Cardiology and Cardiovascular Therapeutics

Biography

Biography: Clarisse E Cledera

Abstract

Acute Kidney Injury (AKI) is a common and significant complication in patients undergoing cardiac surgery. It is associated with progression of chronic kidney disease, increased hospital length of stay and in-hospital mortality. This study was conducted to determine the incidence of AKI in post-coronary artery bypass graft (CABG) patients and to determine the risk factors associated with cardiac surgery-associated AKI (CSA-AKI) in Chinese General Hospital and Medical Center for a period of eight years (2010-2017). This was a retrospective cross-sectional analysis of 160 patients who underwent CABG. Preoperative, intraoperative and post-operative variables were collected and analyzed. Logistic regression analysis was used to determine the factors associated with AKI. Univariate analysis was performed to screen potential factors using a cutoff of p<0.20. Multiple logistic regression analyses with backward elimination technique was then performed. P values ≤0.05 was considered statistically significant. Of the 160 patients, 32 (20%) developed AKI. Among all factors, only hematocrit (OR 0.90 95% CI 0.83-0.99 p=0.026) and history of chronic kidney disease (CKD) was significantly associated with AKI. For every 1% increase in hematocrit, odds of AKI after CABG decreases by 12% (β = -0.12). In multivariate analysis, patients with CKD history are significantly four times more likely to develop AKI after CABG. Mean creatinine value post-op was significantly higher compared to pre-op values using paired t-test (Post: 1.24 mg/dl ± 0.44 vs. Pre: 1.13 mg/dl ± 0.35, p<0.00001). Hematocrit and history of chronic kidney disease were considered to be an independent risk factors for CSA-AKI. Mean creatinine was significantly higher post-operatively compared to pre-operative values.