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Intraoperative Hypotension and Acute Kidney Injury After Off-pump Coronary Artery Bypass Grafting Surgery

Completed
Conditions
Coronary Artery Bypass, Off-Pump
Intraoperative Hypotension
Acute Kidney Injury
Registration Number
NCT03889730
Lead Sponsor
Peking University First Hospital
Brief Summary

Acute renal injury (AKI) is a common complication after cardiac surgery and is associated with worse outcomes. Hypotension is an important risk factor for the development of AKI after noncardiac surgery. However, the association between intraoperative hypotension and AKI after cardiac surgery has not been fully investigated. The purpose of this study is to analyze the association between intraoperative hypotension and acute kidney injury after off-pump coronary artery bypass surgery.

Detailed Description

Acute renal injury (AKI) is a common complication after cardiac surgery. Cardiac surgery-associated acute kidney injury (CSA-AKI) is associated with increased in-hospital mortality, prolonged length of stay in the Intensive Care Unit and hospital, and higher costs of care. Intraoperative hypotension is an important risk factor for the development of AKI after noncardiac surgery. In a retrospective analysis, a mean arterial pressure of less than 55 mmHg predicted the occurrence of adverse cardiac- and renal-related outcomes after noncardiac surgery. Other studies also revealed that intraoperative hypotension is associated with increased incidence of AKI and 1-year mortality after noncardiac surgery. In patients undergoing cardiac surgery, 30-day mortality is proportionate to the extent of systolic blood pressure excursions outside the range of 75 to 135 mm Hg intraoperatively. However, the correlation between intraoperative hypotension and the development of AKI after cardiac surgery has not been fully investigated. The purpose of this study is to analyze the association between intraoperative hypotension and the risk of acute kidney injury after off-pump coronary artery bypass surgery.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
821
Inclusion Criteria
  • Age ≥ 50 years;
  • Underwent off-pump CABG surgery.
Exclusion Criteria
  • End-stage renal disease requiring renal-replacement therapy;
  • Emergency surgery;
  • Kidney transplantation within 3 months;
  • Missing data.

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Incidence of acute kidney injury (AKI) within 7 days after surgeryUp to 7 days after surgery

Development of AKI within 7 days after surgery is diagnosed according to the Kidney Disease Improving Global Outcomes (KDIGO) criteria

Secondary Outcome Measures
NameTimeMethod
Duration of mechanical ventilation after surgeryUp to 30 days after surgery

Duration of mechanical ventilation after surgery

Length of stay in intensive care unit (ICU) after surgeryUp to 30 days after surgery

Length of stay in intensive care unit (ICU) after surgery

Incidence of major adverse cardiovascular events (MACEs) within 30 days after surgeryUp to 30 days after surgery

MACEs within 30 days after surgery include cardiovascular death, non-fatal cardiac arrest, acute myocardial infarction, revascularization, and ischemic stroke.

Classification of AKI within 7 days after surgeryUp to 7 days after surgery

Development of AKI within 7 days after surgery is diagnosed according to the KDIGO criteria

Incidence of non-MACE complications within 30 days after surgeryUp to 30 days after surgery

Non-MACE complications within 30 days after surgery indicate new-onset medical conditions other than MACEs that produce harmful effects on patients' recovery and required therapeutic intervention.

All-cause mortality in hospitalUp to 30 days after surgery

All-cause mortality in hospital

Length of stay in hospital after surgeryUp to 30 days after surgery

Length of stay in hospital after surgery

Trial Locations

Locations (1)

Peking University First Hospital

🇨🇳

Beijing, Beijing, China

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