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Impact of postoperative acute kidney failure in long-term survival after heart valve surgery
We investigated the impact of acute kidney failure after a heart valve procedure among patients with or without chronic kidney disease (CKD). All patients who had undergone a surgical valve procedure between 2005 and 2017 at our institution were divided into 2 groups depending on whether they had pr...
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| Published in: | Interactive cardiovascular and thoracic surgery 2019-07, Vol.29 (1), p.35-42 |
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| cites | cdi_FETCH-LOGICAL-c329t-43ff517ab2cc935597a10f01499ddc3fcfc97efcb851c478cc432a053ffc23523 |
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| container_title | Interactive cardiovascular and thoracic surgery |
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| creator | Rodríguez-Cubillo, Beatriz Carnero-Alcázar, Manuel Cobiella-Carnicer, Javier Rodríguez-Moreno, Antolina Alswies, Ali Velo-Plaza, Mercedes Pérez-Camargo, Daniel Sánchez Fructuoso, Ana Maroto-Castellanos, Luis |
| description | We investigated the impact of acute kidney failure after a heart valve procedure among patients with or without chronic kidney disease (CKD).
All patients who had undergone a surgical valve procedure between 2005 and 2017 at our institution were divided into 2 groups depending on whether they had previous history of CKD (estimated glomerular filtration rate |
| doi_str_mv | 10.1093/icvts/ivz035 |
| format | article |
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All patients who had undergone a surgical valve procedure between 2005 and 2017 at our institution were divided into 2 groups depending on whether they had previous history of CKD (estimated glomerular filtration rate <60 ml/min/1.73 m2) or not. Homogeneous groups were obtained by propensity score matching. Long-term mortality was compared between the 2 groups and according to the occurrence of postoperative acute kidney failure. Level of significance was set at P-value <0.008 for multiple comparison tests.
From the 3907 patients included to this study, 1476 (37.78%) had previous history of CKD. After adjusting for propensity score 1:1, patients with preoperative impaired renal function were at a higher risk of acute kidney failure (26.83% vs 10.16%, P < 0.001) and postoperative mortality (8.48% vs 5.17%, P = 0.001). In the follow-up, they had a poorer survival at 1, 5 and 10 years as compared to patients with normal renal function (88% vs 91.95%, 78.29% vs 81.11% and 56.13% vs 66.29%, respectively; P < 0.001). Patients without postoperative kidney failure had similar survival whether they had preoperative CKD or not [hazard ratio (HR) 1.16, 99.2% confidence interval (CI) 0.87-2.52; P = 0.142]. As compared to patients with postoperative preserved renal function, those with postoperative kidney failure had a higher long-term mortality either if they had previous kidney disease or not [(HR 2.18, 99.2% CI 1.75-2.72; P < 0.001) and (HR 1.48, 99.2% CI 1.33-1.65; P < 0.001), respectively]. Preoperative CKD was the strongest predictor of acute kidney failure (odds ratio 4.45; 95% CI 3.59-5.53; P < 0.001).
Patients with CKD are at higher risk of postoperative adverse events and have poorer long-term outcomes. Postoperative acute kidney failure increases long-term mortality.]]></description><identifier>ISSN: 1569-9285</identifier><identifier>EISSN: 1569-9285</identifier><identifier>DOI: 10.1093/icvts/ivz035</identifier><identifier>PMID: 30844065</identifier><language>eng</language><publisher>England</publisher><subject>Acute Kidney Injury - epidemiology ; Acute Kidney Injury - etiology ; Acute Kidney Injury - physiopathology ; Aged ; Cardiac Surgical Procedures - adverse effects ; Female ; Follow-Up Studies ; Glomerular Filtration Rate ; Heart Valve Diseases - surgery ; Heart Valve Prosthesis Implantation - adverse effects ; Humans ; Incidence ; Male ; Postoperative Complications - epidemiology ; Postoperative Complications - etiology ; Postoperative Complications - physiopathology ; Prognosis ; Propensity Score ; Risk Factors ; Spain - epidemiology ; Survival Rate - trends ; Time Factors</subject><ispartof>Interactive cardiovascular and thoracic surgery, 2019-07, Vol.29 (1), p.35-42</ispartof><rights>The Author(s) 2019. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c329t-43ff517ab2cc935597a10f01499ddc3fcfc97efcb851c478cc432a053ffc23523</citedby><cites>FETCH-LOGICAL-c329t-43ff517ab2cc935597a10f01499ddc3fcfc97efcb851c478cc432a053ffc23523</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30844065$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Rodríguez-Cubillo, Beatriz</creatorcontrib><creatorcontrib>Carnero-Alcázar, Manuel</creatorcontrib><creatorcontrib>Cobiella-Carnicer, Javier</creatorcontrib><creatorcontrib>Rodríguez-Moreno, Antolina</creatorcontrib><creatorcontrib>Alswies, Ali</creatorcontrib><creatorcontrib>Velo-Plaza, Mercedes</creatorcontrib><creatorcontrib>Pérez-Camargo, Daniel</creatorcontrib><creatorcontrib>Sánchez Fructuoso, Ana</creatorcontrib><creatorcontrib>Maroto-Castellanos, Luis</creatorcontrib><title>Impact of postoperative acute kidney failure in long-term survival after heart valve surgery</title><title>Interactive cardiovascular and thoracic surgery</title><addtitle>Interact Cardiovasc Thorac Surg</addtitle><description><![CDATA[We investigated the impact of acute kidney failure after a heart valve procedure among patients with or without chronic kidney disease (CKD).
All patients who had undergone a surgical valve procedure between 2005 and 2017 at our institution were divided into 2 groups depending on whether they had previous history of CKD (estimated glomerular filtration rate <60 ml/min/1.73 m2) or not. Homogeneous groups were obtained by propensity score matching. Long-term mortality was compared between the 2 groups and according to the occurrence of postoperative acute kidney failure. Level of significance was set at P-value <0.008 for multiple comparison tests.
From the 3907 patients included to this study, 1476 (37.78%) had previous history of CKD. After adjusting for propensity score 1:1, patients with preoperative impaired renal function were at a higher risk of acute kidney failure (26.83% vs 10.16%, P < 0.001) and postoperative mortality (8.48% vs 5.17%, P = 0.001). In the follow-up, they had a poorer survival at 1, 5 and 10 years as compared to patients with normal renal function (88% vs 91.95%, 78.29% vs 81.11% and 56.13% vs 66.29%, respectively; P < 0.001). Patients without postoperative kidney failure had similar survival whether they had preoperative CKD or not [hazard ratio (HR) 1.16, 99.2% confidence interval (CI) 0.87-2.52; P = 0.142]. As compared to patients with postoperative preserved renal function, those with postoperative kidney failure had a higher long-term mortality either if they had previous kidney disease or not [(HR 2.18, 99.2% CI 1.75-2.72; P < 0.001) and (HR 1.48, 99.2% CI 1.33-1.65; P < 0.001), respectively]. Preoperative CKD was the strongest predictor of acute kidney failure (odds ratio 4.45; 95% CI 3.59-5.53; P < 0.001).
Patients with CKD are at higher risk of postoperative adverse events and have poorer long-term outcomes. Postoperative acute kidney failure increases long-term mortality.]]></description><subject>Acute Kidney Injury - epidemiology</subject><subject>Acute Kidney Injury - etiology</subject><subject>Acute Kidney Injury - physiopathology</subject><subject>Aged</subject><subject>Cardiac Surgical Procedures - adverse effects</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Glomerular Filtration Rate</subject><subject>Heart Valve Diseases - surgery</subject><subject>Heart Valve Prosthesis Implantation - adverse effects</subject><subject>Humans</subject><subject>Incidence</subject><subject>Male</subject><subject>Postoperative Complications - epidemiology</subject><subject>Postoperative Complications - etiology</subject><subject>Postoperative Complications - physiopathology</subject><subject>Prognosis</subject><subject>Propensity Score</subject><subject>Risk Factors</subject><subject>Spain - epidemiology</subject><subject>Survival Rate - trends</subject><subject>Time Factors</subject><issn>1569-9285</issn><issn>1569-9285</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><recordid>eNpNkDtPwzAUhS0EoqWwMSOPDIRex3ETj6jiUakSC2xIkXtjF0Ne2E6k8OsJtCCme4_OY_gIOWdwzUDyucU--LntP4GLAzJlYiEjGWfi8N8_ISfevwEwCRyOyYRDliSwEFPysqpahYE2hraND02rnQq211RhFzR9t0WtB2qULTunqa1p2dTbKGhXUd-53vaqpMqMmr5q5QId9Vgera12wyk5Mqr0-mx_Z-T57vZp-RCtH-9Xy5t1hDyWIUq4MYKlahMjSi6ETBUDAyyRsiiQGzQoU21wkwmGSZohJjxWIMYaxlzEfEYud7utaz467UNeWY-6LFWtm87nMcsymQGMlRm52kXRNd47bfLW2Uq5IWeQf_PMf3jmO55j_GK_3G0qXfyFfwHyL2WqdLc</recordid><startdate>20190701</startdate><enddate>20190701</enddate><creator>Rodríguez-Cubillo, Beatriz</creator><creator>Carnero-Alcázar, Manuel</creator><creator>Cobiella-Carnicer, Javier</creator><creator>Rodríguez-Moreno, Antolina</creator><creator>Alswies, Ali</creator><creator>Velo-Plaza, Mercedes</creator><creator>Pérez-Camargo, Daniel</creator><creator>Sánchez Fructuoso, Ana</creator><creator>Maroto-Castellanos, Luis</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20190701</creationdate><title>Impact of postoperative acute kidney failure in long-term survival after heart valve surgery</title><author>Rodríguez-Cubillo, Beatriz ; Carnero-Alcázar, Manuel ; Cobiella-Carnicer, Javier ; Rodríguez-Moreno, Antolina ; Alswies, Ali ; Velo-Plaza, Mercedes ; Pérez-Camargo, Daniel ; Sánchez Fructuoso, Ana ; Maroto-Castellanos, Luis</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c329t-43ff517ab2cc935597a10f01499ddc3fcfc97efcb851c478cc432a053ffc23523</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Acute Kidney Injury - epidemiology</topic><topic>Acute Kidney Injury - etiology</topic><topic>Acute Kidney Injury - physiopathology</topic><topic>Aged</topic><topic>Cardiac Surgical Procedures - adverse effects</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Glomerular Filtration Rate</topic><topic>Heart Valve Diseases - surgery</topic><topic>Heart Valve Prosthesis Implantation - adverse effects</topic><topic>Humans</topic><topic>Incidence</topic><topic>Male</topic><topic>Postoperative Complications - epidemiology</topic><topic>Postoperative Complications - etiology</topic><topic>Postoperative Complications - physiopathology</topic><topic>Prognosis</topic><topic>Propensity Score</topic><topic>Risk Factors</topic><topic>Spain - epidemiology</topic><topic>Survival Rate - trends</topic><topic>Time Factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Rodríguez-Cubillo, Beatriz</creatorcontrib><creatorcontrib>Carnero-Alcázar, Manuel</creatorcontrib><creatorcontrib>Cobiella-Carnicer, Javier</creatorcontrib><creatorcontrib>Rodríguez-Moreno, Antolina</creatorcontrib><creatorcontrib>Alswies, Ali</creatorcontrib><creatorcontrib>Velo-Plaza, Mercedes</creatorcontrib><creatorcontrib>Pérez-Camargo, Daniel</creatorcontrib><creatorcontrib>Sánchez Fructuoso, Ana</creatorcontrib><creatorcontrib>Maroto-Castellanos, Luis</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Interactive cardiovascular and thoracic surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Rodríguez-Cubillo, Beatriz</au><au>Carnero-Alcázar, Manuel</au><au>Cobiella-Carnicer, Javier</au><au>Rodríguez-Moreno, Antolina</au><au>Alswies, Ali</au><au>Velo-Plaza, Mercedes</au><au>Pérez-Camargo, Daniel</au><au>Sánchez Fructuoso, Ana</au><au>Maroto-Castellanos, Luis</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Impact of postoperative acute kidney failure in long-term survival after heart valve surgery</atitle><jtitle>Interactive cardiovascular and thoracic surgery</jtitle><addtitle>Interact Cardiovasc Thorac Surg</addtitle><date>2019-07-01</date><risdate>2019</risdate><volume>29</volume><issue>1</issue><spage>35</spage><epage>42</epage><pages>35-42</pages><issn>1569-9285</issn><eissn>1569-9285</eissn><abstract><![CDATA[We investigated the impact of acute kidney failure after a heart valve procedure among patients with or without chronic kidney disease (CKD).
All patients who had undergone a surgical valve procedure between 2005 and 2017 at our institution were divided into 2 groups depending on whether they had previous history of CKD (estimated glomerular filtration rate <60 ml/min/1.73 m2) or not. Homogeneous groups were obtained by propensity score matching. Long-term mortality was compared between the 2 groups and according to the occurrence of postoperative acute kidney failure. Level of significance was set at P-value <0.008 for multiple comparison tests.
From the 3907 patients included to this study, 1476 (37.78%) had previous history of CKD. After adjusting for propensity score 1:1, patients with preoperative impaired renal function were at a higher risk of acute kidney failure (26.83% vs 10.16%, P < 0.001) and postoperative mortality (8.48% vs 5.17%, P = 0.001). In the follow-up, they had a poorer survival at 1, 5 and 10 years as compared to patients with normal renal function (88% vs 91.95%, 78.29% vs 81.11% and 56.13% vs 66.29%, respectively; P < 0.001). Patients without postoperative kidney failure had similar survival whether they had preoperative CKD or not [hazard ratio (HR) 1.16, 99.2% confidence interval (CI) 0.87-2.52; P = 0.142]. As compared to patients with postoperative preserved renal function, those with postoperative kidney failure had a higher long-term mortality either if they had previous kidney disease or not [(HR 2.18, 99.2% CI 1.75-2.72; P < 0.001) and (HR 1.48, 99.2% CI 1.33-1.65; P < 0.001), respectively]. Preoperative CKD was the strongest predictor of acute kidney failure (odds ratio 4.45; 95% CI 3.59-5.53; P < 0.001).
Patients with CKD are at higher risk of postoperative adverse events and have poorer long-term outcomes. Postoperative acute kidney failure increases long-term mortality.]]></abstract><cop>England</cop><pmid>30844065</pmid><doi>10.1093/icvts/ivz035</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Interactive cardiovascular and thoracic surgery, 2019-07, Vol.29 (1), p.35-42 |
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| source | Open Access: Oxford University Press Open Journals; PubMed Central |
| subjects | Acute Kidney Injury - epidemiology Acute Kidney Injury - etiology Acute Kidney Injury - physiopathology Aged Cardiac Surgical Procedures - adverse effects Female Follow-Up Studies Glomerular Filtration Rate Heart Valve Diseases - surgery Heart Valve Prosthesis Implantation - adverse effects Humans Incidence Male Postoperative Complications - epidemiology Postoperative Complications - etiology Postoperative Complications - physiopathology Prognosis Propensity Score Risk Factors Spain - epidemiology Survival Rate - trends Time Factors |
| title | Impact of postoperative acute kidney failure in long-term survival after heart valve surgery |
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