Moreira Raquel, Jacinto Tiago, Neves Paulo, Vouga Luís, Baeta Cristina
Health School, Polytechnic Institute of Porto, Porto, Portugal.
Health School, Polytechnic Institute of Porto, Porto, Portugal; CINTESIS - Center for Research in Health Technologies and Information Systems, Faculty of Medicine - University of Porto, Porto, Portugal.
Rev Port Cir Cardiotorac Vasc. 2019 Apr-Jun;26(2):109-115.
To study the incidence of acute kidney injury (AKI) in the postoperative period of cardiac surgery in patients without preoperative renal insufficiency who underwent cardiac surgery with cardiopulmonary bypass (CPB), and to explore the association between the incidence of AKI and predictors related to CPB.
Observational, cross-sectional study. Participants were divided in two groups, those who developed AKI in the postoperative period and those who did not develop AKI. Kidney Disease: Improving Global Outcomes - Clinical Practice Guideline for Acute Kidney Injury (KDIGO) classification was used to characterize AKI. The analysis included preoperative variables (anthropometric data, cardiovascular risk factors and blood parameters), as well as the type of surgery, intraoperative variables related to CPB, and postoperative creatinine variation. Association between variables was studied with binary logistic regression.
We have included 329 patients, of which 62 (19%), developed AKI. There were statistically significant differences between the groups in age (p<0.001; OR (95%)-1.075 (1.037-1.114)), duration of CPB (p=0.011; 1.008 (1.002-1.014)), urine output during CPB (p=0.038; 0.998 (0.996-0.999)), mannitol and furosemide administration during CPB, (respectively, p=0.032; 2.293 (1.075-4.890) and p=0.013; 2.535 (1.214-5.296)).
A significant number of patients developed AKI in the postoperative period of cardiac surgery and this incidence was influenced by factors related to CPB, namely: age, duration of CPB, urine output during CPB, mannitol and furosemide administration during CPB.
研究在接受体外循环（CPB）心脏手术且术前无肾功能不全的患者心脏手术后急性肾损伤（AKI）的发生率，并探讨AKI发生率与CPB相关预测因素之间的关联。
观察性横断面研究。参与者分为两组，即术后发生AKI的患者和未发生AKI的患者。采用《改善全球肾脏病预后组织（KDIGO）急性肾损伤临床实践指南》对AKI进行分类。分析包括术前变量（人体测量数据、心血管危险因素和血液参数），以及手术类型、与CPB相关的术中变量和术后肌酐变化。采用二元逻辑回归研究变量之间的关联。
我们纳入了329例患者，其中62例（19%）发生了AKI。两组在年龄（p<0.001；比值比（95%）-1.075（1.037-1.114））、CPB持续时间（p=0.011；1.008（1.002-1.014））、CPB期间尿量（p=0.038；0.998（0.996-0.999））、CPB期间甘露醇和呋塞米的使用情况（分别为p=0.032；2.293（1.075-4.890）和p=0.013；2.535（1.214-5.296））方面存在统计学显著差异。
大量患者在心脏手术后发生AKI，且该发生率受CPB相关因素影响，即：年龄、CPB持续时间、CPB期间尿量、CPB期间甘露醇和呋塞米的使用情况。
