The Clinical Course of Acute Kidney Disease after Cardiac Surgery: A Retrospective Observational Study.
Ryo MatsuuraMasao IwagamiHidekazu MoriyaTakayasu OhtakeYoshifumi HamasakiMasaomi NangakuKent DoiShuzo KobayashiEisei NoiriPublished in: Scientific reports (2020)
Acute kidney disease (AKD), or renal dysfunction persisting >7 days after an initiating event of acute kidney injury, is a rising concern. This study aimed to elucidate the clinical course of AKD after cardiac surgery with data on post-cardiac surgery patients admitted to intensive care units (ICU) at 18 Japanese hospitals during 2012-2014. Using multivariable logistic models, we evaluated the association of AKD with 90-day mortality and the 50% eGFR decline during 2-year follow-up compared to eGFR at 90 days. AKD was defined as an elevation in serum creatinine to at least 1.5-fold from baseline in >7 days after ICU admission. Of the 3,605 eligible patients undergoing cardiac surgery, 403 patients (11.2%) had AKD. Multivariable analysis revealed that the adjusted odds ratio (OR) of AKD for 90-day mortality was 63.0 (95% confidence interval [CI], 27.9-180.6). In addition, the adjusted OR of AKD for 50% eGFR decline was 3.56 (95% CI, 2.24-5.57) among hospital survivors. In conclusion, AKD after cardiac surgery was associated with higher 90-day mortality and renal function decline after hospital discharge.
Keyphrases
- cardiac surgery
- acute kidney injury
- intensive care unit
- small cell lung cancer
- epidermal growth factor receptor
- cardiovascular events
- tyrosine kinase
- liver failure
- patients undergoing
- end stage renal disease
- respiratory failure
- mechanical ventilation
- healthcare
- ejection fraction
- risk factors
- newly diagnosed
- emergency department
- aortic dissection
- drug induced
- peritoneal dialysis
- young adults
- chronic kidney disease
- electronic health record
- uric acid
- cardiovascular disease
- metabolic syndrome
- big data
- artificial intelligence