Title: Acute Kidney Injury (AKI) After Cardiac Surgery: Incidence, Risk Factors and Outcome
Authors: Lakshminarayana GR, Sheetal LG, Rajesh R, Anil M, George K, Shiv KN, Unni VN
DOI: http://dx.doi.org/10.18535/jmscr/v4i6.10
Abstract
Background: Acute kidney injury (AKI) occurs in up to 30% of patients who undergo cardiac surgery and is associated with substantial morbidity and mortality. There is very limited data regarding the post cardiac surgery AKI from India.
Materials and methods: All consecutive patients who underwent cardiac surgeries at Amrita Institute of Medical Sciences and Research, Kochi, Kerala, from May 2008 to April 2010 were included in the study. Postoperative AKI was defined as >25% change in serum creatinine corresponding to a 20% reduction in Cockroft-Gault GFR from baseline within one week after surgery.
Results: 1146 (males:952; females:194) patients, aged 18-82 years (mean 55.90; SD:11.15) were included in the study. The nature of surgeries and patient number were; CABG (on pump:841, off pump: 73), CABG with valve surgery (32), valve surgery (158) and ASD repair (42) respectively. The overall incidence of AKI was 25.7 % & incidence was highest (53.1 %) in combined CABG with valve surgery and lowest (4.8 %) in ASD repair. Dialysis requiring AKI (AKI-D) was seen 2.1 % of all patients & was highest following (6.25 %) in combined CABG and valve surgeries and none required dialysis after ASD repair. The overall in hospital mortality rate in study was 2.2 % and was highest (50 %) in those with AKI-D.
Conclusions: Cardiac surgery is associated with a high risk for AKI. The incidence of AKI and AKI-D was 25.7 and 2.1%, respectively. Presence of AKI, increased the morbidity and mortality, especially in those with AKI-D.
Keywords: AKI, AKI-D, cardiac surgery
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