Kidney Week

Abstract: TH-OR114

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

Session Information

• Predicting AKI and Clinical Outcomes
  October 25, 2018 | Location: 1B, San Diego Convention Center
  Abstract Time: 05:06 PM - 05:18 PM

Category: Acute Kidney Injury

• 102 AKI: Clinical, Outcomes, and Trials

Authors

• Lee, Soojin, Seoul National University Hospital, Seoul, Korea (the Republic of)

Soojin Lee, MD

• Park, Sehoon, Seoul National University Hospital, Seoul, Korea (the Republic of)

Sehoon Park,

• Kang, Min woo, Seoul National University Hospital, Seoul, Korea (the Republic of)

Min woo Kang,

• Kim, Yaerim, Seoul National University Hospital, Seoul, Korea (the Republic of)

Yaerim Kim,

• Lee, Jung Pyo, Seoul National University Boramae Medical Center, Seoul, Korea (the Republic of)

Jung Pyo Lee,

• Joo, Kwon Wook, Seoul National University Hospital, Seoul, Korea (the Republic of)

Kwon Wook Joo,

• Lim, Chun Soo, Seoul National University Boramae Medical Center, Seoul, Korea (the Republic of)

Chun Soo Lim,

• Kim, Dong Ki, Seoul National University Hospital, Seoul, Korea (the Republic of)

Dong Ki Kim,

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 –