Cardiac Surgery Associated Acute Kidney Injury, Incidence, and Predictors. Prospective Observational Single Center Study

Nilufar Jabayeva 1, Tatyana Li 1 * , Aidyn Kuanyshbek 1, Azhar Zhailauova 1, Ainamkoz Amanzholova 1, Bolat Bekishev 1, Nurila Maltabarova 2, Askar Zhunussov 2
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1 Intensive care unit (adults), National Research Cardiac Surgery Center, Astana, Kazakhstan
2 Chair of Pediatric Anesthesiology, Intensive Care and Emergency Medicine, NpJSC "Astana Medical University", Astana, Kazakhstan
* Corresponding Author
J CLIN MED KAZ, Volume 21, Issue 4, pp. 21-25. https://doi.org/10.23950/jcmk/14965
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Author Contributions: Conceptualization, N.J.; methodology, N.J. and T.L.; investigation, N.J. and A.A.; data curation, N.J., A.A., As.Z., B.B. and N.M.; writing – original draft preparation, N.J. and T.L.; writing – review and editing, T.L., A.K. and Azh.Z.; project administration, A.K. All authors have read and agreed to the published version of the manuscript.

ABSTRACT

Acute kidney injury (AKI) is a condition characterized by a sudden decline in kidney function, leading to accumulation of waste products and fluids in the body. It is a common and serious complication in patients with cardiovascular diseases, and it is associated with increased morbidity and mortality.
Aim: In this study, we explore the relationship between cardiac issues and the development of AKI, as well as strategies for its prevention and management. The primary aim of this study is to examine the incidence and risk factors for the AKI in patients admitted to the cardiac intensive care unit/CICU), as well as the impact of AKI on patient outcomes.
Methods: We conducted prospective observational single center study. 292 consecutive patients admitted to ICU after open heart surgery by sternotomy were included. Patients were monitored in ICU for frequency of AKI, perioperative risk factors, cardiac surgery-associated acute kidney injury (CSA-AKI) and their impact on patients’ outcome.
Results: After admission to the intensive care unit, 33 patients (11.3%) developed CSA-AKI in the postoperative period. According to the analysis, male gender (p=0.03), decreased GFR (p=0.02) as well as high EuroSCORE II (p=0.013), hemoglobin level before surgery (p = 0.002) and the presence of diabetes and chronic kidney disease (p=0.03) were independent predictors of AKI after open-heart surgery. In patients who developed AKI, the duration of artificial lung ventilation was increased (21.3 vs 9.9 hours p = 0.001) and the duration of stay in the intensive care unit (4.3 vs. 1.9 days, P = 0.02).
Conclusion: Patients often have AKI after heart surgery. EuroSCORE II, gender, diabetes, time of cardiopulmonary bypass and chronic kidney disease are independent predictors of AKI development. The appearance of AKI is due to an unfavorable outcome of events. The appearance of acute kidney injury is associated with adverse consequences.
Keywords: acute kidney injury, cardiac surgery, predictors of AKI, postoperative period, complications.

CITATION

Jabayeva N, Li T, Kuanyshbek A, Zhailauova A, Amanzholova A, Bekishev B, et al. Cardiac Surgery Associated Acute Kidney Injury, Incidence, and Predictors. Prospective Observational Single Center Study. J CLIN MED KAZ. 2024;21(4):21-5. https://doi.org/10.23950/jcmk/14965

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