Incidence of Cardiac Surgery-Associated AKI in a Third-Level Hospital

Background: Acute kidney injury (AKI) is a common complication in cardiac surgery patients, the incidence of cardiac surgery-associated AKI is still around 40% increasing mortality, development of chronic kidney disease and has a significant impact on global health care costs. Identication risk factors that can prevent AKI Methods: Prospective cohort included 51 patients who had cardiac surgery Results: The mean preoperative eGFR was 75 ml/min/1.73 m2. The 37 of 51 participants (72%) developed AKI as defined by the KDIGO until 3 days after surgery. Stage 1 occurred in 26 (50.9%); stage 2 happened in 8 (15.6%) and stage 3 was in 3 (5.88%) patients of which 1 (1.9%) required hemodialysis. Day 1 after surgery AKI was present in 4 (10.8%), day 2 AKI occurs in 25 (67.5%) and day 3 AKI happened in 8 (21.6%) patients. All surgeries were elective and cardiopulmonary bypass (CPB) was utilized in 100%, and CPB mean time was 96.4min and aortic clamping mean time was 73.6min. The most frequent cardiac surgery was coronary artery bypass graft (CABG) 25 (49%), valvular surgery 24 (47.1%) and combined 2 (3.9%) in which AKI was present in 36%, 75% and 100% respectively according to the type of surgery. Patients with AKI had an average postoperative fluid balance of 3.7L vs 2.4L without AKI. Venous congestion with portal flow pulsatility >30% and abnormal morphology of renal intraparenchymal venous flow arises in 12 (32.4%) of 37 patients with AKI. On the 1st postoperative day, 9 (56%), on 2nd day 3 (50%) and on 3rd day 1 (33%) related to venous congestion. Overall mortality was 13.7% (n= 7), while for AKI mortality rate was 21% (n=7). Conclusion: AKI was present in 70% of patients undergoing multifactorial cardiac surgery including type of surgery, drug use, cardiac dysfunction and venous congestion