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Factors associated to postoperative kidney failure following myocardial revascularisation

Título de la revista
B., Albert F. Guerrero
M., Jaime Camacho
Sandoval, Néstor F.
M., Juan P. Umaña
Obando, Carlos E.
Carreño, Marisol




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Elsevier B.V.


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Motivation: To determine which medical history and surgical procedure factors are associated to the onset of postoperative kidney failure in patients undergoing myocardial revascularisation. Methods: Case-control cohort study carried out between January 2005 and December 2013 which included patients who had undergone elective myocardial revascularisation and showed postoperative kidney failure immediately after surgery and until discharge. Controls consisted of patients who had undergone elective myocardial revascularisation and did not develop postoperative kidney failure immediately after surgery. A logistic regression model was used to determine the factors associated to postoperative kidney failure. Associations were expressed as grounds of disparity with their corresponding confidence intervals. Results: old age [OR 1.03 CI 95% (1.01-1.04)], preoperative presence of diabetes mellitus [OR 1.8 CI 95% (1.9-3.4)], cardiac insufficiency [OR 2.7 CI 95% (1.1-6.7)] and a longer perfusion time [OR 1.02 CI 95% (1.01-1.03)] were associated to a higher risk of postoperative kidney failure, while higher hematocrit [OR 0.86 CI 95% (0.82-0.91)] and higher ejection fraction [OR 0.94 CI 95% (0.92-0.96)] were associated with a decrease of the risk of postoperative kidney failure. Conclusions: In patients who had undergone myocardial revascularisation, risk factors associated to postoperative kidney failure where comorbidities related to internal and external gradual kidney damage outside the context of the surgery. This implies that strategies to minimise this event should be focused on identifying these patients in a timely manner and offering appropriate nephroprotection. © 2015 Sociedad Colombiana de Cardiología y Cirugía Cardiovascular.
Palabras clave
Age , Article , Case control study , Comorbidity , Controlled study , Diabetes mellitus , Disease association , Elective surgery , Heart ejection fraction , Heart failure , Heart muscle revascularization , Heart perfusion , Hematocrit , Hospital discharge , Human , Kidney failure , Kidney injury , Postoperative complication , Preoperative evaluation , Renal protection , Risk assessment , Risk factor , Coronary disease , Coronary revascularisation surgery , Kidney failure