Published online Jun 6, 2023. doi: 10.12998/wjcc.v11.i16.3791
Peer-review started: February 8, 2023
First decision: March 14, 2023
Revised: March 28, 2023
Accepted: May 4, 2023
Article in press: May 4, 2023
Published online: June 6, 2023
Acute kidney injury (AKI) is a complication for patients undergoing cardiac surgery that might be associated with adverse outcome.
Perioperative targeted monitoring for possible AKI risk factors remains suboptimal and identification of patients at greater risk requires further investigation.
The study aimed to assess AKI presentation after cardiac surgery, to investigate prognostic factors for its development and its association with clinical outcome.
This is a prospective observational single-center study that included 206 patients admitted in ICU post cardiac surgery followed-up until ICU discharge. Patients were divided in two groups, the AKI group that developed AKI within 48 h and the non-AKI group. Preoperative clinical characteristics, intra-operative factors and outcome were compared between two groups.
Patients presented frequently with AKI post cardiac surgery. High EuroScore II (P = 0.003), white blood cells (WBC) pre-operatively (P = 0.002) and history of kidney disease (P = 0.018) were independent predictors of AKI. AKI is associated with prolonged intensive care unit (ICU) stay, greater duration of mechanical ventilation and higher rate of dialysis, reintubation, ICU-acquired weakness, delirium and mortality.
AKI is a frequent complication post cardiac surgery associated with poor outcome. Preoperative clinical characteristics, such as EuroScore II, preoperative WBC or presence of chronic kidney disease may help in early identification and appropriate management of patients in risk for AKI.
Further investigation is necessary to assess preventive and optimal treatment strategy protocols for AKI presentation.