Factores asociados a lesión renal aguda en pacientes sometidos a cirugía cardiaca en la Fundación Cardioinfantil
Peña Peña, Adwar
Ortiz García, César Augusto
Introduction: Acute Kidney Injury (AKI) is one of the major complications of cardiac surgery. AKI has been shown as an independent risk factor for both, early and late postoperative death in this population. The knowledge of the factors that lead to acute renal injury would help to reduce this complication. Methods: Case control study. The objective of this study was to evaluate the factors associated with acute renal injury in patients undergoing cardiac surgery, with the hypothesis that Brain Natriuretic Peptide (BNP), low hemoglobin, and an elevated EuroSCORE and serum creatinine, are associated with the occurrence of AKI in the postoperative period. Results: A total of 491 patients were analyzed, 141 women (28.72%), 35 of them (7.13%) met criteria for AKI in the postoperative period. Patients with AKI had a higher mean creatinine level in the preoperative period (p<0.001) and had a greater EuroSCORE (p<0.001). Univariate analysis showed that preoperative BNP was higher (p<0.001) and hematocrit was lower in the AKI group (p <0.004). Factors associated with LRA were: BNP pμ / ml> 300 OR 3.9 IC95% (1.6-9.5), presence of previous arrhythmia OR 5.4 95% CI (2.2-13.5), EuroSCORE standard OR 1.2 IC95% (1.0-1.3), surgery Valvular OR 2.7 IC95% (0.8-7.6). Conclusion: Elevated preoperative BNP, the presence of previous arrhythmia, a valvular surgery and EuroSCORE are associated with increased risk for impaired renal function and requirement for renal replacement therapy in postoperative cardiovascular surgery patients.