Cardiac Surgery Associated - Acute Kidney Injury
Conditions
Interventions
The model development cohort:none
The validation cohort:none
Sponsors
Zhongshan Hospital, Fudan University
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Inclusion criteria
Inclusion criteria: 1. Patients or their guardian signs the informed consent form. 2. Age>18 years; 3. All patients is going to undergo 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 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;sensitivity;specificity; | — |
Secondary
| Measure | Time frame |
|---|---|
| The number of days of use and cumulative dose of vasoactive drugs;Receipt of renal replacement treatment;Length of stay in the hospital;Patients with CKD before surgery develop AKI after surgery;AKI occurrence within 7 days;mortality;Severe AKI occurrence within 7 days;AKI occurrence within 48 hours;Major adverse kidney events;length of stay in the ICU; | — |
Countries
China
Contacts
Public ContactYing Su
Zhongshan Hospital, Fudan University
Outcome results
None listed