Influence of minimal changes in preoperative renal function on outcomes of cardiac surgery

Kidney & Blood Pressure Research
Linda ShavitDaniel Fink

Abstract

Cardiovascular morbidity and mortality are high in patients with chronic kidney disease. We evaluated the influence of small differences in preoperative kidney function on mortality and complications following cardiac surgery. This is an observational study that included adult patients undergoing cardiac surgery. Preoperative estimated glomerular filtration rate (eGFR) was estimated by the 4-component Modification of Diet in Renal Disease (MDRD) and Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations based on preoperative creatinine levels. For analysis, patients were divided into groups according to their preoperative creatinine (0.2 mg/dl increments) and eGFR levels (15-30 ml/min/1.73 m(2) decrements). Data on 5,340 patients were analyzed. A significant increase in postoperative mortality was demonstrated with preoperative creatinine at high-normal versus low-normal values (OR 1.7, 95% CI: 1-2.5; p = 0.02). For preoperative creatinine >1.2 mg/dl, adjusted OR for in-hospital mortality increased stepwise with every 0.2-mg/dl increment of creatinine. In addition, a statistically significant increment of mortality was detected with every 15-ml/min/1.73 m(2) decrement in preoperative eGFR. Minimal changes of preo...Continue Reading

References

May 12, 1998·The American Journal of Medicine·G M ChertowJ Daley
Jul 29, 1999·The Journal of Thoracic and Cardiovascular Surgery·I DurmazS Başarir
Jun 1, 2001·The Journal of Thoracic and Cardiovascular Surgery·A WeerasingheC Ratnatunga
Aug 14, 2002·The Annals of Thoracic Surgery·Alfonso Penta de PeppoLuigi Chiariello
May 22, 2004·Journal of the American Society of Nephrology : JASN·Andrea LassniggMichael Hiesmayr
Jan 29, 2005·The Journal of Thoracic and Cardiovascular Surgery·Ruud M A van de WalH W Thijs Plokker
Jan 24, 2006·The Annals of Thoracic Surgery·Anne KuitunenVille Pettilä
Nov 8, 2007·JAMA : the Journal of the American Medical Association·Josef CoreshAndrew S Levey
Dec 11, 2007·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Olli-Pekka KangasniemiFausto Biancari
May 6, 2009·Annals of Internal Medicine·Andrew S LeveyUNKNOWN CKD-EPI (Chronic Kidney Disease Epidemiology Collaboration)
Apr 27, 2010·Heart, Lung & Circulation·Adam J HedleyFrancesco L Ierino

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Citations

Feb 8, 2013·Experimental Gerontology·Linda ShavitDaniel Fink
Apr 30, 2015·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·Jacek B CywinskiDaniel I Sessler
May 15, 2018·Minerva anestesiologica·Raquel CallejasUNKNOWN Renal Dysfunction in Cardiac Surgery Spanish Group (GEDRCC2)
Aug 26, 2020·Journal of Cardiac Surgery·Mélanie HébertRaymond Cartier
Nov 15, 2016·Current Opinion in Anaesthesiology·Nicholas LysakCharles Hobson

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