Risk Factors for Long-Term Mortality and Progressive Chronic Kidney Disease Associated With Acute Kidney Injury After Cardiac Surgery

• Published in: Medicine (Baltimore) 2015-11, Vol.94 (45), p.e2025-e2025
• Main Authors: Xu, Jia-Rui, Zhu, Jia-Ming, Jiang, Jun, Ding, Xiao-Qiang, Fang, Yi, Shen, Bo, Liu, Zhong-Hua, Zou, Jian-Zhou, Liu, Lan, Wang, Chun-Sheng, Ronco, Claudio, Liu, Hong, Teng, Jie
• Format: Article
• Language: English
• Subjects: Acute Kidney Injury - etiology; Acute Kidney Injury - mortality; Acute Kidney Injury - physiopathology; Adult; Age Factors; Aged; Cardiac Surgical Procedures - adverse effects; Clinical Trial/Experimental Study; Comorbidity; Disease Progression; Female; Humans; Incidence; Male; Middle Aged; Operative Time; Postoperative Complications - mortality; Postoperative Complications - physiopathology; Renal Insufficiency, Chronic - mortality; Risk Factors; Severity of Illness Index; Sex Factors; Survival Analysis
• ISSN: 0025-7974; 1536-5964
• DOI: 10.1097/MD.0000000000002025

The aim of the study was to evaluate risk factors for long-term mortality and progressive chronic kidney disease (CKD) after cardiac surgery in patients with normal preoperative renal function and postoperative acute kidney injury (AKI). From April 2009 to December 2012, we prospectively enrolled 3245 cardiac surgery patients of our hospital. The primary endpoints included survival rates and the secondary endpoint was the incidence of progressive chronic kidney disease (CKD) in a follow-up period of 2 years. Acute kidney injury was staged by KDIGO classification. Progressive CKD was defined as GFR ≤ 30 mL/min/1.73 m or end-stage renal disease (ESRD) (starting renal replacement therapy or renal transplantation).The AKI incidence was 39.9% (n = 1295). The 1 and 2 year overall survival (OS) rates of AKI patients were significantly lower than that for non-AKI patients (85.9% and 82.3% vs 98.1% and 93.7%, P