Xu JR, et al. - This study inspected the consequence of the renal dysfunction (RD) type and change of postoperative cardiac function on the risk of developing acute kidney injury (AKI), among patients who underwent cardiac valve surgery. Preoperative chronic kidney disease (CKD) was discovered to be an independent risk factor for postoperative AKI, in the case of cardiac valve surgery patients. Nevertheless, reversible renal dysfunction (RRD) did not add to the risk. A marked reduction could be gained in the risk of postoperative AKI via an improved postoperative cardiac function.

Methods

• During this trial, reversible renal dysfunction (RRD) was defined as preoperative RD in patients who had not been initially diagnosed with chronic kidney disease (CKD).
• Furthermore, the cardiac function improvement (CFI) was defined as postoperative left ventricular ejection function -preoperative left ventricular ejection function (ΔEF) >0%, and cardiac function not improved (CFNI) as ΔEF ≤0%.

Results

• Among the 4,805 (94%) cardiac valve surgery patients, 301 (6%) were RD cases.
• Substantially lower AKI incidence was disclosed in the RRD group (n=252) than in the CKD group (n=49) (36.5% vs 63.3%, P=0.018).
• The AKI and renal replacement therapy incidences in the CFI group (n=174) were discovered to be markedly lower than in the CFNI group (n=127) (33.9% vs 50.4%, P=0.004; 6.3% vs 13.4%, P=0.037).
• CKD and CKD + CFNI were determined as being independent risk factors for AKI in all patients after cardiac valve surgery, following the adjustment for age, gender, and other confounding factors.
• In the multivariate logistic regression analysis, age, gender (male), hypertension, diabetes, chronic heart failure, cardiopulmonary bypass time (every 1 min added), and intraoperative hypotension were revealed to be the risk factors for postoperative AKI in preoperative RD patients.
• It was noted that CFI after surgery could reduce the risk.