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A SINGLE CENTER RETROSPECTIVE STUDY OF CARDIAC SURGERY ASSOCIATED ACUTE KIDNEY INJURY – INCIDENCE AND OUTCOMES

SANJA SAKAN orcid id orcid.org/0000-0002-9551-413X ; Magdalena Special Hospital for Cardiovascular Surgery and Cardiology, Krapinske Toplice, Croatia
ZDENKO POVŠIĆ-ČEVRA ; Magdalena Special Hospital for Cardiovascular Surgery and Cardiology, Krapinske Toplice, Croatia
KATARINA TOMULIĆ BRUSICH ; Magdalena Special Hospital for Cardiovascular Surgery and Cardiology, Krapinske Toplice, Croatia
VLADO JURANKO ; Magdalena Special Hospital for Cardiovascular Surgery and Cardiology, Krapinske Toplice, Croatia
DAVORKA PRAJDIĆ-PREDRIJEVAC ; Magdalena Special Hospital for Cardiovascular Surgery and Cardiology, Krapinske Toplice, Croatia
MLADEN NOVKOSKI ; Magdalena Special Hospital for Cardiovascular Surgery and Cardiology, Krapinske Toplice, Croatia
ZLATKO BAUDOIN ; Magdalena Special Hospital for Cardiovascular Surgery and Cardiology, Krapinske Toplice, Croatia


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Abstract

Introduction: Cardiac surgery associated acute kidney injury (CSA-AKI) is an important complication. It is recognized as the second cause of AKI in the intensive care patients after sepsis. Methods: We conducted a single center retrospective threeyear cohort study to reveal the incidence of the postoperative AKI genesis and severity, as well as the use of continuous renal replacement therapy in patients with normal preoperative renal function submitted to cardiac surgery. Our study included 1000 patients. Secondary outcomes were length of intensive care and hospital stay, major postoperative complications, and in-hospital mortality rate. Statistical analysis was applied to correlate CSA-AKI development and patient perioperative variables. Results: The overall CSA-AKI incidence was 15.1% (n=151). The incidence of CSA-AKI was 12.8% (n=128) in stage 1; 1.9% (n=19) in stage 2; and 0.4% (n=4) in stage 3 according to the KDIGO AKI (RIFLE/AKIN) criteria. The incidence of continuous renal replacement therapy in the AKI group was 2.65% or 0.4% of the total cohort (n=4). The CSA-AKI inhospital mortality rate was 2.65% (n=4), while AKI patients that required dialysis survived. Conclusion: Once again, our study revealed the importance of timely recognizing CSA-AKI. It also reaffi rmed CSA-AKI as a serious complication with a high incidence rate. We also confi rmed the usefulness of preoperative AKI risk prediction models such as Cleveland Clinic Score in everyday clinical practice.

Keywords

acute kidney injury; cardiac surgery; dialysis; mortality

Hrčak ID:

193710

URI

https://hrcak.srce.hr/193710

Publication date:

15.2.2018.

Article data in other languages: croatian

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