Barkhordari Khosro, Fakhre Yasseri Ali Mohammad, Yousefshahi Fardin, Shafiee Akbar
Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.
School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
J Tehran Heart Cent. 2018 Apr;13(2):52-57.
Acute kidney injury (AKI) after coronary artery bypass graft surgery (CABG) is a common complication. The present study sought to determine AKI risk factors based on the Acute Kidney Injury Network (AKIN) classification. In a cross-sectional study, performed from March 2010 to April 2012 at Tehran Heart Center, affiliated with Tehran University of Medical Sciences, 29 independent risk factors for AKI based on the AKIN criteria were examined in isolated post-CABG patients. The patients' demographic data and risk factors were extracted from the Electronic Database of Tehran Heart Center. According to restricted inclusion and exclusion criteria as well as a creatinine rise to AKI Stage 1, the patients were divided into 2 groups of AKI-negative and AKI-positive and the risk factors were compared between these groups. Out of 3473 included patients at a mean age of 60.78 (±9.46) years, the majority (2474 [71.23%]) were male. Totally, 958 (27.7%) patients had AKI, according to a creatinine rise to AKI Stage 1. Logistic regression analysis demonstrated that higher age (OR=1.021; P<0.001), higher body mass index (OR=1.035; P<0.001), lower preoperative creatinine level (OR=0.417; P<0.001), longer cardiopulmonary bypass time (OR=1.004; P=0.007), blood transfusion in the ICU (OR=1.408; P=0.001), and lack of intraoperative blood transfusion (OR=0.823; P=0.044) were the independent risk factors for AKI after CABG. Based on the findings of the current study, older age, higher body mass index, lower preoperative creatinine level, more blood transfusion in the intensive care unit (ICU), lack of intraoperative blood transfusion, and high cardiopulmonary bypass time may serve as risk factors for the development of AKI in CABG patients.
冠状动脉搭桥手术（CABG）后发生的急性肾损伤（AKI）是一种常见并发症。本研究旨在根据急性肾损伤网络（AKIN）分类确定AKI的危险因素。在一项横断面研究中，于2010年3月至2012年4月在与德黑兰医科大学相关的德黑兰心脏中心进行，对孤立的CABG术后患者中基于AKIN标准的29个AKI独立危险因素进行了检查。患者的人口统计学数据和危险因素从德黑兰心脏中心的电子数据库中提取。根据严格的纳入和排除标准以及肌酐升高至AKI 1期，将患者分为AKI阴性和AKI阳性两组，并比较两组之间的危险因素。在纳入的3473例平均年龄为60.78（±9.46）岁的患者中，大多数（2474例[71.23%]）为男性。根据肌酐升高至AKI 1期，共有958例（27.7%）患者发生AKI。逻辑回归分析表明，年龄较大（OR=1.021；P<0.001）、体重指数较高（OR=1.035；P<0.001）、术前肌酐水平较低（OR=0.417；P<0.001）、体外循环时间较长（OR=1.004；P=0.007）、在重症监护病房（ICU）输血（OR=1.408；P=0.001）以及术中未输血（OR=0.823；P=0.044）是CABG术后AKI的独立危险因素。基于本研究的结果，年龄较大、体重指数较高、术前肌酐水平较低、重症监护病房（ICU）输血较多、术中未输血以及体外循环时间较长可能是CABG患者发生AKI的危险因素。
