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A Large Animal Model for Acute Kidney Injury by Temporary Bilateral Renal Artery Occlusion
Published on: February 2, 2021
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Acute renal dysfunction: time from coronary angiography to cardiac surgery
Kanwar A Baloria1, Biju S Pillai, Sanjay Goel
1Max Devki Devi Heart and Vascular Institute, New Delhi, India.
Asian Cardiovascular & Thoracic Annals
|February 27, 2014
Summary
Delaying cardiac surgery more than six days after coronary angiography significantly reduces the risk of acute kidney injury. Multiple factors contribute to acute kidney injury and are associated with mortality.
Area of Science:
- Nephrology
- Cardiology
- Cardiovascular Surgery
Background:
- Acute renal dysfunction (AKI) incidence remains unchanged despite improved perioperative care.
- Understanding AKI risk factors and outcomes post-cardiac surgery is crucial.
Purpose of the Study:
- To evaluate the impact of timing between coronary angiography and cardiac surgery on AKI.
- To identify risk factors for AKI development.
- To measure the association between AKI and mortality.
Main Methods:
- 749 patients undergoing cardiac surgery were divided into three groups based on time elapsed since coronary angiography (0-3 days, 4-6 days, >6 days).
- AKI defined as serum creatinine >25% above baseline on postoperative day 3.
- Endpoints included AKI and mortality.
Main Results:
- 15% of patients developed AKI; 5% required dialysis.
- Risk factors for AKI included hypertension, congestive heart failure, COPD, low ejection fraction (<40%), prolonged cardiopulmonary bypass, intraaortic balloon pump use, and urgent surgery.
- Patients undergoing surgery >6 days after angiography (Group C) showed a lower risk of AKI.
Conclusions:
- A significant relationship exists between the timing of cardiac surgery post-angiography and AKI incidence.
- Multiple factors contribute to AKI, and AKI is consistently associated with increased mortality.
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