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Preoperative proteinuria predicts adverse renal outcomes after coronary artery bypass grafting

Tao-Min Huang1, Vin-Cent Wu, Guang-Huar Young

  • 1Division of Nephrology, Department of Internal Medicine, National Taiwan University Hospital, 7 Chung-Shan South Road, Zhong-Zheng District, Taipei 100, Taiwan.

Journal of the American Society of Nephrology : JASN
|December 1, 2010
PubMed

Insights

Preoperative proteinuria is linked to worse kidney outcomes after coronary artery bypass grafting (CABG). Even mild proteinuria increases the risk of cardiac surgery-associated acute kidney injury (CSA-AKI).

Area of Science:

  • Nephrology
  • Cardiology
  • Surgical Outcomes

Background:

  • The association between preoperative proteinuria and adverse renal outcomes following cardiac surgery remains unclear.
  • Proteinuria, a marker of kidney damage, may indicate increased susceptibility to renal injury during major surgery.

Purpose of the Study:

  • To investigate whether preoperative proteinuria predicts adverse renal outcomes, specifically cardiac surgery-associated acute kidney injury (CSA-AKI) and the need for renal replacement therapy (RRT), in patients undergoing coronary artery bypass grafting (CABG).

Main Methods:

  • Secondary analysis of a prospectively enrolled cohort of 1052 adult patients undergoing CABG.
  • Proteinuria assessed via dipstick (mild: trace to 1+; heavy: 2+ to 4+).
  • Exclusion of patients with stage 5 chronic kidney disease (CKD) or prior dialysis.

Main Results:

  • CSA-AKI developed in 17.4% of patients; 4.8% required RRT.
  • Mild and heavy proteinuria independently associated with increased odds of CSA-AKI (OR 1.66 and 2.30, respectively).
  • Heavy proteinuria significantly associated with increased odds of requiring postoperative RRT (OR 7.29).

Conclusions:

  • Preoperative proteinuria is a significant predictor of CSA-AKI in patients undergoing CABG.
  • The presence and severity of proteinuria may help identify patients at higher risk for kidney complications after cardiac surgery.

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