Risk factors of acute kidney injury after cardiopulmonary bypass
SHI Qiu-xia
HAN Dan-nuo
JIA Ming
HOU Xiao-tong
Abstract：Objective To discuss the risk factors of acute kidney injury (AKI) after cardiopulmonary bypass (CPB).Methods The data was retrospectively analyzed in patients undergone CPB (n=1070, male 570 and female 500) chosen the Department of Cardiac Surgery of Beijing Anzhen Hospital affiliated to Capital University of Medical Sciences from Jan. 2016 to Jun. 2016. All patients were divided into non-AKI group (n=850) and AKI group (n=220). The medical materials of the patients were looked over, and indexes of sex, age, body mass index (BMI), complications, class of New York Heart Association (NYHA), left ventricular ejection fraction (LVEF), preoperative blood routine examinations, kidney function, CPB, operation situation, auxiliary time of mechanical ventilation (MV) and blood transfusion volume after operation for 24 h were recorded.Results The age, percentages of patients with hypertension and diabetes, BMI, NYHA, serum creatinine (SCr), CPB duration, aorta cross-clamp time, blood transfusion volume and bleeding volume during operation, dose of hydroxyethyl starch, blood transfusion volume after operation for 24 h and MV auxiliary time increased, and LVEF, hemoglobin (Hb), and percentages of patients with dexmedetomidine, intra-aortic balloon pumps (IABP), deep hypothermic circulatory arrest (DHCA), CPB ultrafiltration and post-operative hypotension decreased in AKI group compared with non-AKI group (allP<0.05). The results of Logistic regression analysis showed that age≥55 (OR=1.823, 95%CI: 1.594~3.083), hypertension (OR=1.465, 95%CI: 1.254~1.762), preoperative SCr≥79.5 μmol/L (OR=1.331, 95%CI: 1.160~3.249), CPB duration≥110 min (OR=2.104, 95%CI: 1.326~7.340) and post-operative hypotension (OR=1.988, 95%CI:1.358~2.947) were independent risk factors of AKI after CPB, and CPB ultrafiltration (OR=0.655, 95%CI:0.512~0.871) and dexmedetomidine administration (OR=0.573, 95%CI: 0.339~0.901) were.Conclusion Age≥55, hypertension, preoperative SCr≥79.5 μmol/L, CPB duration≥110 min and post-operative hypotension are independent risk factors of AKI after CPB, and CPB ultrafiltration and dexmedetomidine administration are protective factors of AKI after CPB, and physicians should pay more attentions to.
Keywords：Cardiopulmonary bypassCardiac surgeryAcute kidney injuryRisk factorsLogistic regression analysis
Publication Date：2017-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：4( 452-455 )