Early postoperative change in serum creatinine predicts acute kidney injury after cardiothoracic surgery: a retrospective cohort study

Clinical and Experimental Nephrology
Hideaki OkaTakanari Kitazono

Abstract

Acute kidney injury (AKI) is one of the most severe complications after cardiothoracic surgery (CTS). However, diagnosis of AKI by elevation of serum creatinine (SCr) misses a critical time period for prevention and treatment of AKI. We have observed that patients who develop AKI show a smaller SCr decrease after CTS than those without AKI. Hence, we hypothesized that the magnitude of the SCr change (ΔSCr) measured early after CTS can predict subsequent AKI. We conducted a retrospective analysis from January 2014 to December 2016 to examine the association of ΔSCr with AKI. ΔSCr was calculated as follows: (early postoperative SCr on intensive care unit [ICU] admission) - (preoperative SCr). Established risk factors and demographics were included in the multivariate-adjusted logistic regression model. AKI was defined by SCr criteria of the Kidney Disease: Improving Global Outcomes group. Among 252 patients who underwent CTS, 69 developed AKI. The median ΔSCr was - 0.14 mg/dL (range - 0.96-0.45). Patients were divided into three groups based on ΔSCr: Group 1, ≤ - 0.2 mg/dL (n = 84); Group 2, > - 0.2 to < - 0.1 mg/dL (n = 76); and Group 3, ≥ - 0.1 mg/dL (n = 92). In the multivariate analysis, Group 3 had a significantly higher inc...Continue Reading

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Sep 30, 2018·Clinical and Experimental Nephrology·Liu-Jia-Zi ShaoLi Zheng

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