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Abstract: TH-OR114

Post-Discharge Long-Term Cardiovascular Outcome of Dialysis Requiring AKI after Cardiac Surgery

Session Information

Category: Acute Kidney Injury

  • 102 AKI: Clinical, Outcomes, and Trials

Authors

  • Lee, Soojin, Seoul National University Hospital, Seoul, Korea (the Republic of)
  • Park, Sehoon, Seoul National University Hospital, Seoul, Korea (the Republic of)
  • Kang, Min woo, Seoul National University Hospital, Seoul, Korea (the Republic of)
  • Kim, Yaerim, Seoul National University Hospital, Seoul, Korea (the Republic of)
  • Lee, Jung Pyo, Seoul National University Boramae Medical Center, Seoul, Korea (the Republic of)
  • Joo, Kwon Wook, Seoul National University Hospital, Seoul, Korea (the Republic of)
  • Lim, Chun Soo, Seoul National University Boramae Medical Center, Seoul, Korea (the Republic of)
  • Kim, Dong Ki, Seoul National University Hospital, Seoul, Korea (the Republic of)
Background

Dialysis requiring acute kidney injury (AKI-D) is one of the serious complications following the cardiac surgery and it is known to increase in short-term in hospital mortality. Nevertheless, long-term prognosis and risk of major cardiovascular events (MACE) has not been examined yet.

Methods

We conducted a nationwide, population-based cohort study using the data of Korean National Health Insurance System. Adult patients who underwent cardiac surgery in tertiary hospitals between 2006 and 2015 were considered. Patients previously received dialysis were excluded. Then, the patients were divided into those who underwent dialysis after cardiac surgery and those who did not.

Results

Of 52,803 patients received cardiac surgery, 1,261 underwent dialysis during the perioperative period of cardiac surgery. All-cause mortality [adjusted hazard ratio (HR) 2.93 (2.65-3.23), P<0.001], progression to end-stage renal disease (ESRD) [adjusted HR 15.95 (13.89-18.33), P<0.001] and risk of MACE [adjusted HR 2.26 (2.04-2.51), P<0.001] were increased in AKI-D group (Figure 1). In the AKI-D group, all-cause mortality [adjusted HR 1.07 (0.83-1.38), P=0.593] and the risk of MACE [adjusted HR 1.25 (0.94-1.67), P=0.126] were comparable between the continuous renal replacement therapy (CRRT) and intermittent renal replacement therapy (IRRT) group.

Conclusion

Patients required dialysis after the cardiac surgery were associated with high all-cause mortality and rate of dialysis dependence. Although AKI-D patients independently survive, they persistently had increased risk of MACE development. Despite higher patient severity in patients requiring CRRT, outcomes among these patients were not deteriorated, compared to IRRT group.

The x-axes represent the time (years), and the y-axes represent the incidence probability. The black, and red lines represent the survival curves of the control, and AKI-D groups, respectively.

Funding

  • NIDDK Support