Serious acute renal failure following open heart surgery.

The influence of 51 preoperative, peroperative and postoperative variables on the development of serious acute renal failure (ARF) following open heart surgery was studied. Although a large number of significant variables was found, a logit-model with only 2 explanatory variables showed an almost perfect fit. With this model the chances of serious ARF up to 90% were estimated. The results suggest that a critical circulation is the main cause of serious ARF. Furthermore, a reduced ability to cope with a critical circulation without renal failure plays an important role in the pathogenesis. There is a higher risk of serious ARF for patients older than 70, especially when circulatory support with dopamine is needed.