Abstract: SA-PO0296
Long-Term Major Adverse Kidney Events After High-Risk Cardiac Surgery
Session Information
- AKI: Epidemiology and Risk Factors
October 24, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Acute Kidney Injury
- 101 AKI: Epidemiology, Risk Factors, and Prevention
Authors
- Shelbaya, Khaled, Alexion Pharmaceuticals Inc, Boston, Massachusetts, United States
- Parikh, Chirag R., Johns Hopkins Medicine, Baltimore, Maryland, United States
- Thakar, Ketan, Alexion Pharmaceuticals Inc, Boston, Massachusetts, United States
- Farag, Youssef MK, Alexion Pharmaceuticals Inc, Boston, Massachusetts, United States
- Solinsky, Christine M., Alexion Pharmaceuticals Inc, Boston, Massachusetts, United States
- McArthur, Eric, London Health Sciences Centre, London, Ontario, Canada
- Garg, Amit X., London Health Sciences Centre, London, Ontario, Canada
- Williams, Cory, Alexion Pharmaceuticals Inc, Boston, Massachusetts, United States
- Singh, Ajay K., Alexion Pharmaceuticals Inc, Boston, Massachusetts, United States
- Thiessen Philbrook, Heather, Johns Hopkins Medicine, Baltimore, Maryland, United States
Background
Cardiac surgery–associated acute kidney injury (CSA-AKI) affects up to 40% of patients and is associated with 6.5-fold and 5-fold higher risks of death and CKD, respectively. The TRIBE-AKI cohort aims to estimate long-term MAKE after cardiopulmonary bypass (CPB) and evaluate associated risk factors and biomarkers.
Methods
TRIBE-AKI is a prospective, multicenter cohort study of adults undergoing cardiac surgery from 2006 to 2010 at high risk of CSA-AKI. The analysis included patients with CPB and follow-up serum creatinine measurements, available via administrative linkages, during the first 365 days after surgery. Patients with single-vessel coronary artery bypass grafting (CABG) without valve surgery were excluded. CSA-AKI was defined by AKIN criteria. MAKE was assessed at 90 (MAKE90) and 365 (MAKE365) days after surgery as a composite endpoint of death, new renal replacement therapy, or ≥25% decrease in eGFR from baseline. Serum biomarkers were measured pre-operatively and daily until day 3. Characteristics of participants were compared by MAKE90 status.
Results
Among 683 participants with one-year follow-up (27% female; mean age 72 ± 9 years), MAKE90 occurred in 7.3% and MAKE365 in 12.3% (Figure 1). Death was the predominant component of MAKE90 (23/50, 46%), whereas eGFR decline was the predominant component of MAKE365 (48/84, 57%). The averaged value of TNFR 1, TNFR2, NT Pro-BNP, Troponin, and FABP over time showed a graded pattern by CSA-AKI Stage. Patients with MAKE90 experienced longer cross-clamp and perfusion times, underwent isolated CABG less frequently, and had higher rates of CSA-AKI.
Conclusion
The incidence of MAKE following CPB increased over time, largely due to declining eGFR. MAKE90 was associated with incident CSA-AKI and greater procedural complexity and duration.
Figure1 Prevalence of MAKE and death at day 90, and 365.
Funding
- NIDDK Support – Alexion Pharmaceutical