Dataset Information

Acute kidney injury after valvular heart surgery and early changes in cardiac function and structure.

ABSTRACT:

Background

Acute kidney injury (AKI) following heart surgery is associated with long-term risk of heart failure. It is not known if AKI following valvular heart surgery is associated with early changes in cardiac function or structure.

Methods

A cohort study was conducted on 201 patients with AKI and 201 patients without AKI after valvular heart surgery, who were matched for age, sex, left ventricular function, and estimated glomerular filtration rate. AKI was defined as an increase in postoperative serum creatinine of ?26 ?mol/l (?0.3 mg/dl) or a relative increase of ?50%. The two primary outcomes were changes in post-compared with preoperative left ventricular ejection fraction (LVEF) and left ventricular end-diastolic diameter (LVEDD) assessed by echocardiography.

Results

The mean age was 72 years, and 33% were female. Aortic valve surgery was the most frequent procedure. The mean time from surgery to the postoperative echocardiographic examination was 4.9 days (SD 3.7). There was no significant change in postoperative mean LVEF (-3.6 vs. -4.3%; p = 0.58) or mean LVEDD (-4.7 vs. -3.9 mm; p = 0.31) in patients with AKI compared to those without AKI.

Conclusion

We found no acute changes in cardiac function or structure assessed by echocardiography in patients with AKI compared to those without AKI after valvular heart surgery.

SUBMITTER: Olsson DP

PROVIDER: S-EPMC4299171 | biostudies-literature | 2014 Dec

REPOSITORIES: biostudies-literature

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Publications

Acute kidney injury after valvular heart surgery and early changes in cardiac function and structure.

Olsson Daniel P DP Eck Arvstrand Christopher C Sartipy Ulrik U Holzmann Martin J MJ

Cardiorenal medicine 20141017 3-4

<h4>Background</h4>Acute kidney injury (AKI) following heart surgery is associated with long-term risk of heart failure. It is not known if AKI following valvular heart surgery is associated with early changes in cardiac function or structure.<h4>Methods</h4>A cohort study was conducted on 201 patients with AKI and 201 patients without AKI after valvular heart surgery, who were matched for age, sex, left ventricular function, and estimated glomerular filtration rate. AKI was defined as an increa ...[more]

PMID: 25737684

Similar Datasets

Project description:BackgroundSerum creatinine is a delayed marker of acute kidney injury (AKI). Our purpose is to discover and validate novel early urinary biomarkers of AKI after cardiac surgery.Study designDiagnostic test study.Setting & participantsChildren undergoing cardiopulmonary bypass surgery. The test set included 15 participants with AKI and 15 matched controls (median age, 1.5 year) of 45 participants without AKI. The validation set included 365 children (median age, 1.9 year).Index testsBiomarkers identified using proteomic profiling: α(1)-microglobulin, α(1)-acid glycoprotein, and albumin.Reference testAKI, defined as ≥50% increase in serum creatinine level from baseline within 3 days of surgery.ResultsProteomic profiling using surface-enhanced laser desorption/ionization time-of-flight mass spectrometry (SELDI-TOF MS) showed 3 protein peaks that appeared consistently within 2 hours in children who developed AKI after cardiopulmonary bypass surgery. The proteins were identified as α(1)-microglobulin, α(1)-acid glycoprotein, and albumin. Using clinical assays, results were confirmed in a test set and validated in an independent prospective cohort. In the validation set, 135 (37%) developed AKI, in whom there was a progressive increase in urinary biomarker concentrations with severity of AKI. Areas under the curve for urinary α(1)-microglobulin, α(1)-acid glycoprotein, and albumin at 6 hours after cardiac surgery were 0.84 (95% CI, 0.79-0.89), 0.87 (95% CI, 0.83-0.91), and 0.76 (95% CI, 0.71-0.81), respectively. Participants with increasing quartiles of biomarkers showed increasing lengths of hospital stays and durations of AKI (P < 0.001).LimitationsSingle-center study of children with normal kidney function at recruitment. The SELDI-TOF MS technique has limited sensitivity for the detection of proteins greater than the 20-kDa range.ConclusionsUrinary α(1)-microglobulin, α(1)-acid glycoprotein, and albumin represent early, accurate, inexpensive, and widely available biomarkers of AKI after cardiac surgery. They also offer prognostic information about the duration of AKI and length of hospitalization after cardiac surgery.

Dataset Information

Acute kidney injury after valvular heart surgery and early changes in cardiac function and structure.

Background

Methods

Results

Conclusion

Publications

Acute kidney injury after valvular heart surgery and early changes in cardiac function and structure.

Similar Datasets

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