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Updated: May 11, 2026

A Large Animal Model for Acute Kidney Injury by Temporary Bilateral Renal Artery Occlusion
Published on: February 2, 2021
Acute Kidney Injury after Isolated Coronary Bypass Surgery
John C Slaughter1, Daniel L Davenport2, Sibu P Saha3
1University of Kentucky College of Medicine, Lexington, Kentucky.
Insights
Acute kidney injury (AKI) after cardiac surgery is a serious complication. This study found chronic lung disease and blood transfusions increase AKI risk, with lower rates than national averages.
Area of Science:
- Nephrology
- Cardiology
- Critical Care Medicine
Background:
- Acute kidney injury (AKI) is a significant postoperative complication following cardiac surgery, increasing patient morbidity and mortality.
- Comparing institutional AKI rates to national benchmarks is crucial for quality improvement.
Purpose of the Study:
- To identify risk factors associated with AKI after coronary artery bypass grafting (CABG).
- To compare the institution's AKI incidence in CABG patients with national averages reported by the Society of Thoracic Surgeons (STS).
Main Methods:
- Retrospective review of 1,068 CABG patients from January 2020 to June 2023.
- Analysis of patient demographics, nonmodifiable conditions, and modifiable risk factors.
- Utilized the STS definition for renal failure (Risk, Injury, Failure, Loss, End-stage renal disease).
Main Results:
- The institutional AKI rate was 1.3% (14 patients), lower than the national average of 1.9% for isolated CABG in 2023.
- Chronic lung disease and lower preoperative ejection fraction were significant risk factors for AKI.
- Perioperative blood transfusion, increased perfusion and cross-clamp times were identified as modifiable risk factors.
- AKI patients experienced longer ventilator times, hospital stays, and increased postoperative mortality.
Conclusions:
- The institution's AKI rate after CABG is favorable compared to national data.
- Chronic lung disease and perioperative blood transfusions are key risk factors for AKI in this patient population.
- Addressing modifiable factors like transfusion management and optimizing surgical times may reduce AKI incidence and improve outcomes.
Abstract:
Acute kidney injury (AKI) is among the most serious of the common postoperative complications of cardiac surgeries, which can increase the short- and long-term morbidity and mortality of patients. This study aimed to examine possible risk factors that lead to AKI. We sought to compare our AKI rates to national averages in coronary artery bypass grafting (CABG) reported by the Society of Thoracic Surgeons (STS). We reviewed our institution's data for renal failure in CABG procedures performed between January 1, 2020, and June 30, 2023. From the database, we identified 1,068 CABG patients and reviewed demographics, nonmodifiable conditions, and modifiable risk factors. The STS database uses the Risk, Injury, Failure, Loss, and End-stage renal disease definition for renal failure. Of our patient sample, 14 (1.3%) experienced renal failure. The national rate for AKI after isolated CABG was 1.9% in 2023. Chronic lung disease was a risk factor for AKI development. The mean perfusion, cross-clamp, ventilator times, and hospital stay increased in AKI patients. All patients who suffered from AKI had undergone perioperative blood transfusion. Our single-center experience with renal failure is slightly better than the national average. In our population, chronic lung disease and lower preoperative ejection fractions were associated with increased rates of AKI. Modifiable risk factors in our population included perioperative blood transfusion and increased perfusion/cross-clamp times. Lastly, AKI patients spent longer time on ventilators, increased lengths of stay, and increased postoperative mortality.
Related Concept Videos
Cardiac Catheterization I: Pre-Procedure Overview
Kidney Transplant II: Surgical Procedure
Acute Kidney Injury I: Introduction
Acute Kidney Injury II: Pathophysiology
Acute Kidney Injury III: Clinical Manifestations
Acute Kidney Injury IV: Diagnostic Studies and Prevention

