Kidney Week

Abstract: PUB011

Incidence of Cardiac Surgery-Associated AKI in a Third-Level Hospital

Session Information

• Publication Only

Category: Acute Kidney Injury

• 101 AKI: Epidemiology, Risk Factors, and Prevention

Authors

• Rosillo-Salgado, Ydris Zelim, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Mexico City, Mexico City, Mexico

Ydris Zelim Rosillo-Salgado, MD

• Alamilla-Sanchez, Mario, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Mexico City, Mexico City, Mexico

Mario Alamilla-Sanchez, MD, MSc

• Torres Cuevas, Jose Luis, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Mexico City, Mexico City, Mexico

Jose Luis Torres Cuevas, MD

Background

Acute kidney injury (AKI) is a common complication in cardiac surgery patients, the incidence of cardiac surgery-associated AKI is still around 40% increasing mortality, development of chronic kidney disease and has a significant impact on global health care costs. Identication risk factors that can prevent AKI

Methods

Prospective cohort included 51 patients who had cardiac surgery

Results

The mean preoperative eGFR was 75 ml/min/1.73 m2. The 37 of 51 participants (72%) developed AKI as defined by the KDIGO until 3 days after surgery. Stage 1 occurred in 26 (50.9%); stage 2 happened in 8 (15.6%) and stage 3 was in 3 (5.88%) patients of which 1 (1.9%) required hemodialysis. Day 1 after surgery AKI was present in 4 (10.8%), day 2 AKI occurs in 25 (67.5%) and day 3 AKI happened in 8 (21.6%) patients. All surgeries were elective and cardiopulmonary bypass (CPB) was utilized in 100%, and CPB mean time was 96.4min and aortic clamping mean time was 73.6min. The most frequent cardiac surgery was coronary artery bypass graft (CABG) 25 (49%), valvular surgery 24 (47.1%) and combined 2 (3.9%) in which AKI was present in 36%, 75% and 100% respectively according to the type of surgery. Patients with AKI had an average postoperative fluid balance of 3.7L vs 2.4L without AKI. Venous congestion with portal flow pulsatility >30% and abnormal morphology of renal intraparenchymal venous flow arises in 12 (32.4%) of 37 patients with AKI. On the 1st postoperative day, 9 (56%), on 2^nd day 3 (50%) and on 3^rd day 1 (33%) related to venous congestion. Overall mortality was 13.7% (n= 7), while for AKI mortality rate was 21% (n=7).

Conclusion

AKI was present in 70% of patients undergoing multifactorial cardiac surgery including type of surgery, drug use, cardiac dysfunction and venous congestion