The Importance of Prognostic Nutritional Index in Predicting Acute Renal Failure After On-Pump Coronary Artery Bypass Operations in Patients with Insulin-Dependent Diabetes Mellitus

Malnutrition Status and Acute Kidney Injury

Authors

  • Arif Gucu, MD University of Health Sciences, Bursa Yuksek Ihtisas Training and Research Hospital, Department of Cardiovascular Surgery, Yıldırım/BURSA, Turkey
  • Ozlem Arican Ozluk, MD University of Health Sciences, Bursa Yuksek Ihtisas Training and Research Hospital, Department of Cardiology, BURSA, Turkey
  • Orhan Guvenc, MD Medical Faculty of Uludağ University, Departments of Cardiovascular Surgery, Bursa, Turkey
  • Sadık Ahmet Sunbul, MD University of Health Sciences, Bursa Yuksek Ihtisas Training and Research Hospital, Department of Cardiovascular Surgery, Yıldırım/BURSA, Turkey
  • Mesut Engin, MD University of Health Sciences, Bursa Yuksek Ihtisas Training and Research Hospital, Department of Cardiovascular Surgery, Yıldırım/BURSA, Turkey

DOI:

https://doi.org/10.1532/hsf.3859

Keywords:

Coronary artery disease, Coronary artery bypass grafting, Nutritional status, Diabetes Mellitus, Renal injury

Abstract

Background: After coronary artery bypass graft (CABG) operations, acute kidney injury (AKI) appears at 5-30% rates, and this rate increases even more in patients with diabetes mellitus (DM). Prognostic nutritional index (PNI) is known as a valuable parameter that affects cardiovascular surgery outcomes. In this current study, we aimed to investigate the importance of PNI value in predicting AKI after on-pump CABG operations in insulin-dependent diabetic patients.

Methods: A total of 254 consecutive patients with insulin-
dependent diabetes who underwent on-pump CABG in our clinic between January 2016 and January 2020 retrospectively were included in this study. In the postoperative period, patients were registered as the renal failure group (Group 1), and those who did not develop renal failure were registered as Group 2.

Results: A total of 255 patients with DM were included in the study. There were 82 patients in Group 1 and 173 patients in Group 2. There was no difference between the groups, in terms of age, gender, smoking, and hyperlipidemia rates. Hypertension rate significantly was higher in Group 2 (P = .001). In multivariate logistic regression analysis, hypertension (OR: 1.226, 95% CI: 1.114-2.459, P = .026), need for inotropic support (OR: 1.128, 95% CI: 1.070-1.784, P = .033), increased blood product use (OR: 1.291, 95% CI: 1.112-2.156, P = .021) preoperative high creatinine (OR: 3.563, 95% CI: 2.497-5.559, P < .001), and PNI (OR: 1.327, 95% CI: 1.118-2.785, P = .012) were independent predictors of AKI.

Conclusion: In our study, we determined PNI value as an independent predictor in predicting acute renal injury occurring after on-pump CABG operations in patients with insulin-dependent DM.

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Published

2021-07-27

How to Cite

GUCU, A., Ozluk, O. A., Guvenc, O., Sunbul, S. A., & Engin, M. (2021). The Importance of Prognostic Nutritional Index in Predicting Acute Renal Failure After On-Pump Coronary Artery Bypass Operations in Patients with Insulin-Dependent Diabetes Mellitus: Malnutrition Status and Acute Kidney Injury. The Heart Surgery Forum, 24(4), E651-E655. https://doi.org/10.1532/hsf.3859

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