Early postoperative change in serum creatinine predicts acute kidney injury after cardiothoracic surgery: a retrospective cohort study

Hideaki Oka, Shunsuke Yamada, Taro Kamimura, Atsumi Harada, Kazuhiko Tsuruya, Toshiaki Nakano, Takanari Kitazono

研究成果: ジャーナルへの寄稿記事

1 引用 (Scopus)

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Background: Acute kidney injury (AKI) is one of the most severe complications after cardiothoracic surgery (CTS). However, diagnosis of AKI by elevation of serum creatinine (SCr) misses a critical time period for prevention and treatment of AKI. We have observed that patients who develop AKI show a smaller SCr decrease after CTS than those without AKI. Hence, we hypothesized that the magnitude of the SCr change (ΔSCr) measured early after CTS can predict subsequent AKI. Methods: We conducted a retrospective analysis from January 2014 to December 2016 to examine the association of ΔSCr with AKI. ΔSCr was calculated as follows: (early postoperative SCr on intensive care unit [ICU] admission) − (preoperative SCr). Established risk factors and demographics were included in the multivariate-adjusted logistic regression model. AKI was defined by SCr criteria of the Kidney Disease: Improving Global Outcomes group. Results: Among 252 patients who underwent CTS, 69 developed AKI. The median ΔSCr was − 0.14 mg/dL (range − 0.96–0.45). Patients were divided into three groups based on ΔSCr: Group 1, ≤ − 0.2 mg/dL (n = 84); Group 2, > − 0.2 to < − 0.1 mg/dL (n = 76); and Group 3, ≥ − 0.1 mg/dL (n = 92). In the multivariate analysis, Group 3 had a significantly higher incidence of AKI than Group 1 (odds ratio, 7.34; 95% confidence interval 2.55–23.3). ΔSCr was an independent risk factor for AKI (odds ratio for every 0.1-mg/dL increase in ΔSCr, 1.55; 95% confidence interval 1.23–1.97). Conclusions: A minor change in the SCr level early after CTS can predict subsequent AKI just after ICU admission.

元の言語英語
ページ(範囲)325-334
ページ数10
ジャーナルClinical and Experimental Nephrology
23
発行部数3
DOI
出版物ステータス出版済み - 3 15 2019

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Acute Kidney Injury
Creatinine
Cohort Studies
Retrospective Studies
Serum
Intensive Care Units
Logistic Models
Odds Ratio
Confidence Intervals
Kidney Diseases
Multivariate Analysis
Demography

All Science Journal Classification (ASJC) codes

  • Physiology
  • Nephrology
  • Physiology (medical)

これを引用

Early postoperative change in serum creatinine predicts acute kidney injury after cardiothoracic surgery : a retrospective cohort study. / Oka, Hideaki; Yamada, Shunsuke; Kamimura, Taro; Harada, Atsumi; Tsuruya, Kazuhiko; Nakano, Toshiaki; Kitazono, Takanari.

:: Clinical and Experimental Nephrology, 巻 23, 番号 3, 15.03.2019, p. 325-334.

研究成果: ジャーナルへの寄稿記事

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abstract = "Background: Acute kidney injury (AKI) is one of the most severe complications after cardiothoracic surgery (CTS). However, diagnosis of AKI by elevation of serum creatinine (SCr) misses a critical time period for prevention and treatment of AKI. We have observed that patients who develop AKI show a smaller SCr decrease after CTS than those without AKI. Hence, we hypothesized that the magnitude of the SCr change (ΔSCr) measured early after CTS can predict subsequent AKI. Methods: We conducted a retrospective analysis from January 2014 to December 2016 to examine the association of ΔSCr with AKI. ΔSCr was calculated as follows: (early postoperative SCr on intensive care unit [ICU] admission) − (preoperative SCr). Established risk factors and demographics were included in the multivariate-adjusted logistic regression model. AKI was defined by SCr criteria of the Kidney Disease: Improving Global Outcomes group. Results: Among 252 patients who underwent CTS, 69 developed AKI. The median ΔSCr was − 0.14 mg/dL (range − 0.96–0.45). Patients were divided into three groups based on ΔSCr: Group 1, ≤ − 0.2 mg/dL (n = 84); Group 2, > − 0.2 to < − 0.1 mg/dL (n = 76); and Group 3, ≥ − 0.1 mg/dL (n = 92). In the multivariate analysis, Group 3 had a significantly higher incidence of AKI than Group 1 (odds ratio, 7.34; 95{\%} confidence interval 2.55–23.3). ΔSCr was an independent risk factor for AKI (odds ratio for every 0.1-mg/dL increase in ΔSCr, 1.55; 95{\%} confidence interval 1.23–1.97). Conclusions: A minor change in the SCr level early after CTS can predict subsequent AKI just after ICU admission.",
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T1 - Early postoperative change in serum creatinine predicts acute kidney injury after cardiothoracic surgery

T2 - a retrospective cohort study

AU - Oka, Hideaki

AU - Yamada, Shunsuke

AU - Kamimura, Taro

AU - Harada, Atsumi

AU - Tsuruya, Kazuhiko

AU - Nakano, Toshiaki

AU - Kitazono, Takanari

PY - 2019/3/15

Y1 - 2019/3/15

N2 - Background: Acute kidney injury (AKI) is one of the most severe complications after cardiothoracic surgery (CTS). However, diagnosis of AKI by elevation of serum creatinine (SCr) misses a critical time period for prevention and treatment of AKI. We have observed that patients who develop AKI show a smaller SCr decrease after CTS than those without AKI. Hence, we hypothesized that the magnitude of the SCr change (ΔSCr) measured early after CTS can predict subsequent AKI. Methods: We conducted a retrospective analysis from January 2014 to December 2016 to examine the association of ΔSCr with AKI. ΔSCr was calculated as follows: (early postoperative SCr on intensive care unit [ICU] admission) − (preoperative SCr). Established risk factors and demographics were included in the multivariate-adjusted logistic regression model. AKI was defined by SCr criteria of the Kidney Disease: Improving Global Outcomes group. Results: Among 252 patients who underwent CTS, 69 developed AKI. The median ΔSCr was − 0.14 mg/dL (range − 0.96–0.45). Patients were divided into three groups based on ΔSCr: Group 1, ≤ − 0.2 mg/dL (n = 84); Group 2, > − 0.2 to < − 0.1 mg/dL (n = 76); and Group 3, ≥ − 0.1 mg/dL (n = 92). In the multivariate analysis, Group 3 had a significantly higher incidence of AKI than Group 1 (odds ratio, 7.34; 95% confidence interval 2.55–23.3). ΔSCr was an independent risk factor for AKI (odds ratio for every 0.1-mg/dL increase in ΔSCr, 1.55; 95% confidence interval 1.23–1.97). Conclusions: A minor change in the SCr level early after CTS can predict subsequent AKI just after ICU admission.

AB - Background: Acute kidney injury (AKI) is one of the most severe complications after cardiothoracic surgery (CTS). However, diagnosis of AKI by elevation of serum creatinine (SCr) misses a critical time period for prevention and treatment of AKI. We have observed that patients who develop AKI show a smaller SCr decrease after CTS than those without AKI. Hence, we hypothesized that the magnitude of the SCr change (ΔSCr) measured early after CTS can predict subsequent AKI. Methods: We conducted a retrospective analysis from January 2014 to December 2016 to examine the association of ΔSCr with AKI. ΔSCr was calculated as follows: (early postoperative SCr on intensive care unit [ICU] admission) − (preoperative SCr). Established risk factors and demographics were included in the multivariate-adjusted logistic regression model. AKI was defined by SCr criteria of the Kidney Disease: Improving Global Outcomes group. Results: Among 252 patients who underwent CTS, 69 developed AKI. The median ΔSCr was − 0.14 mg/dL (range − 0.96–0.45). Patients were divided into three groups based on ΔSCr: Group 1, ≤ − 0.2 mg/dL (n = 84); Group 2, > − 0.2 to < − 0.1 mg/dL (n = 76); and Group 3, ≥ − 0.1 mg/dL (n = 92). In the multivariate analysis, Group 3 had a significantly higher incidence of AKI than Group 1 (odds ratio, 7.34; 95% confidence interval 2.55–23.3). ΔSCr was an independent risk factor for AKI (odds ratio for every 0.1-mg/dL increase in ΔSCr, 1.55; 95% confidence interval 1.23–1.97). Conclusions: A minor change in the SCr level early after CTS can predict subsequent AKI just after ICU admission.

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U2 - 10.1007/s10157-018-1638-3

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