Preoperative Renal Functional Reserve to Predict Risk of Acute Kidney Injury After Cardiac Surgery: The IRRIV Task Force and Collaborators for the Prevention of Acute Kidney Injury
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Acute Kidney Injury
- Sponsor
- University of Giessen
- Enrollment
- 30
- Locations
- 1
- Primary Endpoint
- Whether a reduced preoperative RFR ≤15 ml/min/1.73 m2 increased the odds ratio for postoperative acute kidney injury in patients undergoing elective cardiac surgery.
- Status
- Completed
- Last Updated
- 3 years ago
Overview
Brief Summary
The investigators seek to determine whether a reduced preoperative renal functional reserve predicts postoperative acute kidney injury in patients with normal estimated glomerular filtration rates undergoing elective cardiac surgery.
Detailed Description
Although acute kidney injury (AKI) frequently complicates cardiac surgery, methods to determine AKI risk in patients without underlying kidney disease are lacking. Renal functional reserve (RFR) can be used to measure the capacity of the kidney to increase glomerular filtration rate under conditions of physiological stress and may serve as a functional marker that assesses susceptibility to injury. The investigators seek to determine whether a reduced preoperative RFR predicts postoperative AKI in patients with normal estimated glomerular filtration rates undergoing elective cardiac surgery. All centres will measure RFR with creatinine clearance, except University Hospital Giessen where in addition iohexol plasma-clearance will be used.
Investigators
Faeq Husain-Syed
Senior Physician
University of Giessen
Eligibility Criteria
Inclusion Criteria
- •Subjects older than 18 years
- •Subjects undergoing elective cardiac surgery (with or without cardiopulmonary bypass)
- •Subjects with an estimated GFR ≥60 ml/min/1.73 m2 (CKD-Epidemiology Collaboration equation)
- •Subjects who signed informed consent forms
Exclusion Criteria
- •Preexisting acute kidney injury (as determined by all available serum creatinine values from hospital and outpatient medical records within the previous 90 days)
- •Chronic kidney disease ≥ stage III (KDIGO)
- •Subjects undergoing transcatheter aortic valve implantation (TAVI)
- •Solitary kidney
- •Diabetes mellitus type 1
- •Recent cardiac arrest (within last 3 months)
- •Liver failure or cirrhosis
- •Total parenteral nutrition
- •Hemoglobin \<11 g/dl
- •History of malabsorption, chronic inflammatory bowel disease, short bowel, or pancreatic insufficiency
Outcomes
Primary Outcomes
Whether a reduced preoperative RFR ≤15 ml/min/1.73 m2 increased the odds ratio for postoperative acute kidney injury in patients undergoing elective cardiac surgery.
Time Frame: Preoperative
Renal functional reserve
Secondary Outcomes
- determine preoperative RFR accuracy based on receiver operating characteristic curve curve to predict acute kidney injury.(Preoperative)
- Mortality at 30 and 90 days(30 and 90 days after surgery)
- To evaluate renal function at three months after surgery.(3 months after surgery)
- Use and duration of renal replacement therapy during hospital stay.(Postoperative)
- Renal replacement therapy dependence at days 30 and 90.(30 and 90 days after surgery)
- To evaluate whether chronic kidney disease is associated to preoperative RFR.(Preoperative)
- To analyze an acute kidney injury risk prediction model based on clinical covariates.(Preoperative)
- Length of stay in intensive care unit and hospital.(Postoperative)
- To evaluate whether preoperative RFR is correlated to renal function at three months after surgery.(Preoperative)