Document Detail


Preoperative left ventricular dysfunction predisposes to postoperative acute kidney injury and long-term mortality.
MedLine Citation:
PMID:  21360471     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Both preoperative left ventricular dysfunction (LVD) and acute kidney injury (AKI) in the postoperative period are independently associated with mortality. We evaluated the prevalence and prognostic implications of AKI in a cohort of vascular surgery patients.
METHODS: Before vascular surgery, 1,158 patients were screened for LVD. Development of AKI, defined by RIFLE classification, was detected by serial serum creatinine measurements at days 1 to 3 after surgery. Primary end point was cardiovascular mortality during a median follow-up of 2.2 years (interquartile range [IQR] 1.0-4.0).
RESULTS: LVD was present in 558 patients (48%), and 120 patients (10%) developed postoperative AKI. Subjects with LVD developed postoperative AKI more often than patients without LVD (8% vs. 13%, p=0.01). Patients were categorized as (i) no LVD, without AKI (n=551, 48%), (ii) LVD without AKI (n=487, 42%), (iii) no LVD, with AKI (n=49, 4%) and (iv) LVD with AKI (n=71/6%). Patients with LVD prior to surgery who developed postoperative AKI had the highest cardiovascular mortality risk (hazard ratio = 4.9; 95% confidence interval, 2.9-8.2).
CONCLUSION: Patients with preoperatively LVD have an increased risk of developing AKI after vascular surgery. The occurrence of AKI in patients with LVD has an incremental predictive value toward cardiovascular mortality risk during long-term follow-up.
Authors:
Jan-Peter van Kuijk; Willem-Jan Flu; Tabita M Valentijn; Michel Chonchol; Michiel T Voûte; Ruud J Kuiper; Hence J M Verhagen; Jeroen J Bax; Don Poldermans
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of nephrology     Volume:  24     ISSN:  1724-6059     ISO Abbreviation:  J. Nephrol.     Publication Date:    2011 Nov-Dec
Date Detail:
Created Date:  2011-11-07     Completed Date:  2012-04-18     Revised Date:  2012-04-27    
Medline Journal Info:
Nlm Unique ID:  9012268     Medline TA:  J Nephrol     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  764-70     Citation Subset:  IM    
Affiliation:
Department of Vascular Surgery, Erasmus Medical Center, Rotterdam, The Netherlands.
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MeSH Terms
Descriptor/Qualifier:
Acute Kidney Injury / epidemiology*
Aged
Aged, 80 and over
Aortic Aneurysm, Abdominal / surgery*
Cardiovascular Diseases / diagnosis,  mortality*
Carotid Artery Diseases / surgery*
Causality
Cohort Studies
Female
Follow-Up Studies
Humans
Kaplan-Meier Estimate
Male
Middle Aged
Postoperative Period*
Preoperative Period*
Prevalence
Prognosis
Retrospective Studies
Risk Factors
Survival Rate
Ventricular Dysfunction, Left / complications*,  diagnosis

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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