Predicting kidney disease progression in patients with acute kidney injury after cardiac surgery
| Autor: | Prem Shekar, K. Annette Mizuguchi, Justin Wang, Ian Shempp, Gyorgy Frendl, Chuan-Chin Huang |
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| Rok vydání: | 2017 |
| Předmět: |
Pulmonary and Respiratory Medicine
Male medicine.medical_specialty Urology Renal function Disease 030204 cardiovascular system & hematology 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine medicine Humans 030212 general & internal medicine Cardiac Surgical Procedures Renal Insufficiency Chronic Aged Retrospective Studies Aged 80 and over Creatinine Receiver operating characteristic urogenital system business.industry Acute kidney injury Acute Kidney Injury Middle Aged medicine.disease Cardiac surgery chemistry Relative risk Disease Progression Surgery Female Cardiology and Cardiovascular Medicine business Kidney disease |
| Zdroj: | The Journal of thoracic and cardiovascular surgery. 155(6) |
| ISSN: | 1097-685X |
| Popis: | The study objective was to identify patients who are likely to develop progressive kidney dysfunction (acute kidney disease) before their hospital discharge after cardiac surgery, allowing targeted monitoring of kidney function in this at-risk group with periodic serum creatinine measurements.Risks of progression to acute kidney disease (a state in between acute kidney injury and chronic kidney disease) were modeled from acute kidney injury stages (Kidney Disease: Improving Global Outcomes) in patients undergoing cardiac surgery. A modified Poisson regression with robust error variance was used to evaluate the association between acute kidney injury stages and the development of acute kidney disease (defined as doubling of creatinine 2-4 weeks after surgery) in this observational study.Acute kidney disease occurred in 4.4% of patients with no preexisting kidney disease and 4.8% of patients with preexisting chronic kidney disease. Acute kidney injury predicted development of acute kidney disease in a graded manner in which higher stages of acute kidney injury predicted higher relative risk of progressive kidney disease (area under the receiver operator characteristic curve = 0.82). This correlation persisted regardless of baseline kidney function (P .001). Of note, development of acute kidney disease was associated with higher mortality and need for renal replacement therapy.The degree of acute kidney injury can identify patients who will have a higher risk of progression to acute kidney disease. These patients may benefit from close follow-up of renal function because they are at risk of progressing to chronic kidney disease or end-stage renal disease. |
| Databáze: | OpenAIRE |
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