Coronary Angiography Within 48 Hours Before Cardiac Surgery Increases the Risk of Postoperative Acute Kidney Injury
DOI:
https://doi.org/10.1532/hsf.4777Keywords:
acute kidney injury, coronary angiography, cardiac surgery, risk factorsAbstract
Background: Cardiac surgery and coronary examination, such as invasive coronary angiography (CAG), are both possibly associated with acute kidney injury (AKI). Preoperative CAG examination and cardiac surgery within a short interval may increase the incidence of AKI.
Methods: We retrospectively reviewed 1112 patients who underwent CAG examination within 30 days prior to the cardiac operation in this study. Postoperative AKI was defined, according to Kidney Disease Improving Global Outcomes Definition and Staging (KDIGO) criteria.
Results: The total incidence of AKI was 40.8% and cystatin C level was 1.260 (1.028, 1.672) mg/L. For patients who received CAG, age, body mass index, cardiopulmonary time, and the time interval between preoperative CAG examination and cardiac operation within 48h was shown to be independent predictors of postoperative AKI. The incidence of AKI in patients undergoing preoperative CAG within 48h was 11.2% higher than in those more than 48h (P < 0.001). Patients undergoing valve surgery with or without coronary artery bypass grafting (CABG) exhibited a higher AKI risk than those only accepting CABG. The in-hospital stay of patients who developed AKI was 2 days longer than those without AKI. However, undergoing CAG within 48h prior to cardiac operation did not prolong ICU length of stay or hospital length of stay, nor did it increase the risk of death or renal failure after an operation.
Conclusion: Undergoing CAG within 48 hours before cardiac surgery increases the risk of postoperative AKI.
References
Al-Naimi MS, Rasheed HA, Hussien NR, et al. 2019. Nephrotoxicity: Role and significance of renal biomarkers in the early detection of acute renal injury. J Adv Pharm Technol Res. 10(3):95-99.
Azzalini L, Candilio L, McCullough PA, et al. 2017. Current Risk of Contrast-Induced Acute Kidney Injury After Coronary Angiography and Intervention: A Reappraisal of the Literature. Can J Cardiol. 33(10):1225-1228.
Balemans CE, Reichert LJ, van Schelven BI, et al. 2012. Epidemiology of contrast material-induced nephropathy in the era of hydration. Radiology. 263(3):706-713.
Dangas G, Iakovou I, Nikolsky E, et al. 2005. Contrast-induced nephropathy after percutaneous coronary interventions in relation to chronic kidney disease and hemodynamic variables. Am J Cardiol. 95(1):13-19.
Del Duca D, Iqbal S, Rahme E, et al. 2007. Renal failure after cardiac surgery: timing of cardiac catheterization and other perioperative risk factors. Ann Thorac Surg. 84(4):1264-1271.
Fan PC, Chang CH, Chen YC. 2018. Biomarkers for acute cardiorenal syndrome. Nephrology (Carlton). 23 Suppl 4:68-71.
Grayson AD, Khater M, Jackson M, et al. 2003. Valvular heart operation is an independent risk factor for acute renal failure. Ann Thorac Surg. 75(6):1829-1835.
Ghincea CV, Reece TB, Eldeiry M, et al. 2019. Predictors of Acute Kidney Injury Following Aortic Arch Surgery. J Surg Res. 242:40-46.
Inohara T, Kohsaka S, Miyata H, et al. 2016. Performance and Validation of the U.S. NCDR Acute Kidney Injury Prediction Model in Japan. J Am Coll Cardiol. 67(14):1715-1722.
Ko B, Garcia S, Mithani S, et al. 2012. Risk of acute kidney injury in patients who undergo coronary angiography and cardiac surgery in close succession. Eur Heart J. 33(16):2065-2070.
Karim HM, Yunus M, Saikia MK, et al. 2017. Incidence and progression of cardiac surgery-associated acute kidney injury and its relationship with bypass and cross clamp time. Ann Card Anaesth. 20(1):22-27.
Mehran R, Nikolsky E. 2006. Contrast-induced nephropathy: definition, epidemiology, and patients at risk. Kidney Int Suppl. (100):S11-15.
Mehta RH, Honeycutt E, Patel UD, et al. 2011. Relationship of the time interval between cardiac catheterization and elective coronary artery bypass surgery with postprocedural acute kidney injury. Circulation. 124(11 Suppl):S149-155.
Moledina DG, Parikh CR. 2018. Phenotyping of Acute Kidney Injury: Beyond Serum Creatinine. Semin Nephrol. 38(1):3-11.
Nunag M, Brogan M, Garrick R. 2009. Mitigating contrast-induced acute kidney injury associated with cardiac catheterization. Cardiol Rev. 17(6):263-269.
Ranucci M, Ballotta A, Agnelli B, et al. 2013. Acute kidney injury in patients undergoing cardiac surgery and coronary angiography on the same day. Ann Thorac Surg. 95(2):513-519.
Svaland MG, Haider T, Langseth-Manrique K, et al. 1992. Human pharmacokinetics of iodixanol. Invest Radiol. 27(2):130-133.
Tsai TT, Patel UD, Chang TI, et al. 2014. Contemporary incidence, predictors, and outcomes of acute kidney injury in patients undergoing percutaneous coronary interventions: insights from the NCDR Cath-PCI registry. JACC Cardiovasc Interv. 7(1):1-9.
Yue Z, Yan-Meng G, Ji-Zhuang L. 2019. Prediction model for acute kidney injury after coronary artery bypass grafting: a retrospective study. Int Urol Nephrol. 51(9):1605-1611.
Zhang Z, Lu B, Sheng X, et al. 2011. Cystatin C in prediction of acute kidney injury: a systemic review and meta-analysis. Am J Kidney Dis. 58(3):356-365.
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