Division of Cardiothoracic Surgery, Washington University School of Medicine in St. Louis, Barnes- Jewish Hospital, St. Louis, MO, USA.
Division of Cardiology, Washington University School of Medicine in St. Louis, Barnes- Jewish Hospital, St. Louis, MO, USA.
Clin Transplant. 2021 Jun;35(6):e14296. doi: 10.1111/ctr.14296. Epub 2021 Apr 8.
Acute kidney injury is a common complication following heart transplantation, and the factors contributing to acute kidney injury are not well understood. We conducted a retrospective cohort study evaluating patients who underwent heart transplantation between 2009 and 2016 at a single institution. The primary endpoint was incidence of acute kidney injury as defined by Kidney Disease Improving Global Outcomes criteria. Secondary endpoints included 30-day hospital readmission, 30-day mortality, and 1-year mortality. A total of 228 heart transplant patients were included in the study for analysis. In total, 145 (64%) developed acute kidney injury, where 43 (30%) were classified as stage I, 28 (19%) as stage II, and 74 (51%) as stage III. Risk factors found to be associated with the presence of acute kidney injury included increased use of vasopressors and inotropes post-transplant. Protective factors included cardiopulmonary bypass time <170 min. Acute kidney injury was found to be associated with increased 30-day and 1-year mortality.
急性肾损伤是心脏移植后的常见并发症,其发病因素尚不清楚。我们进行了一项回顾性队列研究,评估了 2009 年至 2016 年在一家机构接受心脏移植的患者。主要终点是根据改善全球肾脏病预后组织标准定义的急性肾损伤发生率。次要终点包括 30 天住院再入院、30 天死亡率和 1 年死亡率。共有 228 例心脏移植患者纳入研究进行分析。共有 145 例(64%)发生急性肾损伤,其中 43 例(30%)为 1 期,28 例(19%)为 2 期,74 例(51%)为 3 期。与急性肾损伤发生相关的危险因素包括移植后血管加压素和正性肌力药的使用增加。保护因素包括体外循环时间<170 分钟。急性肾损伤与 30 天和 1 年死亡率增加相关。