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Predictors of acute kidney injury in patients undergoing adult cardiac surgery.

Publication Type : Journal Article

Source : Ann Card Anaesth, Volume 21, Issue 4, p.448-454 (2018), DOI: 10.4103/aca.ACA_21_18.

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Campus : Kochi

School : School of Medicine

Department : Biostatistics, C. V. T. S.

Year : 2018

Abstract : Background: Acute kidney injury (AKI) after cardiac surgery (CS) is not uncommon and has serious effects on mortality and morbidity. A majority of patients suffer mild forms of AKI. There is a paucity of Indian data regarding this important complication after CS.

Aims and Objectives: The primary objective was to study the incidence of AKI associated with CS in an Indian study population. Secondary objectives were to describe the risk factors associated with AKI-CS in our population and to generate outcome data in patients who suffer this complication.

Methods: Serial patients (n = 400) presenting for adult CS (emergency/elective) at a tertiary referral care hospital in South India from August 2016 to November 2017 were included as the study individuals. The incidence of AKI-CS AKI network (AKIN criteria), risk factors associated with this condition and the outcomes following AKI-CS are described.

Results: Out of 400, 37 (9.25%) patients developed AKI after CS. AKI associated with CS was associated with a mortality of 13.5% (no AKI group mortality 2.8%, P = 0.001 [P < 0.05]). When AKI was severe enough to need renal replacement therapy, the mortality increased to 75%. Patients with AKI had a mean hospital stay 16.92 ± 12.75 days which was comparatively longer than patients without AKI (14 ± 7.98 days). Recent acute coronary syndrome, postoperative atrial fibrillation, and systemic hypertension significantly predicted the onset of AKI-CS in our population.

Conclusions: The overall incidence of AKI-CS was 9.25%. The incidence of AKI-CS requiring dialysis (Stage 3 AKIN) AKI-CS was lower (2%). However, mortality risks were disproportionately high in patients with AKIN Stage 3 AKI-CS (75%). There is a need for quality improvement in the care of patients with AKI-CS in its most severe forms since mortality risks posed by the development of Stage 3 AKIN AKI is higher than reported in other index populations from high resource settings.

Cite this Research Publication : Gangadharan S, SundaramKR ,Vasudevan S , Ananthakrishnan B, Balachandran R, Cherian A, Varma PK ,et al. Predictors of Acute Kidney Injury in Patients Undergoing Adult Cardiac Surgery. Ann Card Anaesth, 2018; 21:448-54. DOI: 10.4103/aca.ACA_21_18.

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