Acute renal failure after coronary artery bypass surgery with extracorporeal circulation -- incidence, risk factors, and mortality.
OBJECTIVE
To identify the incidence, risk factors, and mortality of acute renal failure (ARF) in patients undergoing myocardial coronary artery bypass surgery with extracorporeal circulation.


METHODS
All patients undergoing myocardial coronary artery bypass surgery were prospectively studied, and their clinical and laboratory variables were assessed using uni- and multivariate analysis (logistic regression).


RESULTS
Acute renal failure occurred in 16.1% of the 223 patients studied; 4.9% of patients required dialysis. Risk factors associated with ARF in the univariate analysis were age > 63 years, OR 3.6 (95% CI=1.6 to 8.3); preoperative serum creatinine > 1.2 mg/dL, OR 5.9 (95% CI=2.4 to 14.6); duration of extracorporeal circulation > 90 min, OR 2.1 (95% CI=1.0 to 4.4); use of intraaortic balloon, OR 2.6 (95% CI=1.2 to 5.5); need for inotropic drugs, OR 4.4 (95% CI=1.9 to 10.2). In the multivariate analysis, independent factors associated with ARF were: age > 63 years, OR 3.0 (95% CI=1.3 to 7.2); preoperative serum creatinine > 1.2 mg/dL, OR 4.3 (95% CI=1.6 to 11.4); need for inotropic drugs, OR 3.2 (95% CI=1.3 to 8.0). Mortality in the patients with ARF was 25.0% compared with 1.1% in those without ARF and 63.6% in those who required dialysis.


CONCLUSIONS
Acute renal failure after myocardial coronary artery bypass surgery is a frequent complication associated with a high mortality rate. The independent risk factors are age, previous renal failure, and the need for inotropic drugs.
Hospital Santa Isabel, Salvador, BA, Brazil. xfsantos@uol.com.br
Fernando Oliveira
FO
Santos
Marco Antonio
MA
Silveira
Roberto Barreto
RB
Maia
Marcelo Dantas Cerqueira
MD
Monteiro
Reinaldo
R
Martinelli
D058186:Acute Kidney Injury / Q000453:epidemiology* / Q000209:etiology / Q000401:mortality; D000368:Aged; D001938:Brazil / Q000453:epidemiology; D001026:Coronary Artery Bypass; D004812:Epidemiologic Methods; D005112:Extracorporeal Circulation; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology* / Q000209:etiology / Q000401:mortality