Risk factors for acute kidney injury after heart valve surgery:a Meta-analysis
JI Cui
MA Yaya
WANG Yuan
XING Xiaoying
WANG Lei
Abstract：Objective:The risk factors for acute kidney injury(AKI)were investigated by Meta-analysis.Methods:Computer searches were conducted on CNKI,WanFang Database,VIP,full-text database of Chinese medical journals,the Cochrane Library,PubMed,and other databases to identify risk factors for AKI after heart valve surgery.The retrieval time was from the inception to February 20,2024.Two researchers independently screened literature according to standards,extracted relevant data,and used the Newcastle Ottawa Scale(NOS)to evaluate the quality of the included studies.RevMan 5.3 software was used for Meta-analysis.Results:28 articles were included,with a sample size of 14 855 cases,including 3 255 in the case group and 11 600 in the control group.The Meta-analysis results showed that:age(MD=5.25,95%CI 1.30-9.20,P=0.009),male(OR=1.69,95%CI 1.06-2.69,P=0.03),BMI(MD=0.95,95%CI 0.20-1.71,P=0.01),LVEF(MD=-3.58,95%CI-5.54--1.63,P<0.001),basal Scr increased(OR=2.72,95%CI 1.75-4.21,P<0.001),eGFR<60 mL/(min·1.73 m2)(OR=2.73,95%CI 2.17-3.47,P<0.001),hemoglobin(MD=1.19,95%CI-2.03--0.36,P=0.005),hypertension(OR=2.31,95%CI 1.84-2.90,P<0.001),diabetes mellitus(OR=3.62,95%CI 2.69-4.87,P<0.001),and renal insufficiency(OR=8.34,95%CI 5.03-13.82,P<0.001),cerebrovascular disease(OR=2.89,95%CI 1.81-4.61,P<0.001),anaemia(OR=1.94,95%CI 1.49-2.54,P<0.001),time of surgery(MD=75.03,95%CI 6.44-143.61,P=0.03),time of extracorporeal circulation(MD=22.40,95%CI 10.88-33.92,P<0.001),perioperative blood transfusion(OR=2.69,95%CI 1.85-3.91,P<0.001),ventilator application time>24 h(OR=6.64,95%CI 1.10-40.00,P=0.04),postoperative low cardiac output syndrome(OR=2.92,95%CI 1.35-6.29,P=0.006)were all risk factors for AKI after heart valve surgery,and IABP(OR=4.33,95%CI 1.12-16.74,P=0.03)was an independent risk factor for AKI and follow-up death.And blood albumin is a risk factor for AKI after heart valve surgery(OR=-0.43,95%CI-1.08-0.21,P=0.19).Conclusion:Current evidence shows that age,male,BMI,LVEF,elevated Scr,eGFR<60 mL/(min·1.73 m2),anemia,hypertension,diabetes,cerebrovascular disease,renal insufficiency,long operation time,long cardiopulmonary bypass,perioperative transfusion,ventilator application time,postoperative low cardiac discharge syndrome are risk factors for AKI after heart valves,and IABP may be an independent risk factor for AKI and follow-up death.According to the above risk factors,clinical medical staff should early identify the high-risk groups of AKI after heart valve surgery,and take measures to prevent and treat them to reduce the incidence of postoperative AKI and improve their prognosis.
Keywords：heart valve surgeryacute kidney injuryAKIrisk factorsMeta-analysisevidence-based nursing
Publication Date：2025-02-14
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：7( 381-387 )