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The duration of acute kidney injury after cardiac surgery increases the risk of long-term chronic kidney disease

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Abstract

Background

Acute kidney injury (Dasta et al., Nephrol Dial Transplant 23(6):1970–1974, 2008) following cardiac surgery is associated with higher perioperative morbidity and mortality, but its impact on long term development of chronic kidney disease (CKD) is uncertain.

Methods

A total of 350 patients submitted to elective cardiac surgery were evaluated for AKI, defined as an increase in serum creatinine (SCr) ≥ 0.3 mg/dL over baseline value. Univariate and multivariate analysis were used to study pre, intra and postoperative parameters associated with occurrence CKD after 12 months of follow-up.

Results

AKI incidence was 41 % (n = 88). The 12-month prevelence of CKD was 9 % (n = 19) in non-AKI patients versus 25 % (n = 54, p < 0.0001) in the AKI group. The factors identified as independent risk factors for long-term CKD development in the multivariate logistic regression model were age >60 years, hospitalization serum creatinine >0.8 mg/dL, peripheral artery disease, hemorrhage and AKI duration > 3 days.

Conclusion

Patients developing AKI after cardiac surgery presented high prevalence of long-term incident CKD. The duration of AKI was a strong independent risk factor for this late CKD development. Recognition of predictive factors for CKD development following cardiac surgery-associated AKI may help to develop strategies to prevent or halt CKD progression in this population.

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Authors and Affiliations

  1. Critical Care Department, Hospital Israelita Albert Einstein, Rua Jovina 66 ap 61, São Paulo, SP, 04363-080, Brazil

    Henrique Palomba

  2. Division of Nephrology, University of Sao Paulo Medical School, São Paulo, SP, Brazil

    Isac Castro, Luis Yu & Emmanuel A. Burdmann

Authors
  1. Henrique Palomba
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  2. Isac Castro
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  3. Luis Yu
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  4. Emmanuel A. Burdmann
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Correspondence to Henrique Palomba.

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The authors declare that they have no conflict of interest.

Informed consent

For this type of study formal consent is not required. The ethical Institutional Review Board approved the study and waived informed consent due to the pure observational character of the study.

Ethical approval

This article does not contain any studies with human participants performed by any of the authors.

Additional information

Emmanuel A. Burdmann and Luis Yu share the senior authorship of this manuscript.

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Palomba, H., Castro, I., Yu, L. et al. The duration of acute kidney injury after cardiac surgery increases the risk of long-term chronic kidney disease. J Nephrol 30, 567–572 (2017). https://doi.org/10.1007/s40620-016-0351-0

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  • DOI: https://doi.org/10.1007/s40620-016-0351-0

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