Cardiac-surgery associated acute kidney injury requiring renal replacement therapy. A Spanish retrospective case-cohort study

Acute kidney injury is among the most serious complications after cardiac surgery and is associated with an impaired outcome. Multiple factors may concur in the development of this disease. Moreover, severe renal failure requiring renal replacement therapy (RRT) presents a high mortality rate. Conse...

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Autores: Perez-Valdivieso, J.R. (José Ramón)|||/items/30f505ac-240b-477f-9c9e-ecd6cd2447e6, Monedero, P. (Pablo)|||/items/f5fa19bc-d457-437f-a986-1c0bc5fe365e, Vives-Santacana, M. (Marc)|||/items/a3b36ed6-65be-4b87-a1e3-77fa22916053, Garcia-Fernandez, N. (Nuria)|||/items/775bfac6-047c-423c-b940-e5e2dba00f55, Bes-Rastrollo, M. (Maira)|||/items/d46c05fd-209a-4259-90c6-07202d4c72af
Tipo de recurso: artículo
Fecha de publicación:2009
País:España
Institución:Universidad de Navarra
Repositorio:Dadun. Depósito Académico Digital de la Universidad de Navarra
Idioma:inglés
OAI Identifier:oai:dadun.unav.edu:10171/22293
Acceso en línea:https://hdl.handle.net/10171/22293
Access Level:acceso abierto
Palabra clave:Acute Kidney Injury/mortality/therapy
Cardiac Surgical Procedures/mortality
Renal Replacement Therapy/mortality
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spelling Cardiac-surgery associated acute kidney injury requiring renal replacement therapy. A Spanish retrospective case-cohort studyPerez-Valdivieso, J.R. (José Ramón)|||/items/30f505ac-240b-477f-9c9e-ecd6cd2447e6Monedero, P. (Pablo)|||/items/f5fa19bc-d457-437f-a986-1c0bc5fe365eVives-Santacana, M. (Marc)|||/items/a3b36ed6-65be-4b87-a1e3-77fa22916053Garcia-Fernandez, N. (Nuria)|||/items/775bfac6-047c-423c-b940-e5e2dba00f55Bes-Rastrollo, M. (Maira)|||/items/d46c05fd-209a-4259-90c6-07202d4c72afAcute Kidney Injury/mortality/therapyCardiac Surgical Procedures/mortalityRenal Replacement Therapy/mortalityAcute kidney injury is among the most serious complications after cardiac surgery and is associated with an impaired outcome. Multiple factors may concur in the development of this disease. Moreover, severe renal failure requiring renal replacement therapy (RRT) presents a high mortality rate. Consequently, we studied a Spanish cohort of patients to assess the risk factors for RRT in cardiac surgery-associated acute kidney injury (CSA-AKI). METHODS: A retrospective case-cohort study in 24 Spanish hospitals. All cases of RRT after cardiac surgery in 2007 were matched in a crude ratio of 1:4 consecutive patients based on age, sex, treated in the same year, at the same hospital and by the same group of surgeons. RESULTS: We analyzed the data from 864 patients enrolled in 2007. In multivariate analysis, severe acute kidney injury requiring postoperative RRT was significantly associated with the following variables: lower glomerular filtration rates, less basal haemoglobin, lower left ventricular ejection fraction, diabetes, prior diuretic treatment, urgent surgery, longer aortic cross clamp times, intraoperative administration of aprotinin, and increased number of packed red blood cells (PRBC) transfused. When we conducted a propensity analysis using best-matched of 137 available pairs of patients, prior diuretic treatment, longer aortic cross clamp times and number of PRBC transfused were significantly associated with CSA-AKI.Patients requiring RRT needed longer hospital stays, and suffered higher mortality rates. CONCLUSION: Cardiac-surgery associated acute kidney injury requiring RRT is associated with worse outcomes. For this reason, modifiable risk factors should be optimised and higher risk patients for acute kidney injury should be identified before undertaking cardiac surgery.BioMed CentralDadun. Depósito Académico Digital Universidad de Navarra20122012-05-2920092009-09-0120092009-09-01journal articlehttp://purl.org/coar/resource_type/c_6501info:eu-repo/semantics/articleapplication/pdfhttps://hdl.handle.net/10171/22293reponame:Dadun. Depósito Académico Digital de la Universidad de Navarrainstname:Universidad de NavarraInglésengopen accesshttp://purl.org/coar/access_right/c_abf2info:eu-repo/semantics/openAccessoai:dadun.unav.edu:10171/222932026-06-21T12:47:57Z
dc.title.none.fl_str_mv Cardiac-surgery associated acute kidney injury requiring renal replacement therapy. A Spanish retrospective case-cohort study
title Cardiac-surgery associated acute kidney injury requiring renal replacement therapy. A Spanish retrospective case-cohort study
spellingShingle Cardiac-surgery associated acute kidney injury requiring renal replacement therapy. A Spanish retrospective case-cohort study
Perez-Valdivieso, J.R. (José Ramón)|||/items/30f505ac-240b-477f-9c9e-ecd6cd2447e6
Acute Kidney Injury/mortality/therapy
Cardiac Surgical Procedures/mortality
Renal Replacement Therapy/mortality
title_short Cardiac-surgery associated acute kidney injury requiring renal replacement therapy. A Spanish retrospective case-cohort study
title_full Cardiac-surgery associated acute kidney injury requiring renal replacement therapy. A Spanish retrospective case-cohort study
title_fullStr Cardiac-surgery associated acute kidney injury requiring renal replacement therapy. A Spanish retrospective case-cohort study
title_full_unstemmed Cardiac-surgery associated acute kidney injury requiring renal replacement therapy. A Spanish retrospective case-cohort study
title_sort Cardiac-surgery associated acute kidney injury requiring renal replacement therapy. A Spanish retrospective case-cohort study
dc.creator.none.fl_str_mv Perez-Valdivieso, J.R. (José Ramón)|||/items/30f505ac-240b-477f-9c9e-ecd6cd2447e6
Monedero, P. (Pablo)|||/items/f5fa19bc-d457-437f-a986-1c0bc5fe365e
Vives-Santacana, M. (Marc)|||/items/a3b36ed6-65be-4b87-a1e3-77fa22916053
Garcia-Fernandez, N. (Nuria)|||/items/775bfac6-047c-423c-b940-e5e2dba00f55
Bes-Rastrollo, M. (Maira)|||/items/d46c05fd-209a-4259-90c6-07202d4c72af
author Perez-Valdivieso, J.R. (José Ramón)|||/items/30f505ac-240b-477f-9c9e-ecd6cd2447e6
author_facet Perez-Valdivieso, J.R. (José Ramón)|||/items/30f505ac-240b-477f-9c9e-ecd6cd2447e6
Monedero, P. (Pablo)|||/items/f5fa19bc-d457-437f-a986-1c0bc5fe365e
Vives-Santacana, M. (Marc)|||/items/a3b36ed6-65be-4b87-a1e3-77fa22916053
Garcia-Fernandez, N. (Nuria)|||/items/775bfac6-047c-423c-b940-e5e2dba00f55
Bes-Rastrollo, M. (Maira)|||/items/d46c05fd-209a-4259-90c6-07202d4c72af
author_role author
author2 Monedero, P. (Pablo)|||/items/f5fa19bc-d457-437f-a986-1c0bc5fe365e
Vives-Santacana, M. (Marc)|||/items/a3b36ed6-65be-4b87-a1e3-77fa22916053
Garcia-Fernandez, N. (Nuria)|||/items/775bfac6-047c-423c-b940-e5e2dba00f55
Bes-Rastrollo, M. (Maira)|||/items/d46c05fd-209a-4259-90c6-07202d4c72af
author2_role author
author
author
author
dc.contributor.none.fl_str_mv Dadun. Depósito Académico Digital Universidad de Navarra
dc.subject.none.fl_str_mv Acute Kidney Injury/mortality/therapy
Cardiac Surgical Procedures/mortality
Renal Replacement Therapy/mortality
topic Acute Kidney Injury/mortality/therapy
Cardiac Surgical Procedures/mortality
Renal Replacement Therapy/mortality
description Acute kidney injury is among the most serious complications after cardiac surgery and is associated with an impaired outcome. Multiple factors may concur in the development of this disease. Moreover, severe renal failure requiring renal replacement therapy (RRT) presents a high mortality rate. Consequently, we studied a Spanish cohort of patients to assess the risk factors for RRT in cardiac surgery-associated acute kidney injury (CSA-AKI). METHODS: A retrospective case-cohort study in 24 Spanish hospitals. All cases of RRT after cardiac surgery in 2007 were matched in a crude ratio of 1:4 consecutive patients based on age, sex, treated in the same year, at the same hospital and by the same group of surgeons. RESULTS: We analyzed the data from 864 patients enrolled in 2007. In multivariate analysis, severe acute kidney injury requiring postoperative RRT was significantly associated with the following variables: lower glomerular filtration rates, less basal haemoglobin, lower left ventricular ejection fraction, diabetes, prior diuretic treatment, urgent surgery, longer aortic cross clamp times, intraoperative administration of aprotinin, and increased number of packed red blood cells (PRBC) transfused. When we conducted a propensity analysis using best-matched of 137 available pairs of patients, prior diuretic treatment, longer aortic cross clamp times and number of PRBC transfused were significantly associated with CSA-AKI.Patients requiring RRT needed longer hospital stays, and suffered higher mortality rates. CONCLUSION: Cardiac-surgery associated acute kidney injury requiring RRT is associated with worse outcomes. For this reason, modifiable risk factors should be optimised and higher risk patients for acute kidney injury should be identified before undertaking cardiac surgery.
publishDate 2009
dc.date.none.fl_str_mv 2009
2009-09-01
2009
2009-09-01
2012
2012-05-29
dc.type.none.fl_str_mv journal article
http://purl.org/coar/resource_type/c_6501
dc.type.openaire.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv https://hdl.handle.net/10171/22293
url https://hdl.handle.net/10171/22293
dc.language.none.fl_str_mv Inglés
eng
language_invalid_str_mv Inglés
language eng
dc.rights.none.fl_str_mv open access
http://purl.org/coar/access_right/c_abf2
dc.rights.openaire.fl_str_mv info:eu-repo/semantics/openAccess
rights_invalid_str_mv open access
http://purl.org/coar/access_right/c_abf2
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv BioMed Central
publisher.none.fl_str_mv BioMed Central
dc.source.none.fl_str_mv reponame:Dadun. Depósito Académico Digital de la Universidad de Navarra
instname:Universidad de Navarra
instname_str Universidad de Navarra
reponame_str Dadun. Depósito Académico Digital de la Universidad de Navarra
collection Dadun. Depósito Académico Digital de la Universidad de Navarra
repository.name.fl_str_mv
repository.mail.fl_str_mv
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