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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...

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Autores principales: Xu, Jia-Rui, Zhuang, Ya-Min, Liu, Lan, Shen, Bo, Wang, Yi-Mei, Luo, Zhe, Teng, Jie, Wang, Chun-Sheng, Ding, Xiao-Qiang
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove Medical Press 2017
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.
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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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