Acute Kidney Injury Following Surgical Aortic Valve Replacement

作者：Najjar Marc; Yerebakan Halit; Sorabella Robert A; Donovan Denis J; Kossar Alexander P; Sreekanth Sowmyashree; Kurlansky Paul; Borger Michael A; Argenziano Michael; Smith Craig R; George Isaac^*

来源：Journal of Cardiac Surgery, 2015, 30(8): 631-639.

DOI：10.1111/jocs.12586

BackgroundAcute kidney injury (AKI) is a significant complication of surgical aortic valve replacement (SAVR). This study sought to describe AKI following SAVR, its risk factors, predictors and effect on long-term survival.
MethodsWe retrospectively reviewed 2169 patients who underwent isolated SAVR between 2000 and 2012. The main end-points were occurrence of AKI, postoperative complications, and short- and long-term survival rates following SAVR. Patients were divided into two groups: AKI+ (n=181) and AKI- (n=1945).
ResultsAKI occurred in 8.5% of patients, of which 3.9% (n=7) needed dialysis. Predictors of AKI after SAVR were body mass index (BMI) and intraoperative packed red blood cells (PRBC) transfusion. AKI+ patients had a more complicated postoperative course and higher cumulative mortality (25% vs. 17%, p=0.012) with a median follow-up of 4.1 years. AKI was not found to be an independent predictor of mortality.
ConclusionsPredictors of AKI after SAVR are increased BMI and intraoperative PRBC transfusion. AKI conferred an increase in hospital length of stay and cumulative mortality while the need for postoperative dialysis was associated with the most complicated hospital stays and the highest in-hospital and cumulative mortalities; therefore careful recognition of patients at risk of AKI is warranted for a better preoperative renal optimization. However, incidence of AKI was lower than what is reported after both on-CPB cardiac surgeries and transcatheter aortic valve replacement, moreover AKI was not found to be an independent predictor of mortality. doi: 10.1111/jocs.12586 (J Card Surg 2015;30:631-639)

• 出版日期2015-8