Acute kidney injury after adult cardiac surgery with cardiopulmonary bypass: Incidence and predictors

Aim: to study the incidence and predictorsfor postoperative acute kidney injury in adults undergoing cardiac surgery using cardiopulmonary bypass in pakistani population methods: this prospective observational study was performed at the department of cardiac surgery,punjab institute of cardiology,lahore,pakistan over a period of 6 months from 1st march 2013 to 1 st september 2013. all those adult patients undergoing cardiac surgery with a cardiopulmonary bypass were included in the study. preoperative,per operative and cardiopulmonary bypass related variables were studied prospectively. acute kidney injury was diagnosed as postoperative creatinine >1.6 mg/dl,in the postoperative period in icu within the first 24 hours after surgery. the data was analyzed using spss version 16.0. p-value ≤0.05 were considered significant. results: out of 250 patients,(39.13%) patients were females and (60.87%) patients were male.acute kidney injury was observed in 16 (6.5%) patients. predictors of postoperative kidney injury identified by logistic regression were diabetes mellitus (or: 1.50,ci 95%:0.47-4.83; p value = 0.004),hypertension (or:3.819,ci:95%,0.79-18.35),pre-op urea (or: 1.88,ci: 95%,0.43-1.78,p=0.001),pre-op creatinine (or:1.93,ci:95%,0.74-1.84,p=0.001),cpb time (or: 1.01,ci: 95%,0.98-1.039,p= 0.001),cross clamp time (or: 1.01,ci 95%: 0.93-0.99; p value = 0.001 )and lowest hematocrit on pump (or: 1.89,ci: 95%,0.90-3.98,p=0.001). conclusion: acute kidney injury (aki) is a significant complication after cardiac surgery. predictors of acute kidney injury are diabetes mellitus,hypertension,pre-op urea,pre-op creatinine,cardiopulmonary bypass time,cross clamp time,lowest hematocrit on pump.