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Kidney Week

Abstract: TH-PO075

Risks and Outcomes of Postoperative Dialysis-Requiring AKI in Patients Who Underwent Coronary Artery Bypass Grafting Surgery: A Large Retrospective Study

Session Information

Category: Acute Kidney Injury

  • 101 AKI: Epidemiology, Risk Factors, and Prevention


  • Chiu, Ijen, Shuang-Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
  • Hsiao, Li-Li, Brigham and Women's Hospital , Harvard Medical University, Boston, Massachusetts, United States
  • Hsu, Yung-Ho, Shuang-Ho Hospital, Taipei Medical University, New Taipei City, Taiwan

In-hospital acute kidney injury (AKI) has been linked to higher mortality and kidney disease progression. We aim to evaluate the associated factors and long-term outcome from patients underwent coronary artery bypass grafting (CABG) surgery, who developed dialysis-requiring AKI.


Data were collected by the National Health Insurance Research Database of Taiwan from 2002 to 2012. Individuals 18 and older, who underwent scheduled isolated CABG were identified (n=33790). Patients who were ESRD or received renal replacement therapy (RRT) within one year before surgery were excluded. AKI requiring dialysis was identified by the dialysis procedure code. The long-term mortality and ESRD were examined using multivariate Cox regression.


The incidence of dialysis-requiring AKI after CABG is 7.6% (2,575). Patients with age 65 and older, history of Type 2 diabetes (T2DM), hypertension (HTN) and use of Angiotensin receptor blocker (ARB), erythropoietin (EPO) as well as on-pump CABG were the risk factors. And older age (>=65 y.o), T2DM and in-hospital RRT were associated with increased long-term mortality (HR 2.62, 1.49 & 4.47, p<0.0001). RRT also had a significantly increased risk of progression to ESRD (HR 17.16, p<0.0001). Neither on-pump nor off-pump CABG affects long-term mortality (HR 0.95, p=0.051), but on-pump CABG patients had a higher risk of developing ESRD (HR 1.19, p=0.001). While preoperative statin use linked to lower long-term mortality (HR 0.82), it caused a higher risk of ESRD progression (HR 1.23m)(p<0.0001). A similar observation was also seen in ARB use (HR 1.23, p< 0.0001). Furthermore, EPO use significantly increased the risk of progression to ESRD (HR 7.10, p<0.0001) despite no worsening effect on long-term mortality (HR 0.77, p=0.13)


We have identified the risk factors that increase the incidence of dialysis-requiring AKI after CABG; we further identified factors that affect the risk of mortality and ESRD progression. Statin appears to have protective effects in mortality and on-pump CABG showed higher risks in developing post-operative AKI and ESRD progression. Our finding may serve as a guideline for risk assessment and managing those who undergo CABG.