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Reversible preoperative renal dysfunction does not add to the risk of postoperative acute kidney injury after cardiac valve surgery
OBJECTIVE: To evaluate the impact of the renal dysfunction (RD) type and change of postoperative cardiac function on the risk of developing acute kidney injury (AKI) in patients who underwent cardiac valve surgery. METHOD: Reversible renal dysfunction (RRD) was defined as preoperative RD in patients...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Dove Medical Press
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5689023/ https://www.ncbi.nlm.nih.gov/pubmed/29184415 http://dx.doi.org/10.2147/TCRM.S148549 |
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author | Xu, Jia-Rui Zhuang, Ya-Min Liu, Lan Shen, Bo Wang, Yi-Mei Luo, Zhe Teng, Jie Wang, Chun-Sheng Ding, Xiao-Qiang |
author_facet | Xu, Jia-Rui Zhuang, Ya-Min Liu, Lan Shen, Bo Wang, Yi-Mei Luo, Zhe Teng, Jie Wang, Chun-Sheng Ding, Xiao-Qiang |
author_sort | Xu, Jia-Rui |
collection | PubMed |
description | OBJECTIVE: To evaluate the impact of the renal dysfunction (RD) type and change of postoperative cardiac function on the risk of developing acute kidney injury (AKI) in patients who underwent cardiac valve surgery. METHOD: Reversible renal dysfunction (RRD) was defined as preoperative RD in patients who had not been initially diagnosed with chronic kidney disease (CKD). Cardiac function improvement (CFI) was defined as postoperative left ventricular ejection function – preoperative left ventricular ejection function (ΔEF) >0%, and cardiac function not improved (CFNI) as ΔEF ≤0%. RESULTS: Of the 4,805 (94%) cardiac valve surgery patients, 301 (6%) were RD cases. The AKI incidence in the RRD group (n=252) was significantly lower than in the CKD group (n=49) (36.5% vs 63.3%, P=0.018). The AKI and renal replacement therapy incidences in the CFI group (n=174) were significantly lower than in the CFNI group (n=127) (33.9% vs 50.4%, P=0.004; 6.3% vs 13.4%, P=0.037). After adjustment for age, gender, and other confounding factors, CKD and CKD + CFNI were identified as independent risk factors for AKI in all patients after cardiac valve surgery. Multivariate logistic regression analysis showed that the risk factors for postoperative AKI in preoperative RD patients were age, gender (male), hypertension, diabetes, chronic heart failure, cardiopulmonary bypass time (every 1 min added), and intraoperative hypotension, while CFI after surgery could reduce the risk. CONCLUSION: For cardiac valve surgery patients, preoperative CKD was an independent risk factor for postoperative AKI, but RRD did not add to the risk. Improved postoperative cardiac function can significantly reduce the risk of postoperative AKI. |
format | Online Article Text |
id | pubmed-5689023 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Dove Medical Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-56890232017-11-28 Reversible preoperative renal dysfunction does not add to the risk of postoperative acute kidney injury after cardiac valve surgery Xu, Jia-Rui Zhuang, Ya-Min Liu, Lan Shen, Bo Wang, Yi-Mei Luo, Zhe Teng, Jie Wang, Chun-Sheng Ding, Xiao-Qiang Ther Clin Risk Manag Original Research OBJECTIVE: To evaluate the impact of the renal dysfunction (RD) type and change of postoperative cardiac function on the risk of developing acute kidney injury (AKI) in patients who underwent cardiac valve surgery. METHOD: Reversible renal dysfunction (RRD) was defined as preoperative RD in patients who had not been initially diagnosed with chronic kidney disease (CKD). Cardiac function improvement (CFI) was defined as postoperative left ventricular ejection function – preoperative left ventricular ejection function (ΔEF) >0%, and cardiac function not improved (CFNI) as ΔEF ≤0%. RESULTS: Of the 4,805 (94%) cardiac valve surgery patients, 301 (6%) were RD cases. The AKI incidence in the RRD group (n=252) was significantly lower than in the CKD group (n=49) (36.5% vs 63.3%, P=0.018). The AKI and renal replacement therapy incidences in the CFI group (n=174) were significantly lower than in the CFNI group (n=127) (33.9% vs 50.4%, P=0.004; 6.3% vs 13.4%, P=0.037). After adjustment for age, gender, and other confounding factors, CKD and CKD + CFNI were identified as independent risk factors for AKI in all patients after cardiac valve surgery. Multivariate logistic regression analysis showed that the risk factors for postoperative AKI in preoperative RD patients were age, gender (male), hypertension, diabetes, chronic heart failure, cardiopulmonary bypass time (every 1 min added), and intraoperative hypotension, while CFI after surgery could reduce the risk. CONCLUSION: For cardiac valve surgery patients, preoperative CKD was an independent risk factor for postoperative AKI, but RRD did not add to the risk. Improved postoperative cardiac function can significantly reduce the risk of postoperative AKI. Dove Medical Press 2017-11-10 /pmc/articles/PMC5689023/ /pubmed/29184415 http://dx.doi.org/10.2147/TCRM.S148549 Text en © 2017 Xu et al. This work is published and licensed by Dove Medical Press Limited The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. |
spellingShingle | Original Research Xu, Jia-Rui Zhuang, Ya-Min Liu, Lan Shen, Bo Wang, Yi-Mei Luo, Zhe Teng, Jie Wang, Chun-Sheng Ding, Xiao-Qiang Reversible preoperative renal dysfunction does not add to the risk of postoperative acute kidney injury after cardiac valve surgery |
title | Reversible preoperative renal dysfunction does not add to the risk of postoperative acute kidney injury after cardiac valve surgery |
title_full | Reversible preoperative renal dysfunction does not add to the risk of postoperative acute kidney injury after cardiac valve surgery |
title_fullStr | Reversible preoperative renal dysfunction does not add to the risk of postoperative acute kidney injury after cardiac valve surgery |
title_full_unstemmed | Reversible preoperative renal dysfunction does not add to the risk of postoperative acute kidney injury after cardiac valve surgery |
title_short | Reversible preoperative renal dysfunction does not add to the risk of postoperative acute kidney injury after cardiac valve surgery |
title_sort | reversible preoperative renal dysfunction does not add to the risk of postoperative acute kidney injury after cardiac valve surgery |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5689023/ https://www.ncbi.nlm.nih.gov/pubmed/29184415 http://dx.doi.org/10.2147/TCRM.S148549 |
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