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Asian Cardiovasc Thorac Ann. 2013 Dec;21(6):649-54. doi: 10.1177/0218492312465421. Epub 2013 Jul 9.

Acute renal dysfunction: time from coronary angiography to cardiac surgery.

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1
Max Devki Devi Heart and Vascular Institute, New Delhi, India.

Abstract

BACKGROUND:

The incidence of acute renal dysfunction has not changed much over the years, despite improvements in perioperative care. Our objectives were to evaluate the impact of timing of cardiac surgery after coronary angiography on acute renal dysfunction, to identify risk factors associated with development of acute renal dysfunction, and to measure the association between acute renal dysfunction and mortality.

PATIENTS AND METHODS:

The patients were divided into 3 groups: group A (cardiac surgery 0-3 days after angiography), group B (surgery 4-6 days after angiography), and group C (surgery > 6 days after angiography). Endpoints were acute renal dysfunction, defined as serum creatinine > 25% of baseline on the 3rd postoperative day, and mortality.

RESULTS:

In 749 patients, the incidence of acute renal dysfunction was 15%; 5% required dialysis. Hypertension, congestive heart failure, chronic obstructive pulmonary disease, ejection fraction < 40%, prolonged cardiopulmonary bypass time, intraaortic balloon pump use, and urgent surgery were risk factors for acute renal dysfunction after cardiac surgery. Patients in group C had a lower risk of acute renal dysfunction.

CONCLUSION:

Acute renal dysfunction has a definite relationship with the time period between angiography and cardiac surgery. The causative factors for this condition are multiple and also show a consistent association with mortality.

KEYWORDS:

Acute kidney injury; cardiopulmonary bypass; coronary artery bypass; postoperative complications; renal dialysis

PMID:
24569321
DOI:
10.1177/0218492312465421
[Indexed for MEDLINE]
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