Preoperative 24-hour urine amount as an independent predictor of renal outcome in poor cardiac function patients after coronary artery bypass grafting.
OBJECTIVE
To investigate the incidence and the main pre-operative risk factors for the development of acute renal failure (ARF) in triple vessels coronary artery bypass grafting (CABG) with special reference to a subset of patients with poor cardiac function (ejection fraction <50%).


METHODS
The study included the patients (n = 66) requiring CABG from January 1, 1995 to January 1, 2002 in a medical center.


RESULTS
A high percentage (84.8%) of patients developed ARF and 57.6% of patients received hemodialysis (HD). Preoperative variables significantly associated with the development of ARF included increased age, increased preoperative serum creatinine, decreased preoperative 24-hour urine output and accepted emergent CABG. By the logistic multivariate regression model, increased age (OR = 1.16), preoperative serum creatinine (OR = 3.58,), decreased preoperative 24-hour urine amount (OR = 0.99,) and emergent CABG (OR = 2.01) were independently associated with ARF. As for the need for HD, those factors including, preoperative serum creatinine (2.11 +/- 1.13 v 3.08 +/- 1.67 mg/dL) and preoperative 24-hour urine output (1358.6 +/- 745.9 v 755.2 +/- 572.1 mL/day) were significantly associated with requirement of dialysis. Using multivariate logistic regression, the significant risk factors independently associated with dialysis were preoperative serum creatinine (OR = 1.34) and preoperative 24-hour urine output (OR = 0.99). Patients with non- oliguric renal failure had significantly greater chance of recovering their renal function after cardiac surgery compared to those with oliguria (36.9% v 10.0%, P <.05).


CONCLUSIONS
Preoperative 24-hour urine amount and pre-operative serum creatinine can provide valuable information for predicting the likelihood of developing acute renal failure and requiring dialysis in this subgroup of patients.
Lin
Chun-Liang
CL
Department of Nephrology, Chang Gung Memorial Hospital, Chang Gung University, Tapei, Taiwan.
Pan
Kun-Ying
KY
Hsu
Po-Yaur
PY
Yang
Huan-Yu
HY
Guo
Huey-Liang
HL
Huang
Chiu-Ching
CC
D058186:Acute Kidney Injury / Q000453:epidemiology / Q000209:etiology* / Q000628:therapy; D000367:Age Factors; D000368:Aged; D001026:Coronary Artery Bypass / Q000009:adverse effects / Q000379:methods; D003327:Coronary Disease / Q000601:surgery*; D003404:Creatinine / Q000097:blood; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D016017:Odds Ratio; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology* / Q000628:therapy; D011300:Preoperative Care / Q000379:methods; D011446:Prospective Studies; D006435:Renal Dialysis; D012307:Risk Factors; D014554:Urination / Q000502:physiology*; D014556:Urine
D003404:Creatinine