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. 2018 Jan-Mar;21(1):41-45.
doi: 10.4103/aca.ACA_104_17.

Long-term quality of life postacute kidney injury in cardiac surgery patients

Pankaj Kumar Mishra  1 , Heyman Luckraz  1 , Jayanta Nandi  1 , Alan Nevill  2 , Ramesh Giri  3 , Andrew Panayiotou  1 , Johann Nicholas  4
Affiliations

Long-term quality of life postacute kidney injury in cardiac surgery patients

Pankaj Kumar Mishra et al. Ann Card Anaesth. 2018 Jan-Mar.

Abstract

Background: Acute renal failure after cardiac surgery is known to be associated with significant short-term morbidity and mortality. There have as yet been no major reports on long-term quality of life (QOL). This study assessed the impact of acute kidney injury (AKI) and renal replacement therapy (RRT) on long-term survival and QOL after cardiac surgery. The need for long-term RRT is also assessed.

Materials and methods: Patients who underwent cardiac surgery between 2005 and 2011 (n = 6087) and developed AKI (RIFLE criteria, n = 570) were included. They were propensity-matched 1:1 to patients without renal impairment (control). Data were prospectively collected, and health-related QOL questionnaire was sent to patients who were alive at least 1-year postoperatively at the time of the study.

Results: There was no significant difference in the preoperative characteristics between the two groups (age, gender, left ventricular ejection fraction, procedure, urgency, logistic Euroscore), respectively. Median follow-up was 52 months. Survival data were available in all patients. Questionnaires were returned in 64% of eligible patients. Long-term survival was significantly lower, and QOL, in particular the physical aspect, was significantly worse for the AKI group as compared to non-AKI group (38.8 vs. 44.2, P = 0.002), especially so in patients who required RRT. In alive respondents, despite an 18% (66/359) incidence of ongoing renal follow-up, the need for late RRT was only in 1.1% (4/359).

Conclusion: AKI and especially the need for RRT following cardiac surgery are associated with increased long-term mortality as well as worse quality of life in a propensity-matched control group.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Kaplan–Meier survival curves for the three groups
Figure 2
Figure 2
Box plots – median (range) – for the (a) mental and (b) physical performance using Short-Form-12 questionnaire for patients with and without acute kidney injury
Figure 3
Figure 3
Box plots – median (range) – for the physical performance using Short-Form-12 questionnaire for patients without acute kidney injury, with acute kidney injury and no renal replacement therapy and with acute kidney injury and renal replacement therapy
See this image and copyright information in PMC

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