Preoperative risk factors for the development of acute renal failure in cardiac surgery

Abstract

Objective: To evaluate clinical risk factors for the development of Acute Renal Failure (ARF) in patients who undergo cardiac surgery.

Method: Over a period of 21 consecutive months, one hundred and fifty patients who underwent cardiac surgery were studied. There was a slight prevalence of men (57%) and the average age was 56 +/- 14.8 years. Sixty-six percent presented with coronary artery disease as the main diagnosis and 34% valvular heart disease. The median preoperative serum creatinine was 1.1 mg/dL. ARF was defined as a 30% increase in serum creatinine above baseline. The protocol of clinical variables initiated 48 hours before the surgical procedure and finished 48 hours after it and included cardiological and non-cardiological variables and laboratory data.

Results: ARF was present in 34% of the cases. After multivariate analysis, being a man and the presence of peripheral vascular disease were identified as the preoperative factors.

Conclusion: The results obtained in this study identified some risk factors for the development of ARF in cardiac surgery, suggesting simple clinical procedures that may prevent renal dysfunction in these situations and, consequently, reduce the mortality rate. In the present study, the sample size has possibly impeded the identification of other significant risk factors.