0.001, respectively).

CONCLUSION:

Severe acute kidney injury (AKI) requiring postoperative RRT dramatically increases in-hospital mortality and is associated with the development of serious postoperative complications. The need for postoperative RRT is clearly associated with the presence of preoperative co-morbidities. Preoperative chronic renal failure and cardiogenic shock were particularly related with the development of this complication.

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Int J Surg Año: 2024 Tipo del documento: Article País de afiliación: Polonia

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Int J Surg Año: 2024 Tipo del documento: Article País de afiliación: Polonia