ArticlePloS one2021
Risk factors for acute kidney injury and mortality in high risk patients undergoing cardiac surgery.
Article in PloS one, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.
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20 citing papers in PubMed, 32 citations in OpenAlex.
- Controlled low central venous pressure after cardiopulmonary bypass reduces acute kidney injury following cardiac surgery: a randomized controlled trial.Frontiers in medicine · 2026Trial
- Preoperative Anaemia, Renal Function, and Operative Factors in Acute Kidney Injury and Mortality After Cardiac Surgery with a Prolonged ICU Stay: A Retrospective Cohort Study.Journal of clinical medicine · 2026Article
- Development and external validation of a machine learning model for predicting post-CABG acute kidney injury: insights from MIMIC database and real-world cardiac surgery cohort.BMC nephrology · 2026Article
- Predictors for and Consequences of Acute Kidney Injury After Surgical Aortic Valve Replacement: An Observational Retrospective Study.Journal of clinical medicine · 2025Article
- Predictability of kinetic estimated glomerular filtration rate for acute kidney injury in patients undergoing coronary artery bypass surgery.BMC nephrology · 2025Article
- Temporary bilateral clamping of renal arteries induces ischemia-reperfusion: A new pig model of acute kidney injury using total intravenous anesthesia.Physiological reports · 2025Article
- Development and validation of a prediction model for acute kidney injury following cardiac valve surgery.Frontiers in medicine · 2025Article
- Adverse renal effects associated with cardiopulmonary bypass.Perfusion · 2024Review
- Acute kidney injury interacts with VKORC1 genotype on initiative warfarin dose among heart surgery recipients: a real-world research.Scientific reports · 2023Article
- Acute kidney injury after arterial switch operation: incidence, risk factors, clinical impact - a retrospective single-center study.Renal failure · 2023Article
- Prediction of acute kidney injury following coronary artery bypass graft surgery in elderly Chinese population.Journal of cardiothoracic surgery · 2023Article
- Risk Factors for Death Among Veterans Following Acute Kidney Injury.The American journal of medicine · 2023Article
- Article
- The value of the ACEF II score in Chinese patients with elective and non-elective cardiac surgery.BMC cardiovascular disorders · 2022Article
- Predictive Value of the Transthoracic Echocardiography Index for Acute Kidney Injury after Cardiac Valve Surgery.Journal of cardiovascular development and disease · 2022Article
- Risk Factors for Postoperative Acute Kidney Injury in Patients Undergoing Redo Cardiac Surgery Using Cardiopulmonary Bypass.Journal of cardiovascular development and disease · 2022Article
- Acute Kidney Injury After Open Heart Surgery.Cureus · 2022Article
- Observational
- Diagnosis of Cardiac Surgery-Associated Acute Kidney Injury.Journal of clinical medicine · 2021Review
- Smoking habit as a risk amplifier in chronic kidney disease patients.Scientific reports · 2021Observational
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Authors and funding
8 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAcute Kidney Injury (AKI) represents a clinical condition with poor prognosis. The incidence of AKI in hospitalized patients was about 22-57%. Patients undergoing cardiac surgery (CS) are particularly exposed to AKI because of the related oxidative stress, inflammation and ischemia-reperfusion damage. Hence, the risk profile of patients undergoing CS who develop AKI and who are consequently at increased mortality risk deserves further investigation.
methodsWe designed a retrospective study examining consecutive patients undergoing any type of open-heart surgery from January to December 2018. Patients with a history of AKI were excluded. AKI was diagnosed according to KDIGO criteria. Univariate associations between clinical variables and AKI were tested using logistic regression analysis. Variable thresholds maximizing the association with AKI were measured with the Youden index. Multivariable logistic regression analysis was performed to assess predictors of AKI through backward selection. Mortality risk factors were assessed through the Cox proportional hazard model.
resultsWe studied 158 patients (mean age 51.2±9.7 years) of which 74.7% were males. Types of procedures performed were: isolated coronary artery bypass (CABG, 50.6%), valve (28.5%), aortic (3.2%) and combined (17.7%) surgery. Overall, incidence of AKI was 34.2%. At multivariable analysis, young age (p = 0.016), low blood glucose levels (p = 0.028), estimated Glomerular Filtration Rate (p = 0.007), pH (p = 0.008), type of intervention (p = 0.031), prolonged extracorporeal circulation (ECC, p = 0.028) and cross-clamp (p = 0.021) times were associated with AKI. The threshold for detecting AKI were 91 and 51 minutes for ECC and cross-clamp times, respectively. At survival analysis, the presence of AKI, prolonged ECC and cross-clamp times, and low blood glucose levels forecasted mortality.
conclusionsAKI is common among CS patients and associates with shortened life-expectancy. Several pre-operative and intra-operative predictors are associated with AKI and future mortality. Future studies, aiming at improving prognosis in high-risk patients, by a stricter control of these factors, are awaited.
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