Cardiovascular and Thoracic Surgery

Biography

Biography: Attaullah Khan Niazi

Abstract

Acute renal failure after cardiac surgery is a serious complication that is closely associated with postoperative mobidity and mortality. In previous studies that evaluated risk factors for acute renal failure , most of the identified risk factors were not modifiable (eg,

diabetes mellitus, preexisting kidney disease). In this present single center study of 1000 adult patients undergoing cardiac surgery in 2015, we focused on identifying potentially modifiable risk factors for postoperative Acute renal failoure.

We found that acute renal failure, as defined by consensus-based criteria (_25%, _50%, and _75% decrease in estimated glomerular filtration rate or need for dialysis within 1 week of surgery), was independently associated with a _4-fold increase in death rates. Three common and potentially modifiable variables (preoperative anemia, red blood cell transfusions, and surgical reexploration) were highly associated with Acute renal failure, even after adjustment for other perioperative risk factors (eg, preoperative intra-aortic balloon

pump, cardiopulmonary bypass duration). Given these results, we propose that randomized trials are now needed to determine whether interventions that modify these risk factors might also prevent Acute renal failure after cardiac surgery

Cox regression was used to correct for various established demographic preoperative risk indicators, intraoperative parameters, and postoperative complications

Conclusions—Acute renal failure  after cardiac surgery is highly prevalent and prognostically important. Therapies aimed at mitigating preoperative anemia, perioperative red blood cell transfusions, and surgical reexploration may offer protection against this complication.