Association between carotid intima–media thickness and acute kidney injury following isolated coronary artery bypass surgery

• Published in: Cardiovascular Journal of Africa 2023-09, Vol.34 (4), p.6-13
• Main Authors: Düzyol, Çağrı, Şaşkin, Hüseyin
• Format: Article
• Language: English
• Subjects: Atherosclerosis; Biomarkers; Cardiovascular disease; Cardiovascular Topics; Carotid arteries; Coronary vessels; Creatinine; Diabetes; Heart attacks; Heart surgery; Hemodynamics; Hypertension; Inflammation; Kidney diseases; Leukocytes; Lymphocytes; Mortality; Neutrophils; Normal distribution; Postoperative period; Regression analysis; Risk factors; Software; Statistical analysis; Ultrasonic imaging
• ISSN: 1995-1892; 1680-0745
• DOI: 10.5830/CVJA-2022-035

SummaryObjectiveThe association between pre-operative carotid intima–media thickness (CIMT) and early postoperative acute kidney injury (AKI) following isolated coronary artery bypass grafting (CABG) was investigated.MethodsData were sought retrospectively of 237 patients (166 male, 71 female; mean age 61.4 ± 8.1 years; range: 32–74), operated on for isolated CABG with cardiopulmonary bypass (CPB) in a single centre between June 2014 and December 2020, with a serum creatinine level < 1.5 mg/dl and normal carotid arteries on Doppler ultrasonography. AKI diagnosis was made according to the Kidney Disease Improving Global Outcomes 2012 Acute Kidney Injury Guideline. Patients were grouped as group 1 with AKI in the early postoperative period (n = 63) and group 2 without AKI (n = 174). Univariate analyses were done to determine significant clinical factors, and subsequent multiple logistic regression analysis was done to determine independent predictors of AKI.ResultsAKI occurred in 63 (26.6%) patients. Pre-operative CIMT was significantly higher in the AKI group (p = 0.0001). Multivariate logistic regression analysis revealed that elevated pre-operative CIMT (p = 0.005), C-reactive protein (p = 0.001), erythrocyte sedimentation rate (p = 0.005), neutrophil– lymphocyte ratio (p = 0.0001) and platelet–lymphocyte ratio (p = 0.0001) increased on the postoperative seventh day. C-reactive protein (p = 0.04), postoperative first day platelet– lymphocyte ratio (p = 0.0001), postoperative seventh day erythrocyte sedimentation rate (p = 0.02) and intubation time (p = 0.02) were independent predictors of early postoperative AKI following isolated CABG.ConclusionPre-operative CIMT was found to be an independent predictor of AKI in the early postoperative period of isolated CABG.