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Chapter 19 - Renal Morbidity Associated with Cardiopulmonary Bypass

Published online by Cambridge University Press:  24 October 2022

By
Juan Pablo Domecq  and
Robert C Albright
Edited by
Florian Falter ,
Albert C. Perrino, Jr  and
Robert A. Baker
Florian Falter
Affiliation:
Royal Papworth Hospital, Cambridge
Albert C. Perrino, Jr
Affiliation:
Yale University Medical Center, Connecticut
Robert A. Baker
Affiliation:
Flinders Medical Centre, Adelaide
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Summary

Acute kidney injury is the most common major complication after cardiac surgery. The incidence of cardiac surgery-associated AKI (CSA-AKI) varies between 5% to 40% and leads to dramatically worse outcomes. The incidence of CSA-AKI requiring renal replacement therapyafter coronary artery bypass grafting alone is roughly 1%. After valve surgery or combined CABG plus valve surgery the risk of requiring RRT increases to 1.7 and 3.3% respectively.Regardless of its reversibility, CSA-AKI has been associated with increased mortality and risk of developing chronic or end-stage renal disease, and consequently generating substantial cost.

Keywords

Acute Kidney InjuryEpidemiologyPathophysiology of Acute Kidney InjuryRisk Factors of Acute Kidney InjuryPrevention of Acute Kidney Injurychronic Kidney disease
Type
Chapter
Information
Cardiopulmonary Bypass , pp. 184 - 193
Publisher: Cambridge University Press
Print publication year: 2022

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References

Suggested Further Reading

Cheungpasitporn, W, Thongprayoon, C, Kittanamongkolchai, W et al. Comparison of renal outcomes in off-pump versus on-pump coronary artery bypass grafting: a systematic review and meta-analysis of randomized controlled trials. Nephrology. October 2015;20(10):727–735.Google Scholar
Chew, STH, Hwang, NC. Acute kidney injury after cardiac surgery: a narrative review of the literature. J Cardiothorac Vasc Anesth. August 7, 2018.Google Scholar
Cole, SP. Stratification and risk reduction of perioperative acute kidney injury: an update. Anesthesiol Clin. December 2018;36(4):539–551.CrossRefGoogle ScholarPubMed
Hoste, EAJ, Vandenberghe, W. Epidemiology of cardiac surgery-associated acute kidney injury. Best Pract Res Clin Anaesthesiol. September 2017;31(3):299–303.CrossRefGoogle ScholarPubMed
Kim, WH, Hur, M, Park, SK et al. Pharmacological interventions for protecting renal function after cardiac surgery: a Bayesian network meta-analysis of comparative effectiveness. Anaesthesia. August 2018;73(8):1019–1031.CrossRefGoogle ScholarPubMed
Nadim, MK, Forni, LG, Bihorac, A et al. Cardiac and vascular surgery-associated acute kidney injury: The 20th International Consensus Conference of the ADQI (Acute Disease Quality Initiative) Group. J Am Heart Assoc. June 1, 2018;7(11).Google Scholar
Wang, Y, Bellomo, R. Cardiac surgery-associated acute kidney injury: risk factors, pathophysiology and treatment. Nat Rev Nephrol. November 2017;13(11):697–711.Google Scholar
Whiting, P, Morden, A, Tomlinson, LA et al. What are the risks and benefits of temporarily discontinuing medications to prevent acute kidney injury? A systematic review and meta-analysis. BMJ open. April 7, 2017;7(4):e012674.Google Scholar
Ranucci, M, Biagioli, B, Scolletta, S et al. Lowest hematocrit on cardiopulmonary bypass impairs the outcome in coronary surgery: nn Italian multicenter study from the National Cardioanesthesia Database. Tex Heart Inst J. 2006;33(3):300–305.Google Scholar
Newland, RF, Baker, RA, Mazzone, AL et al. Perfusion downunder collaboration. rewarming temperature during cardiopulmonary bypass and acute kidney injury: a multicenter analysis. Ann Thorac Surg. May 2016;101(5):1655–1662.Google Scholar

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