Cardiac Surgery Associated Acute Kidney Injury
Conditions
Interventions
Case series :none
Sponsors
Zhongshan Hospital, Fudan University
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Inclusion criteria
Inclusion criteria: 1. The patient (or their guardian) signs the informed consent form. 2. Age >= 18 years. 3. All patients underwent non-emergency cardiac surgeries, including cardiopulmonary bypass or non-cardiopulmonary bypass surgeries. 4. Patients must have the risk of developing AKI, and at least meet one of the following criteria: cardiopulmonary bypass cardiac surgery + at least one risk factor; or non-cardiopulmonary bypass surgery such as simple coronary artery bypass grafting + at least two AKI risk factors. The risk factors includes: (1) Age >= 70 years; (2) Diabetes (type 1 or type 2), requiring at least one oral hypoglycemic drug or insulin; (3) 30 = eGFR 30 mg/g, or 24-hour urine albumin > 300 mg/24 hours, or urine protein >= +1 in urine test strips/urine routine tests); (5) Previous history of hospitalization for congestive heart failure or NYHA classification III/IV; (6) Left ventricular ejection fraction (LVEF) <= 40%; (7) Previous history of open-chest cardiac surgery (regardless of whether extracorporeal circulation was used); (8) CABG combined with valve surgery; (9) Surgery involving more than one heart valve; (10) Emergency surgery; (11) Preoperative IABP.
Exclusion criteria
Exclusion criteria: 1. There were urgent indications for initiating RRT at the time of enrollment, including serum potassium >= 6.0 mmol/L, pH value <= 7.20, serum bicarbonate <= 12 mmol/L, oxygenation index <= 200 mmHg; presence of volume overload, severe respiratory failure, etc. 2. Preoperative end-stage CKD (eGFR < 30 mL/min/1.73 m^2; or RRT treatment had been received within 4 weeks before enrollment); 3. AKI was present at screening. But transient (<= 5 days) stage 1 AKI after iodinated contrast agent exposure will be included in this study. 4. Previous kidney transplantation or urinary tract obstruction and other urinary system diseases; 5. End-stage heart disease, HIV infection, hematological tumors, etc., with an expected survival period of < 1 year; 6. Expected survival time < 48 hours or patients with a DNR order; 7. Multiple transfers to ICU; 8. Pregnant or lactating women; 9. Medical or psychological conditions that the investigator believed might interfere with the subject's participation in the study, or confuse the subject's assessment or study outcome.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| AKI occurrence within 3 days; | — |
Secondary
| Measure | Time frame |
|---|---|
| AKI occurrence within 7 days;MAKE at discharge, 30days, 90 days, and 365 days;Severe AKI occurrence within 7 days;AKI occurrence within 48 hours;Receipt of renal replacement treatment during hospital stay;mortality within 30 days?90 days and 365 days;Length of stay in the ICU;Length of stay in the hospital;Patients with CKD before surgery develop AKI after surgery;The number of days of use and cumulative dose of vasoactive drugs during ICU stay; | — |
Countries
China
Contacts
Public ContactYing Su
Zhongshan Hospital, Fudan University
Outcome results
None listed