This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Bahar, I. Articles by Tasdemir, O. Search for Related Content PubMed PubMed Citation Articles by Bahar, I. Articles by Tasdemir, O. Pubmed/NCBI databases Medline Plus Health Information Coronary Artery Bypass Surgery Social Bookmarking                         What's this?

Acute renal failure following open heart surgery: risk factors and prognosis

Department of Cardiovascular Surgery, Turkiye Yuksek Ihtisas Hospital, Ankara, Turkey

Ahmet Akgul

Department of Cardiovascular Surgery, Turkiye Yuksek Ihtisas Hospital, Ankara, Turkey, aakgul{at}hotmail.com

Mehmet Ali Ozatik

Department of Cardiovascular Surgery, Turkiye Yuksek Ihtisas Hospital, Ankara, Turkey

Kerem M Vural

Department of Cardiovascular Surgery, Turkiye Yuksek Ihtisas Hospital, Ankara, Turkey

Ali E Demirbag

Department of Gastrointestinal Surgery, Turkiye Yuksek Ihtisas Hospital, Ankara, Turkey

Mediha Boran

Hemodialysis Unit, Turkiye Yuksek Ihtisas Hospital, Ankara, Turkey

Oguz Tasdemir

Department of Cardiovascular Surgery, Turkiye Yuksek Ihtisas Hospital, Ankara, Turkey

Background: Acute renal failure (ARF) development after cardiac surgery carries high mortality and morbidity.

Methods: Out of 14 437 consecutive patients undergoing open-heart surgery between January 1991 and May 2001, 168 (1.16%) developed postoperative ARF mandating hemodialysis. Possible perioperative risk factors, and the prognosis of this dreadful, often fatal complication were investigated.

Results: The mortality rate in this group was 79.7% (134 patients). The risk factors associated with postoperative ARF were advanced age (p-0.000), diabetes mellitus (p-0.000), hypertension (p-0.000), high preoperative serum creatinine levels (p-0.004), impaired left ventricular function (p-0.002), urgent operation (p-0.000) or reoperation (p-0.007), prolonged cardiopulmonary bypass (CPB) (p-0.000) and aortic cross-clamp (ACC) (p-0.000) periods, level of hypothermia (p-0.000), concomitant procedures (p-0.000), low cardiac output state (p-0.000), re-exploration for bleeding or pericardial tamponade (p-0.000), and deep sternal or systemic infection (p-0.000). Of those who could be discharged from hospital, renal functions were restored in 21 patients (12.5%); however, eight patients (4.7%) became hemodialysis dependent. The mean follow-up period was 5.79/3.2 years (range: 4 months to 13 years; a total of 195 patient-years), and 10-year survival was 58.69/10.2% in the discharged patients.

Conclusions: ARF development after cardiac surgery often results in high morbidity and mortality. Recognizing risk factors permits the timely institution of proper treatment, which is the key to reducing untoward outcomes.

Perfusion, Vol. 20, No. 6, 317-322 (2005)
DOI: 10.1191/0267659105pf829oa


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?

This article has been cited by other articles:

				H Vermeer, S Teerenstra, R. de Sevaux, H. van Swieten, and P. Weerwind The effect of hemodilution during normothermic cardiac surgery on renal physiology and function: a review Perfusion, November 1, 2008; 23(6): 329 - 338. [Abstract] [PDF]

				J. R. Brown, R. P. Cochran, T. A. MacKenzie, A. P. Furnary, K. S. Kunzelman, C. S. Ross, C. W. Langner, D. C. Charlesworth, B. J. Leavitt, L. J. Dacey, et al. Long-Term Survival After Cardiac Surgery is Predicted by Estimated Glomerular Filtration Rate Ann. Thorac. Surg., July 1, 2008; 86(1): 4 - 11. [Abstract] [Full Text] [PDF]

				M. A. Albert, N. Halevy, and E. M. Antman Preoperative Evaluation for Cardiac Surgery Card. Surg. Adult, January 1, 2008; 3(2008): 261 - 280. [Full Text]

				Z. I. Khalpey, R. B. Ganim, and J. D. Rawn Postoperative Care of Cardiac Surgery Patients Card. Surg. Adult, January 1, 2008; 3(2008): 465 - 486. [Full Text]

				J. R. Brown, R. P. Cochran, B. J. Leavitt, L. J. Dacey, C. S. Ross, T. A. MacKenzie, K. S. Kunzelman, R. S. Kramer, F. Hernandez Jr, R. E. Helm, et al. Multivariable Prediction of Renal Insufficiency Developing After Cardiac Surgery Circulation, September 11, 2007; 116(11_suppl): I-139 - I-143. [Abstract] [Full Text] [PDF]