Issue: 2012 > December > original article

Identification of modifiable risk factors for acute kidney injury after cardiac surgery

S. Vellinga, W. Verbrugghe, R. De Paep, G.A. Verpooten, K. Janssen van Doorn


Objectives: Acute kidney injury (AKI) is a common
problem after cardiac surgery and is associated with an
increase in morbidity, mortality and duration of hospital
stay. With this study we aimed to identify potential risk
factors for cardiac surgery associated AKI (CS-AKI) in a
single-centre population with a special focus on modifiable risk factors. Methods: Retrospective single-centre cohort study of 565 consecutive patients who underwent isolated coronary artery bypass grafting (CABG) with the use of cardiopulmonary bypass. AKI was defined by the AKIN classification. Known risk scores were applied when possible. Results: Of the population, 14.7% were diagnosed with AKI. When considering baseline characteristics we found a significant difference in age, preoperative estimated
glomerular filtration rate (eGFR) and chronic kidney
disease (CKD) stage and urgency of surgery between the
CS-AKI group and the control population. Regarding the
intraoperative characteristics, patients with CS-AKI had
a significantly lower haematocrit and were more likely
to receive a transfusion of packed cells. Postoperative
administration of furosemide and packed cell transfusions
were also associated with AKI. We found no differences
in other characteristics (history of diabetes mellitus,
history of congestive heart failure, sex, body mass index
(BMI), history of cardiac surgery, low cardiac output and
need for intra-aortic balloon pump (IABP), duration of
cardiopulmonary bypass (CPB) and cross clamping).
Conclusion: In our series we could identify intraoperative
administration of packed cells and postoperative
administration of furosemide or packed cells as potentially modifiable risk factors in the development of AKI.