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 language | English |
|---|---|
| Pages (from-to) | 51 |
| Number of pages | 5 |
| Journal | Journal of Cardiothoracic Surgery |
| Volume | 14 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - 7 Mar 2019 |
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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
}
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 Journal › Article
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
M3 - Article
C2 - 30845970
VL - 14
SP - 51
JO - Journal of Cardiothoracic Surgery
JF - Journal of Cardiothoracic Surgery
SN - 1749-8090
IS - 1
ER -