Association between Changes in Preoperative Serum Creatinine and Acute Kidney Injury after Cardiac Surgery: A Retrospective Cohort Study
Introduction: Limited information exists regarding the impact of preoperative serum creatinine changes on cardiac surgery-associated acute kidney injury (CSA-AKI). This study aimed to investigate the development of AKI in patients with a baseline estimated glomerular filtration rate of ≥60 mL/min/1....
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Karger Publishers
2024-10-01
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| Series: | Kidney & Blood Pressure Research |
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| author | Bo Jiang Yi Hao Haiping Yang Meiping Wang Ran Lou Yibing Weng Genshen Zhen Li Jiang |
| author_facet | Bo Jiang Yi Hao Haiping Yang Meiping Wang Ran Lou Yibing Weng Genshen Zhen Li Jiang |
| author_sort | Bo Jiang |
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| description | Introduction: Limited information exists regarding the impact of preoperative serum creatinine changes on cardiac surgery-associated acute kidney injury (CSA-AKI). This study aimed to investigate the development of AKI in patients with a baseline estimated glomerular filtration rate of ≥60 mL/min/1.73 m2 who present with an elevation in preoperative serum creatinine. Methods: This retrospective cohort study assessed patients who underwent open-heart surgery. Preoperative serum creatinine change was calculated as the ratio of the maximum preoperative serum creatinine value to the baseline creatinine (MCR). Patients were categorized into three groups based on MCR: non-elevation (≤1.0), mild elevation (1.0 to 1.5), and pronounced elevation (≥1.5). Multivariable logistic regression was used to estimate the risk of AKI, severe AKI, and non-recovery from AKI. Results: There were significant increases in the odds of AKI (adjusted odds ratio [OR], 1.42; 95% confidence interval [CI], 1.29–1.57; per 0.1 increase in MCR), severe AKI (adjusted OR, 1.28; 95% CI, 1.15–1.41), and AKI non-recovery (adjusted OR, 1.29; 95% CI, 1.16–1.43). Pronounced elevation in preoperative serum creatinine was associated with a higher risk of AKI (adjusted OR, 15.45; 95% CI, 6.63–36.00), severe AKI (adjusted OR, 3.62; 95% CI, 1.20–10.87), and AKI non-recovery (adjusted OR, 4.74; 95% CI, 1.63–13.89) than non-elevation. Mild elevation in preoperative serum creatinine was also significantly associated with AKI (adjusted OR, 3.76; 95% CI, 1.92–7.37). Conclusions: Elevation in preoperative serum creatinine from baseline was associated with an increased risk of AKI; even mild elevation significantly increased the risk of AKI. |
| format | Article |
| id | doaj-art-65c1ec6e2c504d0aa5529006e949b3e0 |
| institution | Kabale University |
| issn | 1423-0143 |
| language | English |
| publishDate | 2024-10-01 |
| publisher | Karger Publishers |
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| series | Kidney & Blood Pressure Research |
| spelling | doaj-art-65c1ec6e2c504d0aa5529006e949b3e02024-11-14T07:28:49ZengKarger PublishersKidney & Blood Pressure Research1423-01432024-10-0149187488310.1159/000541643541643Association between Changes in Preoperative Serum Creatinine and Acute Kidney Injury after Cardiac Surgery: A Retrospective Cohort StudyBo Jiang0Yi Hao1Haiping Yang2Meiping Wang3Ran Lou4Yibing Weng5Genshen Zhen6Li Jiang7Intensive Critical Unit, Fuxing Hospital, Capital Medical University, Beijing, ChinaDepartment of Cardiac Surgery, Beijing Luhe Hospital, Capital Medical University, Beijing, ChinaDepartment of Cardiac Surgery, Beijing Luhe Hospital, Capital Medical University, Beijing, ChinaIntensive Critical Unit, Xuanwu Hospital, Capital Medical University, Beijing, ChinaIntensive Critical Unit, Xuanwu Hospital, Capital Medical University, Beijing, ChinaIntensive Critical Unit, Beijing Luhe Hospital, Capital Medical University, Beijing, ChinaIntensive Critical Unit, Beijing Luhe Hospital, Capital Medical University, Beijing, ChinaIntensive Critical Unit, Xuanwu Hospital, Capital Medical University, Beijing, ChinaIntroduction: Limited information exists regarding the impact of preoperative serum creatinine changes on cardiac surgery-associated acute kidney injury (CSA-AKI). This study aimed to investigate the development of AKI in patients with a baseline estimated glomerular filtration rate of ≥60 mL/min/1.73 m2 who present with an elevation in preoperative serum creatinine. Methods: This retrospective cohort study assessed patients who underwent open-heart surgery. Preoperative serum creatinine change was calculated as the ratio of the maximum preoperative serum creatinine value to the baseline creatinine (MCR). Patients were categorized into three groups based on MCR: non-elevation (≤1.0), mild elevation (1.0 to 1.5), and pronounced elevation (≥1.5). Multivariable logistic regression was used to estimate the risk of AKI, severe AKI, and non-recovery from AKI. Results: There were significant increases in the odds of AKI (adjusted odds ratio [OR], 1.42; 95% confidence interval [CI], 1.29–1.57; per 0.1 increase in MCR), severe AKI (adjusted OR, 1.28; 95% CI, 1.15–1.41), and AKI non-recovery (adjusted OR, 1.29; 95% CI, 1.16–1.43). Pronounced elevation in preoperative serum creatinine was associated with a higher risk of AKI (adjusted OR, 15.45; 95% CI, 6.63–36.00), severe AKI (adjusted OR, 3.62; 95% CI, 1.20–10.87), and AKI non-recovery (adjusted OR, 4.74; 95% CI, 1.63–13.89) than non-elevation. Mild elevation in preoperative serum creatinine was also significantly associated with AKI (adjusted OR, 3.76; 95% CI, 1.92–7.37). Conclusions: Elevation in preoperative serum creatinine from baseline was associated with an increased risk of AKI; even mild elevation significantly increased the risk of AKI.https://beta.karger.com/Article/FullText/541643acute kidney injurycardiac surgerypreoperative carerisk assessment |
| spellingShingle | Bo Jiang Yi Hao Haiping Yang Meiping Wang Ran Lou Yibing Weng Genshen Zhen Li Jiang Association between Changes in Preoperative Serum Creatinine and Acute Kidney Injury after Cardiac Surgery: A Retrospective Cohort Study Kidney & Blood Pressure Research acute kidney injury cardiac surgery preoperative care risk assessment |
| title | Association between Changes in Preoperative Serum Creatinine and Acute Kidney Injury after Cardiac Surgery: A Retrospective Cohort Study |
| title_full | Association between Changes in Preoperative Serum Creatinine and Acute Kidney Injury after Cardiac Surgery: A Retrospective Cohort Study |
| title_fullStr | Association between Changes in Preoperative Serum Creatinine and Acute Kidney Injury after Cardiac Surgery: A Retrospective Cohort Study |
| title_full_unstemmed | Association between Changes in Preoperative Serum Creatinine and Acute Kidney Injury after Cardiac Surgery: A Retrospective Cohort Study |
| title_short | Association between Changes in Preoperative Serum Creatinine and Acute Kidney Injury after Cardiac Surgery: A Retrospective Cohort Study |
| title_sort | association between changes in preoperative serum creatinine and acute kidney injury after cardiac surgery a retrospective cohort study |
| topic | acute kidney injury cardiac surgery preoperative care risk assessment |
| url | https://beta.karger.com/Article/FullText/541643 |
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