Arterial stiffness is a predictor for acute kidney injury following coronary artery bypass graft surgery

Sharlene A. Greenwood, Emmanuel Mangahis, Ellen M. Castle, Joe Wang, Jackie Campbell, Ranjit Deshpande, Satish Jayawardene

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Abstract

BACKGROUND: Cardiac surgery-associated acute kidney injury (CSA-AKI) is a serious postoperative complication of cardiac surgery, an episode of which impacts on patient morbidity and mortality. Pulse wave velocity (PWV; a non-invasive measurement tool to assess arterial stiffness) has been shown to predict kidney disease progression, and cardiovascular and all-cause mortality in patients with chronic kidney disease. We hypothesised that PWV would also predict acute kidney injury in subjects who have undergone non-valve repair elective coronary artery bypass graft (CABG) surgery .

METHODS: This was a prospective, observational, exploratory study. PWV was determined with a Vicorder device, together with standard clinical and biochemical parameters. AKI staging was defined according to the Kidney Disease Improving Global Outcomes (KDIGO) Clinical Practice Guidelines.

RESULTS: 137 patients were included in the study. 85% were male, and mean age was 66.3 years (SD = 9.7 years). There were 40 episodes (29%) of CSA-AKI. Each 1 unit increase in PWV score was associated with a 1.5 fold greater odds of a CSA-AKI event (p = 0.006(odds ratio = 1.5; confidence interval:1.13-2.10). A 1 unit increase in estimated glomerular filtration rate resulted in an estimated 85% decrease in the odds of developing AKI, each year, men have an odds reduction of 15% of developing AKI compared with females and each 1 year increase in age lowered the odds of developing AKI by 87%.

CONCLUSIONS: This pilot exploratory study revealed that PWV, assessed prior to non-valve repair elective CABG surgery, independently predicts CSA-AKI events. PWV is a simple, non-invasive technique that could potentially be used to risk stratify for CSA- AKI following elective cardiac surgery.

TRIAL REGISTRATION: ClinTrial.Gov NCT02364427 . Registered 18 February 2015.

Original languageEnglish
Pages (from-to)51
Number of pages5
JournalJournal of Cardiothoracic Surgery
Volume14
Issue number1
DOIs
Publication statusPublished - 7 Mar 2019

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Vascular Stiffness
Acute Kidney Injury
Coronary Artery Bypass
Thoracic Surgery
Transplants
Kidney Diseases
Pulse Wave Analysis
Mortality
Glomerular Filtration Rate
Chronic Renal Insufficiency
Practice Guidelines
Observational Studies
Disease Progression
Odds Ratio
Confidence Intervals
Morbidity
Equipment and Supplies

Keywords

  • Acute Kidney Injury/diagnosis
  • Aged
  • Coronary Artery Bypass/adverse effects
  • Coronary Disease/physiopathology
  • Female
  • Glomerular Filtration Rate
  • Humans
  • Male
  • Middle Aged
  • Pilot Projects
  • Predictive Value of Tests
  • Prospective Studies
  • Pulse Wave Analysis
  • Risk Factors
  • Vascular Stiffness/physiology

Cite this

Greenwood, Sharlene A. ; Mangahis, Emmanuel ; Castle, Ellen M. ; Wang, Joe ; Campbell, Jackie ; Deshpande, Ranjit ; Jayawardene, Satish. / Arterial stiffness is a predictor for acute kidney injury following coronary artery bypass graft surgery. In: Journal of Cardiothoracic Surgery. 2019 ; Vol. 14, No. 1. pp. 51.
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abstract = "BACKGROUND: Cardiac surgery-associated acute kidney injury (CSA-AKI) is a serious postoperative complication of cardiac surgery, an episode of which impacts on patient morbidity and mortality. Pulse wave velocity (PWV; a non-invasive measurement tool to assess arterial stiffness) has been shown to predict kidney disease progression, and cardiovascular and all-cause mortality in patients with chronic kidney disease. We hypothesised that PWV would also predict acute kidney injury in subjects who have undergone non-valve repair elective coronary artery bypass graft (CABG) surgery .METHODS: This was a prospective, observational, exploratory study. PWV was determined with a Vicorder device, together with standard clinical and biochemical parameters. AKI staging was defined according to the Kidney Disease Improving Global Outcomes (KDIGO) Clinical Practice Guidelines.RESULTS: 137 patients were included in the study. 85{\%} were male, and mean age was 66.3 years (SD = 9.7 years). There were 40 episodes (29{\%}) of CSA-AKI. Each 1 unit increase in PWV score was associated with a 1.5 fold greater odds of a CSA-AKI event (p = 0.006(odds ratio = 1.5; confidence interval:1.13-2.10). A 1 unit increase in estimated glomerular filtration rate resulted in an estimated 85{\%} decrease in the odds of developing AKI, each year, men have an odds reduction of 15{\%} of developing AKI compared with females and each 1 year increase in age lowered the odds of developing AKI by 87{\%}.CONCLUSIONS: This pilot exploratory study revealed that PWV, assessed prior to non-valve repair elective CABG surgery, independently predicts CSA-AKI events. PWV is a simple, non-invasive technique that could potentially be used to risk stratify for CSA- AKI following elective cardiac surgery.TRIAL REGISTRATION: ClinTrial.Gov NCT02364427 . Registered 18 February 2015.",
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Arterial stiffness is a predictor for acute kidney injury following coronary artery bypass graft surgery. / Greenwood, Sharlene A.; Mangahis, Emmanuel; Castle, Ellen M.; Wang, Joe; Campbell, Jackie; Deshpande, Ranjit; Jayawardene, Satish.

In: Journal of Cardiothoracic Surgery, Vol. 14, No. 1, 07.03.2019, p. 51.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Arterial stiffness is a predictor for acute kidney injury following coronary artery bypass graft surgery

AU - Greenwood, Sharlene A.

AU - Mangahis, Emmanuel

AU - Castle, Ellen M.

AU - Wang, Joe

AU - Campbell, Jackie

AU - Deshpande, Ranjit

AU - Jayawardene, Satish

PY - 2019/3/7

Y1 - 2019/3/7

N2 - BACKGROUND: Cardiac surgery-associated acute kidney injury (CSA-AKI) is a serious postoperative complication of cardiac surgery, an episode of which impacts on patient morbidity and mortality. Pulse wave velocity (PWV; a non-invasive measurement tool to assess arterial stiffness) has been shown to predict kidney disease progression, and cardiovascular and all-cause mortality in patients with chronic kidney disease. We hypothesised that PWV would also predict acute kidney injury in subjects who have undergone non-valve repair elective coronary artery bypass graft (CABG) surgery .METHODS: This was a prospective, observational, exploratory study. PWV was determined with a Vicorder device, together with standard clinical and biochemical parameters. AKI staging was defined according to the Kidney Disease Improving Global Outcomes (KDIGO) Clinical Practice Guidelines.RESULTS: 137 patients were included in the study. 85% were male, and mean age was 66.3 years (SD = 9.7 years). There were 40 episodes (29%) of CSA-AKI. Each 1 unit increase in PWV score was associated with a 1.5 fold greater odds of a CSA-AKI event (p = 0.006(odds ratio = 1.5; confidence interval:1.13-2.10). A 1 unit increase in estimated glomerular filtration rate resulted in an estimated 85% decrease in the odds of developing AKI, each year, men have an odds reduction of 15% of developing AKI compared with females and each 1 year increase in age lowered the odds of developing AKI by 87%.CONCLUSIONS: This pilot exploratory study revealed that PWV, assessed prior to non-valve repair elective CABG surgery, independently predicts CSA-AKI events. PWV is a simple, non-invasive technique that could potentially be used to risk stratify for CSA- AKI following elective cardiac surgery.TRIAL REGISTRATION: ClinTrial.Gov NCT02364427 . Registered 18 February 2015.

AB - BACKGROUND: Cardiac surgery-associated acute kidney injury (CSA-AKI) is a serious postoperative complication of cardiac surgery, an episode of which impacts on patient morbidity and mortality. Pulse wave velocity (PWV; a non-invasive measurement tool to assess arterial stiffness) has been shown to predict kidney disease progression, and cardiovascular and all-cause mortality in patients with chronic kidney disease. We hypothesised that PWV would also predict acute kidney injury in subjects who have undergone non-valve repair elective coronary artery bypass graft (CABG) surgery .METHODS: This was a prospective, observational, exploratory study. PWV was determined with a Vicorder device, together with standard clinical and biochemical parameters. AKI staging was defined according to the Kidney Disease Improving Global Outcomes (KDIGO) Clinical Practice Guidelines.RESULTS: 137 patients were included in the study. 85% were male, and mean age was 66.3 years (SD = 9.7 years). There were 40 episodes (29%) of CSA-AKI. Each 1 unit increase in PWV score was associated with a 1.5 fold greater odds of a CSA-AKI event (p = 0.006(odds ratio = 1.5; confidence interval:1.13-2.10). A 1 unit increase in estimated glomerular filtration rate resulted in an estimated 85% decrease in the odds of developing AKI, each year, men have an odds reduction of 15% of developing AKI compared with females and each 1 year increase in age lowered the odds of developing AKI by 87%.CONCLUSIONS: This pilot exploratory study revealed that PWV, assessed prior to non-valve repair elective CABG surgery, independently predicts CSA-AKI events. PWV is a simple, non-invasive technique that could potentially be used to risk stratify for CSA- AKI following elective cardiac surgery.TRIAL REGISTRATION: ClinTrial.Gov NCT02364427 . Registered 18 February 2015.

KW - Acute Kidney Injury/diagnosis

KW - Aged

KW - Coronary Artery Bypass/adverse effects

KW - Coronary Disease/physiopathology

KW - Female

KW - Glomerular Filtration Rate

KW - Humans

KW - Male

KW - Middle Aged

KW - Pilot Projects

KW - Predictive Value of Tests

KW - Prospective Studies

KW - Pulse Wave Analysis

KW - Risk Factors

KW - Vascular Stiffness/physiology

UR - https://cardiothoracicsurgery.biomedcentral.com/articles/10.1186/s13019-019-0873-3

UR - http://www.mendeley.com/research/arterial-stiffness-predictor-acute-kidney-injury-following-coronary-artery-bypass-graft-surgery

U2 - 10.1186/s13019-019-0873-3

DO - 10.1186/s13019-019-0873-3

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VL - 14

SP - 51

JO - Journal of Cardiothoracic Surgery

JF - Journal of Cardiothoracic Surgery

SN - 1749-8090

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ER -