The Association Between the Duration of Acute Kidney Injury and New-onset Chronic Kidney Disease After Cardiac or Thoracic Aortic Surgery: a Retrospective Observational Cohort Study
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 2,009
- 试验地点
- 1
- 主要终点
- new-onset chronic kidney disease stage 3 or higher or mortality
研究概览
简要总结
The investigators aimed to evaluate the association between the duration and stage of acute kidney injury (AKI) and the development of chronic kidney disease during postoperative three years in patients undergoing cardiac or thoracic aortic surgery.
详细描述
Postoperative acute kidney injury (AKI) has been investigated as an important contributor to postoperative morbidity and mortality after cardiovascular surgery. Also, temporary worsening of renal function after aortic surgery is associated with higher long-term mortality. Although the associations between AKI and chronic kidney disease (CKD) in medical or other surgical settings were reported, only a few studies evaluated this relationship in patients undergoing cardiac surgery. More specifically, the association of the severity or duration of AKI with the risk of the development of new-onset CKD after cardiac surgery has not been clearly elucidated.
It would be important to find predictors of the long-term renal function or risk factors for the development of CKD after cardiac surgery because postoperative management of high-risk patients to develop long-term renal dysfunction may prevent further deterioration in renal function and improve patient prognosis.
The investigators aimed to evaluate (1) the long-term renal function after cardiac surgery and (2) the association between the duration and stage of acute kidney injury (AKI) and the development of chronic kidney disease during postoperative three years in patients undergoing cardiac or thoracic aortic surgery.
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Retrospective
入排标准
- 年龄范围
- 20 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Adult patients who underwent cardiac or thoracic aortic surgery under cardiopulmonary bypass at Seoul National University Hospital between 2008 and 2017
排除标准
- •Those with off-pump coronary artery bypass
- •Missing baseline serum creatinine
- •Missing postoperative serum creatinine values of more than three among seven postoperative days
- •Preoperative baseline chronic kidney disease with estimated glomerular filtration rate <60 ml/min/1.73m2
结局指标
主要结局
new-onset chronic kidney disease stage 3 or higher or mortality
时间窗: during 3 years after surgery
development of new-onset chronic kidney disease stage 3 or higher or all-cause mortality developed during 3 years after surgery. The new-onset chronic kidney disease was defined by at least two estimated Glomerular Filtration Rate values \<60 ml/min/1.73 m2 separated by an interval of at least three months.
次要结局
- Length of postoperative hospital stay(during one month after surgery)
- Incidence of estimated Glomerular Filtration Rate <60 mL/min/1.73m2(at three years after surgery)
- intra-aortic balloon pulsation insertion(during surgery and postoperative one week)
- Reopen for surgical bleeding(during one month after surgery)
- Respiratory complication(during one month after surgery)
- in-hospital mortality(during one month after surgery)
- Dependence on the regular hemodialysis(at three years after surgery)
- new-onset chronic kidney disease stage 3 or higher or mortality(during 2 years after surgery)
- Length of postoperative intensive care unit stay(during one month after surgery)
- estimated Glomerular Filtration Rate(at three years after surgery)