Predictors of renal replacement therapy following isolated coronary artery surgery: a retrospective case-controlled study.

Autor:	Krauchuk A; Department of Anesthesiology and Intensive Therapy, Silesian Centre for Heart Diseases, Medical University of Silesia., Hrapkowicz T; Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Silesian Centre for Heart Diseases, Medical University of Silesia, Zabrze., Suwalski P; Department of Cardiac Surgery, Central Clinical Hospital of the Ministry of Interior and Administration, Warsaw and Centre of Postgraduate Medical Education, Warsaw., Perek B; Department of Cardiac Surgery and Transplantology, Poznan University of Medical Sciences, Poznań., Jasiński M; Department and Clinic of Cardiac Surgery, Wroclaw Medical University, Wroclaw., Hirnle T; Department of Cardiosurgery, Medical University of Bialystok, Bialystok, Poland., Nadziakiewicz P; Department of Anesthesiology and Intensive Therapy, Silesian Centre for Heart Diseases, Medical University of Silesia., Knapik P; Department of Anesthesiology and Intensive Therapy, Silesian Centre for Heart Diseases, Medical University of Silesia.
Jazyk:	angličtina
Zdroj:	International journal of surgery (London, England) [Int J Surg] 2024 Oct 01; Vol. 110 (10), pp. 6684-6690. Date of Electronic Publication: 2024 Oct 01.
DOI:	10.1097/JS9.0000000000001772
Abstrakt:	Objectives: Severe acute kidney injury (AKI) requiring postoperative renal replacement therapy (RRT) is associated with increased morbidity and mortality rates following cardiac surgery. Our study aimed to analyze patients requiring postoperative RRT in a population undergoing isolated coronary artery surgery. Methods: Following exclusions, we analyzed 124 944 consecutive patients in the Polish National Registry of Cardiac Surgical Procedures (KROK Registry), scheduled for isolated coronary artery surgery between January 2010 and December 2019. Patients who underwent preoperative chronic dialysis were excluded from the study. Data of patients requiring postoperative RRT and patients without postoperative RRT were compared. Results: In the analyzed population, 1668 patients (1.3%) developed AKI requiring RRT. In-hospital mortality among patients with and without postoperative RRT was 40.1 and 1.6%, respectively ( P <0.001). Patients requiring postoperative RRT had significantly more preoperative co-morbidities and more frequent postoperative complications. Preoperative chronic renal failure and cardiogenic shock were the two most prominent independent risk factors for postoperative RRT in these patients (OR: 5.0, 95% CI: 3.9-6.4, P <0.001 and OR: 3.9, 95% CI: 2.8-5.6, P <0.001, respectively). Conclusion: Severe AKI requiring postoperative RRT dramatically increases in-hospital mortality and is associated with the development of serious postoperative complications. The need for postoperative RRT is clearly associated with the presence of preoperative co-morbidities. Preoperative chronic renal failure and cardiogenic shock were particularly related to the development of this complication. (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.)
Databáze:	MEDLINE
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