Preoperative proteinuria predicts adverse renal outcomes after coronary artery bypass grafting
Journal
Journal of the American Society of Nephrology
Journal Volume
22
Journal Issue
1
Pages
156-163
Date Issued
2011
Author(s)
Young G.-H.
Shiao C.-C.
Wu P.-C.
Tsai P.-R.
Ko W.-J.
Abstract
Whether preoperative proteinuria associates with adverse renal outcomes after cardiac surgery is unknown. Here, we performed a secondary analysis of a prospectively enrolled cohort of adult patients undergoing coronary artery bypass grafting (CABG) at a medical center and its two affiliate hospitals between 2003 and 2007. We excluded patients with stage 5 CKD or those who received dialysis previously. We defined proteinuria, measured with a dipstick, as mild (trace to 1+) or heavy (2+ to 4+). Among a total of 1052 patients, cardiac surgery-associated acute kidney injury (CSA-AKI) developed in 183 (17.4%) patients and required renal replacement therapy (RRT) in 50 (4.8%) patients. In a multiple logistic regression model, mild and heavy proteinuria each associated with an increased odds of CSA-AKI, independent of CKD stage and the presence of diabetes mellitus (mild: OR 1.66, 95% CI 1.09 to 2.52; heavy: OR 2.30, 95% CI 1.35 to 3.90). Heavy proteinuria also associated with increased odds of postoperative RRT (OR 7.29, 95% CI 3.00 to 17.73). In summary, these data suggest that preoperative proteinuria is a predictor of CSA-AKI among patients undergoing CABG. Copyright ? 2011 by the American Society of Nephrology.
SDGs
Other Subjects
adrenalin; creatinine; dobutamine; dopamine; hemoglobin; isoprenaline; noradrenalin; acute kidney failure; adult; adverse outcome; anemia; article; cardiac surgery associated acute kidney injury; cardiopulmonary bypass; cerebrovascular accident; chronic kidney disease; chronic obstructive lung disease; comorbidity; congestive heart failure; coronary artery bypass graft; creatinine blood level; diabetes mellitus; dialysis; disease severity; female; heart infarction; heart left ventricle ejection fraction; heart surgery; hemodialysis patient; human; hypertension; major clinical study; male; meta analysis; peripheral occlusive artery disease; postoperative period; prediction; preoperative evaluation; priority journal; prospective study; proteinuria; renal replacement therapy; sensitivity analysis; Acute Kidney Injury; Aged; Cohort Studies; Coronary Artery Bypass; Female; Glomerular Filtration Rate; Humans; Kidney; Male; Middle Aged; Predictive Value of Tests; Preoperative Period; Prospective Studies; Proteinuria; Renal Replacement Therapy; Retrospective Studies; Risk Factors
Type
journal article