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Postoperative acute kidney injury after on-pump cardiac surgery in patients with connective tissue disease

OBJECTIVE: Patients with connective tissue disease have a poor prognosis after receiving cardiac surgery. This study described the clinical scenarios and investigated factors correlated with acute kidney injury (AKI) after on-pump cardiac surgery in patients with systemic lupus erythematosus (SLE) o...

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Autores principales: Zhang, Xue, Miao, Qi, Yu, Chunhua, Zhang, Yuelun, Wu, Di, Tian, Yajie, Li, Hanchen, Wang, Chunrong
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10646509/
https://www.ncbi.nlm.nih.gov/pubmed/38028488
http://dx.doi.org/10.3389/fcvm.2023.1266549
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author Zhang, Xue
Miao, Qi
Yu, Chunhua
Zhang, Yuelun
Wu, Di
Tian, Yajie
Li, Hanchen
Wang, Chunrong
author_facet Zhang, Xue
Miao, Qi
Yu, Chunhua
Zhang, Yuelun
Wu, Di
Tian, Yajie
Li, Hanchen
Wang, Chunrong
author_sort Zhang, Xue
collection PubMed
description OBJECTIVE: Patients with connective tissue disease have a poor prognosis after receiving cardiac surgery. This study described the clinical scenarios and investigated factors correlated with acute kidney injury (AKI) after on-pump cardiac surgery in patients with systemic lupus erythematosus (SLE) or vasculitis. METHODS: Patients with SLE or vasculitis who underwent on-pump cardiac surgery from March 2002 to March 2022 were enrolled, while patients with preoperative renal dysfunction were excluded. AKI was defined according to the Kidney Disease: Improving Global Outcomes (KDIGO) criteria. Uni- and multivariable analyses were performed to identify potential factors associated with postoperative AKI. RESULTS: Among 123 patients enrolled, 39 (31.7%) developed AKI within seven days after receiving on-pump cardiac surgery. Four patients died in the hospital, resulting in an overall in-hospital mortality of 3.3%, and all deaths occurred in the AKI group. Patients in the AKI group also had longer ICU stays (median difference 3.0 day, 95% CI: 1.0–4.0, P < 0.001) and extubation time (median difference 1.0 days, 95% CI: 0–2.0, P < 0.001) than those in the non-AKI group. Multivariable logistic regression revealed that BMI over 24 kg/m(2) (OR: 3.00, 95% CI: 1.24–7.28) and comorbid SLE (OR: 4.73, 95% CI: 1.73–12.93) were independently correlated with postoperative AKI. CONCLUSION: Factors potentially correlated with AKI following on-pump cardiac surgery in patients with connective tissue disease were explored. Clinicians should pay more attention to preoperative evaluation and intraoperative management in patients with risk factors.
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spelling pubmed-106465092023-01-01 Postoperative acute kidney injury after on-pump cardiac surgery in patients with connective tissue disease Zhang, Xue Miao, Qi Yu, Chunhua Zhang, Yuelun Wu, Di Tian, Yajie Li, Hanchen Wang, Chunrong Front Cardiovasc Med Cardiovascular Medicine OBJECTIVE: Patients with connective tissue disease have a poor prognosis after receiving cardiac surgery. This study described the clinical scenarios and investigated factors correlated with acute kidney injury (AKI) after on-pump cardiac surgery in patients with systemic lupus erythematosus (SLE) or vasculitis. METHODS: Patients with SLE or vasculitis who underwent on-pump cardiac surgery from March 2002 to March 2022 were enrolled, while patients with preoperative renal dysfunction were excluded. AKI was defined according to the Kidney Disease: Improving Global Outcomes (KDIGO) criteria. Uni- and multivariable analyses were performed to identify potential factors associated with postoperative AKI. RESULTS: Among 123 patients enrolled, 39 (31.7%) developed AKI within seven days after receiving on-pump cardiac surgery. Four patients died in the hospital, resulting in an overall in-hospital mortality of 3.3%, and all deaths occurred in the AKI group. Patients in the AKI group also had longer ICU stays (median difference 3.0 day, 95% CI: 1.0–4.0, P < 0.001) and extubation time (median difference 1.0 days, 95% CI: 0–2.0, P < 0.001) than those in the non-AKI group. Multivariable logistic regression revealed that BMI over 24 kg/m(2) (OR: 3.00, 95% CI: 1.24–7.28) and comorbid SLE (OR: 4.73, 95% CI: 1.73–12.93) were independently correlated with postoperative AKI. CONCLUSION: Factors potentially correlated with AKI following on-pump cardiac surgery in patients with connective tissue disease were explored. Clinicians should pay more attention to preoperative evaluation and intraoperative management in patients with risk factors. Frontiers Media S.A. 2023-11-01 /pmc/articles/PMC10646509/ /pubmed/38028488 http://dx.doi.org/10.3389/fcvm.2023.1266549 Text en © 2023 Zhang, Miao, Yu, Zhang, Wu, Tian, Li and Wang. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) (https://creativecommons.org/licenses/by/4.0/) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Cardiovascular Medicine
Zhang, Xue
Miao, Qi
Yu, Chunhua
Zhang, Yuelun
Wu, Di
Tian, Yajie
Li, Hanchen
Wang, Chunrong
Postoperative acute kidney injury after on-pump cardiac surgery in patients with connective tissue disease
title Postoperative acute kidney injury after on-pump cardiac surgery in patients with connective tissue disease
title_full Postoperative acute kidney injury after on-pump cardiac surgery in patients with connective tissue disease
title_fullStr Postoperative acute kidney injury after on-pump cardiac surgery in patients with connective tissue disease
title_full_unstemmed Postoperative acute kidney injury after on-pump cardiac surgery in patients with connective tissue disease
title_short Postoperative acute kidney injury after on-pump cardiac surgery in patients with connective tissue disease
title_sort postoperative acute kidney injury after on-pump cardiac surgery in patients with connective tissue disease
topic Cardiovascular Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10646509/
https://www.ncbi.nlm.nih.gov/pubmed/38028488
http://dx.doi.org/10.3389/fcvm.2023.1266549
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