Kidney Week

Abstract: TH-PO023

Incidence and Risk Factors of AKI After Coronary Artery Bypass Grafting

Session Information

• AKI: Epidemiology, Risk Factors, Prevention
  October 25, 2018 | Location: Exhibit Hall, San Diego Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Acute Kidney Injury

• 101 AKI: Epidemiology, Risk Factors, and Prevention

Authors

• Salha, Ahmad, St George's University Hospital NHS Foundation Trust, London, United Kingdom

Ahmad Salha,

• Valencia, Jose Oswaldo, St George's University Hospital NHS Foundation Trust, London, United Kingdom

Jose Oswaldo Valencia,

• Klaud francheska, Bayiha daho, St George's University Hospital NHS Foundation Trust, London, United Kingdom

Bayiha daho Klaud francheska,

• Lowe-Jones, Racquel M., St George's University Hospital NHS Foundation Trust, London, United Kingdom

Racquel M. Lowe-Jones,

• Wang, Joe, Epsom & St Helier Hospital NHS Trust, London, United Kingdom

Joe Wang,

• Kanagasabay, Robin, St George's University Hospital NHS Foundation Trust, London, United Kingdom

Robin Kanagasabay,

• Banerjee, Debasish, St George's University Hospital NHS Foundation Trust, London, United Kingdom

Debasish Banerjee,

Background

Acute kidney injury (AKI) Post-coronary artery bypass graft (CABG) is common, but the exact incidence remains controversial, and contributing risk factors varies in different studies. We aimed to investigate the true incidence and risk factors of AKI post Cardiopulmonary bypass (CPB) CABG; in a large inner-city, multi-ethnic, population.

Methods

We examined 2413 patients undergoing first time CPB CABG in a large tertiary care, UK hospital. Creatinine measurements (on isotope dilution mass spectroscopy or spectrometry) were derived from hospital records, pre-surgery and post-surgery days 1,2,3 and 4. AKI was defined as a rise of serum creatinine 26.4 µmol/L or 50% or 1.5-fold from baseline creatinine. . All data for the study was recorded prospectively, as a part of institutional audit process. All statistics were done using SPSS 17 and p value<0.05 was considered significant.

Results

Baseline characteristics of the patients are shown in table 1. The incidence of AKI was 23%. Majority of new AKI cases occurred on the second day post-operatively with 19% occurring on day 2 compared to 6%, 9% and 3% occurring on days 1, 3 and 4 respectively.
Patients who developed AKI were older, with higher proportion of blacks, diabetics, hypertensives, higher CCS score (Canadian Cardiovascular Society grading of angina) and higher NYHA class compared to non-AKI patients (table 2).
Incidence of AKI was associated with increased in-hospital mortality (4.4% vs 0.5%; p=0.000) and length of stay (8[IQR5] vs 6[IQR3] days; p=0.000).
On multiple regression analysis, the independent predictors of AKI were age, CCS score 3-4, hypertension, emergency nature of surgery, insulin dependent diabetes and raised pre-operative creatinine (table 3).

Conclusion

In a multi-ethnic, inner-city population the incidence of AKI was 23% in first time CPB CABG patients and the independent risk factors were age, CCS score 3-4, hypertension, emergency surgery, diabetes and CKD.

Tables on baseline characteristics; comparisons & predictors of AKI