Acute kidney injury in patients who underwent cardiac surgery


Cite item

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription or Fee Access

Abstract

Acute kidney injury (AKI) is a serious complication of cardiovascular surgery, and its detection rate, depending on diagnostic criteria and the severity of AKI, ranges from 12 to 55%. The development of AKI is caused by the repeated effects of aggressive factors on the kidneys, occurring before and after surgery. AKI remains a strong independent factor of increased risk of progression of chronic kidney disease and is associated with high hospital mortality and late adverse cardiovascular events. To improve the long-term prognosis, more attention should be paid to the prevention of AKI after cardicac surgery. Severe AKI, requiring renal replacement therapy, is rare, but mortality ranges from 40% to 80%. This fact emphasizes the primary importance of therapeutic interventions that can maintain renal function during the perioperative period, especially in high-risk patients.

Full Text

Restricted Access

About the authors

B. G Iskanderov

FSBEI FPE "Russian Medical Academy of Continuous Professional Education" of the Ministry of Health of the Russian Federation

Email: iskenderovbg@mail.ru
Doctor of Medical Sciences, Professor at the Department of Therapy, Cardiology and Functional Diagnostics of the Penza Institute for Advanced Medical Training -branch of FSBEIFPE RMACPE of the Ministry of Health of the Russian Federation

References

  1. KDIGO 2012 Clinical practice guideline for the evaluation and management of chronic kidney disease. Kidney Int. 2013;3:1-150. doi: 10.1038/kisup.2012.73.
  2. Мухин Н.А., Моисеев С.В., Кобалава Ж.Д., Моисеев В.С., Фомин В.В. Кардиоренальные взаимодействия: клиническое значение и роль в патогенезе сердечно-сосудистой системы и почек. Тер. архив. 2004;6:39-46
  3. Гарсиа-Донаире Ж.А., Руилопе Л.М., Воронкова Е.В. Кардио-васкулярно-ренальные связи в кардиоренальном континууме. Нефрология. 2013;1:11-41. Doi:https://doi. org/10.24884/1561-6274-2013-17-1-11-19.
  4. Смирнов А.В., Добронравов В.А., Румянцев А.Ш., Шилов Е.М., Ватазин А.В., Каюков И.Г., Кучер А.Г., Есаян А.М. Национальные рекомендации. Острое повреждение почек: основные принципы диагностики, профилактики и терапии. Часть I. Нефрология. 2016;20(1):79-104. Doi:https://doi.org/10.24884/1561-6274-2016-20-1-8-15.
  5. Kellum J.A. Kidney disease improving global outcomes: KDIGO clinical practice guideline for acute kidney injury. Kidney Int. 2012;2:8-12. Doi:10.1038/ kisup.2012.1.
  6. Lenihan C.R., Montez-Rath M.E., Mora Mangano C.T., Chertow G.M., Winkelmayer W.C. Trends in acute kidney injury associated use of dialysis, and mortality after cardiac surgery 1999 to 2008. Ann. Thorac. Surg. 2013;95:20-28. doi: 10.1016/j.athoracsur.2012. 05.131.
  7. Gaffney A.M., Sladen R.N. Acute kidney injury in cardiac surgery. Curr. Opin. Anaesthesiol. 2015;28(1):50-59. doi: 10.1097/ACO.0000000000000154.
  8. Nadim M.K., Forni L.G., Bihorac A., Hobson Ch., Koyner J.L., Shaw A., et al. Cardiac and vascular surgery-associated acute kidney injury: The 20th International Consensus Conference of the ADQI (Acute Disease Quality Initiative) Group. J. Am. Heart Assoc. 2018;7(11):e008834. Doi: 10.1161/ JAHA.118.008834.
  9. McCullough P.A. Contrast-induced nephropathy: definitions, epidemiology and implications. Intervent. Cardiol. Clin. 2014;3(3):357-362. Doi:https://doi. org/10.1016/j.iccl.2014.03.002.
  10. Najafi M. Serum creatinine role in predicting outcome after cardiac surgery beyond acute kidney injury. World J. Cardiol. 2014;6(9):1006-1021. doi: 10.4330/wjc.v6.i9.1006.
  11. Lagny M.G., Jouret F., Koch J.N., Blaffart F., Donneau A.F., Albert A. Incidence and outcomes of acute kidney injury after cardiac surgery using either criteria of the RIFLE classification. BMC Nephrol. 2015:16:76. Doi: https://doi. org/10.1186/s12882-015-0066-9.
  12. Hobson C.E., Yavas S., Segal M.S., Schold J.D., Tribble C.G., Layon A.J., et al. Acute kidney injury is associated with increased long-term mortality after cardiothoracic surgery. Circulation. 2009;119:2444-2453. Doi:10.1161/ CIRCULATIONAHA.108.800011.
  13. Ortega-Loubon C., Ferndndez-Molina M., Paneda-Delgado L., Jorge-Monjas P., Carrascal Y. Predictors of postoperative acute kidney injury after coronary artery bypass graft surgery. Braz. J. Cardiovasc. Surg. 2018;33(4):323-329. doi: 10.21470/1678-9741-2017-0251.
  14. Bataille Y., Plourde G., Machaalany J., Abdelaal E., Déry J-P., Larose E. Interaction of chronic total occlusion and chronic kidney disease in patients undergoing primary percutaneous coronary intervention for acute ST-elevation myocardial infarction. Am. J. Cardiol. 2013;112:194-199. Doi: 10.1016/j. amjcard. 2013.03.010.
  15. Huang T.M., Wu V.C., Young G.H. Preoperative proteinuria predicts adverse renal outcomes after coronary artery bypass grafting. J. Am. Soc. Nephrol. 2011;22:156-163. doi: 10.1681/ASN.2010050553.
  16. Coca S.G., Jammalamadaka D., Sint K., Thiessen Ph.H., Shlipak M.G., Zappitelli M., et al. Preoperative proteinuria predicts acute kidney injury in patients undergoing cardiac surgery. J. Thorac. Cardiovasc. Surg. 2012;143:495-502. doi: 10.1016/j.jtcvs.2011.09.023.
  17. Valdez G.D., Mihos C.G., Santana O., Heimowitz T.B., Goldszer R., Lamas G.A., et al. Incidence of postoperative acute kidney injury in patients with chronic kidney disease undergoing minimally invasive valve surgery. J. Thorac. Cardiovasc. Surg. 2013;146:1488-1493. Doi:https://doi.org/ 10.1016/j.jtcvs.2013.06.034.
  18. Hori D., Yamaguchi A., Adachi H. Coronary artery bypass surgery in end-stage renal disease patients. Ann. Vasc. Dis. 2017;10(2):79-87. doi: 10.3400/avd. ra.17-00024.
  19. Lim J.Y., Deo S.V., Jung S.H., Altarabsheh S.E., Erwin P.J., Dillon J.J., et al. Does off-pump coronary artery bypass confer any advantage in patients with endstage renal failure? A systematic review and meta-analysis. Heart Lung Circ. 2015;24(1):55-61. doi: 10.1016/j.hlc.2014.06.005.
  20. Shroff G.R., Solid C.A., Herzog C.A. Long-term survival and repeat coronary revascularization in dialysis patients after surgical and percutaneous coronary revascularization with drug-eluting and bare metal stents in the United States. Circulation. 2013;127:1861-1869. Doi:10.1161/ CIRCULATIONAHA.112.001264.
  21. Vohra H.A., Armstrong L.A., Modi A., Barlow C.W. Outcomes following cardiac surgery in patients with preoperative renal dialysis. Interact Cardiovasc. Thorac. Surg. 2014;18(1):103-111. doi: 10.1093/icvts/ivt407.
  22. Xu J.R., Zhu J.M., Jiang J., Ding X.Q., Fang Y., Shen B., et al. Risk factors for long-term mortality and progressive chronic kidney disease associated with acute kidney injury after cardiac surgery. Medicine. 2015;94(45):e2025. Doi:10.1097/ MD.0000000000002025.
  23. Grams M.E., Astor B.C., Bash L.D., Matsushita K., Wang Y., Coresh J. Albuminuria and estimated glomerular filtration rate independently associate with acute kidney injury. J. Am. Soc. Nephrol. 2010;21:1757-1764. Doi:10.1681/ ASN.2010010128.
  24. Hsu C.Y., Ordonez J.D., Chertow G.M., Fan D., McCulloch C.E., Go A.S. The risk of acute renal failure in patients with chronic kidney disease. Kidney Int. 2008;74:101-107. doi: 10.1038/ki.2008.107.
  25. Roberts J.K., Rao S.V., Shaw L.K., Gallup D.S., Marroquin O.C., Patel U.D. Comparative efficacy of coronary revascularization procedures for multivessel coronary artery disease in patients with chronic kidney disease. Am. J. Cardiol. 2017;119(9):1344-1351. doi: 10.1016/j.amjcard.2017.01.029.
  26. Meersch M., Schmidt Ch., Zarbock A. Perioperative acute kidney injury: an under-recognized problem. Anesth. Analg. 2017;125(4):1223-1232. doi: 10.1213/ANE.0000000000002369.
  27. Roh G.U., Lee J.W., Nam S.B., Lee J., Choi J-r, Shim Y.Sh. Incidence and risk factors of acute kidney injury after thoracic aortic surgery for acute dissection. Ann. Thorac. Surg. 2012;94:766-771. Doi: https://doi.org/10.1016/j. athoracsur.2012.04.057.
  28. Hansen M.K., Gammelager H., Mikkelsen M.M., Hjortdal V.E., Layton J.L., Johnsen S.P. et al. Post-operative acute kidney injury and five-year risk of death, myocardial infarction and stroke among elective cardiac surgical patients: a cohort study. Critical. Care. 2013;17: R292. Doi:https://doi.org/10.1186/ cc13158.
  29. Arthur J.M., Hill E.G, Alge J.L., Lewis E.C., Neely B.A., Janech M.G., et al. Evaluation of 32 urine biomarkers to predict the progression of acute kidney injury after cardiac surgery. Kidney Int. 2014;85:431-438. doi: 10.1038/ki.2013.333.
  30. Gammelager H., Christiansen C.F., Johansen M.B., Tonnesen E., Jespersen B., Sorensen H.T. One-year mortality among Danish intensive care patients with acute kidney injury: a cohort study. Critical Care. 2012;16(4):R.124. doi: 10.1186/cc11420.
  31. Mârtensson J., Martling C.R., Bell M. Novel biomarkers of acute kidney injury and failure: clinical applicability. Br. J. Anaesth. 2012;109(6):843-850. doi: 10.1093/bja/aes357.
  32. Guida P., Mastro F., Scrascia G., Whitlock R., Paparella D. Performance of the European system for cardiac operative risk evaluation II: a meta-analysis of 22 studies involving 145,592 cardiac surgery procedures. J. Thorac. Cardiovasc. Surg. 2014;148(6):3049-3057. doi: 10.1016/j.jtcvs.2014.07.039.
  33. Kumada Y., Yoshitani K., Shimabara Y., Ohnishi Y. Perioperative riskfactorsfor acute kidney injury after off-pump coronary artery bypass grafting: a retrospective study. J. Clin. Rep. 2017;3(1):55-63. doi: 10.1186/s40981-017-0125-2.
  34. Loncar G., Barthelemy O., Berman E., Kerneis M., Petroni T., Payot L., et al. Impact of renal failure on all-cause mortality and other outcomes in patients treated by percutaneous coronary intervention. Arch. Cardiovasc. Dis. 2015;108(11):554-562. doi: 10.1016/j.acvd.2015.06.001.
  35. Kajimoto K., Miyauchi K., Kasai T., Yanagisawa N., Yamamoto T., Kikuchi K., et al. Metabolic syndrome is an independent risk factor for stroke and acute renal failure after coronary artery bypass grafting. J. Thorac. Cardiovasc. Surg. 2009;137(3):658-663. doi: 10.1016/j.jtcvs.2008.11.043.
  36. Engel A.M., McDonough S., Smith J.M. Does an obese body mass index affect hospital outcomes after coronary artery bypass graft surgery? Ann. Thorac. Surg. 2009;88(6):1793-1800. doi: 10.1016/j.athoracsur.2009.07.077.
  37. Bhamidipati C.M., La Par D.J., Stukenborg G.J., Morrison C.C., Kern J.A., Kron I.L., et al. Superiority of moderate control of hyperglycemia to tight control in patients undergoing coronary artery bypass grafting. J. Thorac. Cardiovasc. Surg. 2011;141:543-551. doi: 10.1016/j.jtcvs.2010.10.005.
  38. Patel N.N., Angelini G.D. Pharmacological strategies for the prevention of acute kidney injury following cardiac surgery: an overview of systematic reviews. Curr. Pharm. Des. 2014;20(34):5484-5488. doi: 10.2174/1381612820666140325 113422.
  39. Wessely M., Rau S., Lange P., Kehl K., Renz V., Schönermarck U., et al. Chronic kidney disease is not associated with a higher risk for mortality or acute kidney injury in transcatheter aortic valve implantation. Nephrol. Dial. Transplant. 2012;27(9):3502-3508. doi: 10.1093/ndt/gfs102.
  40. Sepehripour A.H., Chaudhry U.A., Harling L., Athanasiou T. Off-pump or on-pump beating heart: which technique offers better outcomes following coronary revascularization ? Interact. Cardiovasc. Thorac. Surg. 2015;20(4):546-549. doi: 10.1093/icvts/ivu451.
  41. Mirolyubova O.A., Alekseeva M.A., Yakovleva A.S., Shonbin A.N. Acute kidney injury after CABG without cardiopulmonary bypass: prediction of outcomes. Nefrol. Dializ. 2014;3:350-358. (Миролюбова О.А., Алексеева М.А., Яковлева А.С., Шонбин А.Н. Острое повреждение почек после аортокоронарного шунтирования на работающем сердце: прогнозирование исходов. Нефрология и диализ 2014;3:350-358).
  42. Kuo Y.T., Chiu K.M., Tsang Y.M., Chiu C.M., Chien M.Y. Influence of chronic kidney disease on physical function and quality of life in patients after coronary artery bypass grafting. Cardiorenal. Med. 2015;5(4):237-245. doi: 10.1159/000433447.
  43. Sabroe J.E., Thayssen P.,Antonsen L.,Hougaard L.M.,Hansen K.N., Jensen L.O. Impact of renal insufficiency on mortality in patients with ST-segment elevation myocardial infarction treated with primary percutaneous coronary intervention. BMC. Cardiovasc. Disord. 2014;14:15. doi: 10.1186/1471-2261-14-15.
  44. Hou C., Gong J., Chen D., Wang W., Liu M., Liu B. Levosimendan for prevention of acute kidney injury after cardiac surgery: a meta-analysis of randomized controlled trials. Am. J. Kidney Dis. 2016;67:408-416. doi: 10.1053/j.ajkd.2015.09.015.
  45. Lewicki M., Ng I., Schneider A.G. HMG CoA redmtase inhibitors (statins) for preventing acute kidney injury after surgical procedures requiring cardiac bypass. Cochrane Database Syst. Rev. 2015;3:CD010480. doi: 10.1002/14651858. CD010480.
  46. Zhou C., Jeon Y., Meybohm P., Zarbock A., Young P.J., Li L., et al. Renoprotection by remote ischemic conditioning during elective coronary revascularization: a systematic review and meta-analysis of randomized controlled trials. Int. J. Cardiol. 2016;222:295-302. doi: 10.1016/j.ijcard.2016.07.176.

Supplementary files

Supplementary Files
Action
1. JATS XML
Download

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies