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Factors associated with postoperative requirement of renal replacement therapy following off-pump coronary bypass surgery.
- Source :
-
Heart and vessels [Heart Vessels] 2017 Feb; Vol. 32 (2), pp. 134-142. Date of Electronic Publication: 2016 Jun 06. - Publication Year :
- 2017
-
Abstract
- Cardiopulmonary bypass usage provokes a systemic inflammatory response resulting in deterioration of renal function. However, risk factors for requiring renal replacement therapy (RRT) following off-pump coronary artery bypass graft surgery (CABG) have not yet been fully elucidated. We reviewed 718 consecutive patients undergoing elective off-pump CABG at our institution, excluding patients on chronic hemodialysis preoperatively. Sub-analysis of patients with preserved renal function, defined as a creatinine level below a cut-off value of 1.12 mg/dL (obtained by receiver operating characteristic curve), was also performed. Of the 718 patients, 41 (5.7 %) required RRT. There were 556 patients (77.4 %) with preserved renal function preoperatively, and 13 (2.4 %) of these required postoperative RRT. Multivariate analysis revealed that age (years) and preoperative serum creatinine (mg/dL) and brain natriuretic peptide (BNP) levels (pg/dL) were associated with RRT [odds ratios (OR) 1.052, 95 % confidence interval (CI) 9.064 and 1.001, respectively, all p < 0.05] in the total population, whereas low albumin concentration was the only independent predictor for RRT in patients with preserved renal function (OR 0.062, p < 0.0001). When creatinine levels were below 1.5 mg/dL, the predictive power of hypoalbuminemia for RRT requirement overwhelmed that of creatinine or BNP levels. Older age, preoperative elevated creatinine and BNP levels were associated with a requirement for RRT following off-pump CABG. In patients with preserved renal function, hypoalbuminemia was most significantly related to the RRT requirement.
- Subjects :
- Aged
Aged, 80 and over
Creatinine blood
Female
Humans
Japan
Kidney Function Tests
Male
Middle Aged
Multivariate Analysis
Natriuretic Peptide, Brain blood
Postoperative Complications epidemiology
ROC Curve
Risk Factors
Coronary Artery Bypass, Off-Pump adverse effects
Hypoalbuminemia epidemiology
Renal Insufficiency therapy
Renal Replacement Therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1615-2573
- Volume :
- 32
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Heart and vessels
- Publication Type :
- Academic Journal
- Accession number :
- 27272895
- Full Text :
- https://doi.org/10.1007/s00380-016-0855-5