Risk Factors for Acute Kidney Injury in Coronary Artery Bypass Graft Surgery Patients Based on the Acute Kidney

Khosro Barkhordari1, Ali Mohammad Fakhre Yasseri2, Fardin Yousefshahi3,4

  • 1Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.

Insights

Older age, higher BMI, and longer bypass times increase the risk of acute kidney injury (AKI) after heart surgery. Blood transfusions in the ICU and lack of intraoperative transfusion are also key factors.

Area of Science:

  • Cardiology
  • Nephrology
  • Surgical Complications

Background:

  • Acute kidney injury (AKI) is a frequent complication following coronary artery bypass graft (CABG) surgery.
  • Identifying risk factors for AKI is crucial for patient management and outcomes.

Purpose of the Study:

  • To determine independent risk factors for AKI in patients undergoing isolated CABG surgery.
  • To utilize the Acute Kidney Injury Network (AKIN) classification for AKI assessment.

Main Methods:

  • A cross-sectional study of 3473 isolated post-CABG patients.
  • Analysis of 29 potential risk factors using logistic regression.
  • Patients categorized into AKI-negative and AKI-positive groups based on creatinine levels and AKIN criteria.

Main Results:

  • 27.7% of patients developed AKI (Stage 1 or higher).
  • Independent risk factors identified: older age, higher body mass index, lower preoperative creatinine, longer cardiopulmonary bypass time, blood transfusion in ICU, and lack of intraoperative blood transfusion.
  • Specific odds ratios (OR) and p-values were calculated for each risk factor.

Conclusions:

  • Older age, elevated BMI, and longer cardiopulmonary bypass times are significant risk factors for AKI post-CABG.
  • Blood transfusion management (ICU vs. intraoperative) impacts AKI risk.
  • Lower preoperative creatinine levels are associated with a reduced risk of AKI.

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