Combined effect of anion gap and red cell distribution width on the risk of acute kidney injury after cardiac surgery.

Bin Zheng, Shanshan Li, Yinglin Peng, Lixian Zhang

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Article in Journal of cardiothoracic surgery, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 · Who and what money

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4 authors.

Bin ZhengDepartment of Anesthesiology, The Second Affiliated Hospital, School of Medicine, South China University of Technology, No.1, Panfu RD, Yuexiu District, Guangzhou, 510180, China. eyzhengbin@scut.edu.cn.

Shanshan LiDepartment of Anesthesiology, The Second Affiliated Hospital, School of Medicine, South China University of Technology, No.1, Panfu RD, Yuexiu District, Guangzhou, 510180, China.

Yinglin PengDepartment of Anesthesiology, The Second Affiliated Hospital, School of Medicine, South China University of Technology, No.1, Panfu RD, Yuexiu District, Guangzhou, 510180, China.

Lixian ZhangDepartment of Anesthesiology, Guangzhou Red Cross Hospital of Jinan University, No.396, Tongfu Zhong RD, Haizhu District, Guangzhou, 510235, China. lixianz3036@163.com.

Funding

Guangzhou Planned Project of Science and Technology 202102010048, 202201010737, and 2023A03J0478

6 · The paper itself

Abstract

backgroundThis study was to analyze the roles of red blood cell distribution width (RDW), anion gap (AG) levels and their combined effects on the risk of acute kidney injury (AKI) following cardiac surgery.

methodsThis cohort study extracted the data of 1951 participants aged ≥ 18 years with the assessment of AKI after cardiac surgery during ICU stay from MIMIC-IV database between 2008 and 2019. Receiver operator characteristic (ROC) curve was used to determine the optimal cut-off value AG and RDW. The associations between AG, RDW, and the combined effects of AG and effects were evaluated via univariable and multivariable Logistic models. Odds ratio (OR) with 95% confidence interval (CI) were imputed.

resultsAmong all the participants, 831 participants had AKI, and 1120 did not have AKI. ROC curves revealed that the optimum cut of points of AG and RDW were 12.75 mmol/L, and 13.65%, respectively. Increased risk of AKI was found in patients after cardiac surgery with AG > 12.75 mmol/L (OR = 1.44, 95%CI 1.15-1.80) or RDW > 13.65% group (OR = 1.23, 95%CI 1.01-1.50). In comparison to subjects with AG ≤ 12.75 mmol/L and RDW ≤ 13.65%, AG > 12.75 mmol/L and RDW ≤ 13.65% (OR = 1.42, 95%CI 1.07-1.89), and AG > 12.75 mmol/L and RDW > 13.65% (OR = 1.75, 95%CI 1.24-2.47) were associated with increased odds of AKI in patients after cardiac surgery.

conclusionsAG and RDW had combined effects on risk of AKI in patients after cardiac surgery, which might offer an insight for the management of patients after cardiac surgery.

Indexed as

Acute Kidney InjuryCardiac Surgical ProceduresErythrocyte IndicesPostoperative ComplicationsAgedFemaleHumansMaleRisk AdjustmentRisk FactorsAcute kidney injuryAnion gapCardiac surgeryRed blood cell distribution width

Identifiers

PMID39443959

DOI10.1186/s13019-024-03100-3

PMCPMC11515780

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LicenceCC BY-NC-ND

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.