Acute renal failure in open heart surgery. 1997

T Llopart, and R Lombardi, and M Forselledo, and R Andrade
Departamento de Medicina Crítica, IMPASA, Montevideo, Uruguay.

A case-control study was performed to establish possible risk factors for acute renal failure (ARF) and mortality in patients undergoing cardiac surgery. A consecutive series of 704 patients were included in the study. A randomized sample of 255 patients was taken to analyze risk factors for ARF and mortality. Incidence of acute renal failure was 3.8% (27/704). Low cardiac output (LCO) was observed in all patients who developed ARF and in 72/255 without ARF (p < 0.0005). When LCO was isolated, no difference was found between groups. Association to prolonged perfusion time and sepsis increased the probability of developing ARF: 5/27 versus 0/255, p < 0.001; and 9/27 versus 0/255, p < 0.001, respectively. Overall mortality was 7.2% (51/704). Significant difference was found between ARF (55.6%, 15/27) and non-ARF patients (5.4%, 36/704), p < 0.005. Neither age nor sex was associated to outcome. Nonsurvivor patients were more oliguric (11/15 vs. 0/12, p < 0.005), required dialysis more frequently (7/15 vs. 0/12, p < 0.005), and were complicated with sepsis more often (9/15 vs. 0/12, p < 0.005), compared to survivors. We concluded that ARF was an uncommon complication in this group of patients, but mortality rate was dramatically high. This study identified LCO associated to prolonged perfusion time and sepsis as risk factors for ARF. Severity of ARF (oliguric forms and dialysis requirement) and postoperative events (sepsis) were associated with mortality.

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D011183 Postoperative Complications Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery. Complication, Postoperative,Complications, Postoperative,Postoperative Complication
D003906 Developing Countries Countries in the process of change with economic growth, that is, an increase in production, per capita consumption, and income. The process of economic growth involves better utilization of natural and human resources, which results in a change in the social, political, and economic structures. LMICs,Less-Developed Countries,Low Income Countries,Low and Middle Income Countries,Lower-Middle-Income Country,Middle Income Countries,Third-World Countries,Under-Developed Countries,Developing Nations,Least Developed Countries,Less-Developed Nations,Third-World Nations,Under-Developed Nations,Countries, Middle Income,Countries, Third-World,Country, Least Developed,Country, Less-Developed,Country, Low Income,Country, Lower-Middle-Income,Country, Middle Income,Country, Third-World,Country, Under-Developed,Developed Country, Least,Developing Country,Developing Nation,Least Developed Country,Less Developed Countries,Less Developed Nations,Less-Developed Country,Less-Developed Nation,Low Income Country,Lower Middle Income Country,Lower-Middle-Income Countries,Middle Income Country,Nation, Less-Developed,Nation, Third-World,Nation, Under-Developed,Third World Countries,Third World Nations,Third-World Country,Third-World Nation,Under Developed Countries,Under Developed Nations,Under-Developed Country,Under-Developed Nation
D005260 Female Females
D006348 Cardiac Surgical Procedures Surgery performed on the heart. Cardiac Surgical Procedure,Heart Surgical Procedure,Heart Surgical Procedures,Procedure, Cardiac Surgical,Procedure, Heart Surgical,Procedures, Cardiac Surgical,Procedures, Heart Surgical,Surgical Procedure, Cardiac,Surgical Procedure, Heart,Surgical Procedures, Cardiac,Surgical Procedures, Heart
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly
D000704 Analysis of Variance A statistical technique that isolates and assesses the contributions of categorical independent variables to variation in the mean of a continuous dependent variable. ANOVA,Analysis, Variance,Variance Analysis,Analyses, Variance,Variance Analyses
D012307 Risk Factors An aspect of personal behavior or lifestyle, environmental exposure, inborn or inherited characteristic, which, based on epidemiological evidence, is known to be associated with a health-related condition considered important to prevent. Health Correlates,Risk Factor Scores,Risk Scores,Social Risk Factors,Population at Risk,Populations at Risk,Correlates, Health,Factor, Risk,Factor, Social Risk,Factors, Social Risk,Risk Factor,Risk Factor Score,Risk Factor, Social,Risk Factors, Social,Risk Score,Score, Risk,Score, Risk Factor,Social Risk Factor

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