Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Multicenter Study
. 2021 May 4;10(9):e019718.
doi: 10.1161/JAHA.120.019718. Epub 2021 Apr 21.

Long-Term Outcomes of Acute Kidney Injury After Different Types of Cardiac Surgeries: A Population-Based Study

Jia-Jin Chen  1 , Chih-Hsiang Chang  1   2 , Victor Chien-Chia Wu  3 , Shang-Hung Chang  3 , Kuo-Chun Hung  3 , Pao-Hsien Chu  3 , Shao-Wei Chen  4   5
Affiliations
Multicenter Study

Long-Term Outcomes of Acute Kidney Injury After Different Types of Cardiac Surgeries: A Population-Based Study

Jia-Jin Chen et al. J Am Heart Assoc. .

Abstract

Background Dialysis-requiring acute kidney injury (D-AKI) is a major complication of cardiovascular surgery that results in worse prognosis. However, the incidence and impacts of D-AKI in different types of cardiac surgeries have not been fully investigated. Methods and Results Patients admitted for cardiovascular surgery between July 1, 2004, and December 31, 2013, were identified from the National Health Insurance Research Database of Taiwan. The patients were grouped into D-AKI (n=3089) and non-D-AKI (n=42 151) groups. The outcome was all-cause mortality and major adverse kidney event. The long-term outcomes were worse in the D-AKI group than the non-D-AKI group (hazard ratio [HR], 3.89; 95% CI, 3.79-3.99 for major adverse kidney event; HR, 2.89; 95% CI, 2.81-2.98 for all-cause mortality). Patients who underwent aortic surgery had higher risk for D-AKI than other types of surgeries, but they were also more likely to recover. The long-term dialysis rate for the patients who recovered from D-AKI was also lowest in those who underwent aortic surgery. Among all types of cardiac surgeries with D-AKI, patients who had heart valve surgery exhibited the greatest risks of all-cause mortality (HR, 6.04; 95% CI, 5.78-6.32). Conclusions Compared with other heart surgeries, aortic surgery resulted in a higher incidence of D-AKI but better renal recovery, better short-term outcome, and lower incidences of long-term dialysis.

Keywords: acute kidney injury; cardiac surgery; cardiovascular; dialysis; prognosis.

PubMed Disclaimer

Conflict of interest statement

None.

Figures

Figure 1
Figure 1. Patient selection process (A) and trends in incidence rate of dialysis‐requiring acute kidney injury (D‐AKI) during admission from 2004 to 2013 for each type of cardiac surgery (B).
CABG indicates coronary artery bypass grafting.
Figure 2
Figure 2. Overall incidence rate of dialysis‐requiring acute kidney injury (D‐AKI) during admission for different cardiac surgeries.
*Present as statistically significant. CABG indicates coronary artery bypass grafting.
Figure 3
Figure 3. Adjusted odds ratio (OR) or hazard ratio (HR) of dialysis‐requiring acute kidney injury (D‐AKI) compared with non–D‐AKI among different cardiac surgeries in terms of risk of hospital mortality (A), long‐term mortality (B), and long‐term major adverse kidney event (MAKE) (C).
CABG indicates coronary artery bypass grafting.
Figure 4
Figure 4. The Kaplan‐Meier survival rate of dialysis after discharge in patients with dialysis‐requiring acute kidney injury with renal recovery among different cardiac surgery types.
CABG indicates coronary artery bypass grafting.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Sawhney S, Mitchell M, Marks A, Fluck N, Black C. Long‐term prognosis after acute kidney injury (AKI): what is the role of baseline kidney function and recovery? A systematic review. BMJ Open. 2015;e006497. DOI: 10.1136/bmjopen-2014-006497. - DOI - PMC - PubMed
    1. Hobson C, Ozrazgat‐Baslanti T, Kuxhausen A, Thottakkara P, Efron PA, Moore FA, Moldawer LL, Segal MS, Bihorac A. Cost and mortality associated with postoperative acute kidney injury. Ann Surg. 2015;1207–1214. DOI: 10.1097/SLA.0000000000000732. - DOI - PMC - PubMed
    1. Shiao CC, Kan WC, Wang JJ, Lin YF, Chen L, Chueh E, Huang YT, Chiang WP, Tseng LJ, Wang CH, et al. Risk of incident non‐valvular atrial fibrillation after dialysis‐requiring acute kidney injury. J Clin Med. 2018;248. DOI: 10.3390/jcm7090248. - DOI - PMC - PubMed
    1. Peters E, Antonelli M, Wittebole X, Nanchal R, François B, Sakr Y, Vincent JL, Pickkers P. A worldwide multicentre evaluation of the influence of deterioration or improvement of acute kidney injury on clinical outcome in critically ill patients with and without sepsis at ICU admission: results from The Intensive Care Over Nations audit. Crit Care. 2018;188. DOI: 10.1186/s13054-018-2112-z. - DOI - PMC - PubMed
    1. Chertow GM, Levy EM, Hammermeister KE, Grover F, Daley J. Independent association between acute renal failure and mortality following cardiac surgery. Am J Med. 1998;343–348. DOI: 10.1016/s0002-9343(98)00058-8. - DOI - PubMed

Publication types

MeSH terms