title: [Acute renal failure as a complication of cardiac surgery].
abstract: We observed acute, postoperative renal failure requiring dialysis in 33 patients from the entire group of adult patients who received cardiac surgery in 2004 in The Silesian Center for Heart Diseases in Zabrze. Over 50% of these were qualified for emergency operation. During the early postoperative period all of the examined patients had cardiac failure and circulatory insufficiency requiring high doses of catecholamine and intraaortic balloon pump support. In the analyzed group of patients the frequency of multi-organ failure was high (neurologic dysfunction, the need for prolonged mechanical ventilation, mesenteric ischemia). Hemodiafiltration was used as a renal replacement therapy with the dialisate volume not exceeding 11/h. The volume of ultrafiltrate was regulated on the basis of fluid overload and directed to optimize intravascular filling. The average start of hemofiltration was the 3rd postoperative day and was continued for 5 days. The mortality rate in the analyzed group was 81.8%. The renal function substitution based on hemodiafiltration performed in the way described above is easy to start, easy to manage, generates low costs, nevertheless its efficacy is low.
authors.affiliation: Z Oddziału Klinicznego Kardioanestezji i Intensywnej Opieki Pooperacyjnej, Slaskiego Centrum Chorób Serca w Zabrzu.
authors.forename: Ewa
authors.initials: E
authors.lastname: Kucewicz-Czech
authors.forename: Maciej
authors.initials: M
authors.lastname: Oliwa
authors.forename: Jacek
authors.initials: J
authors.lastname: Puzio
authors.forename: Piotr
authors.initials: P
authors.lastname: Knapik
authors.forename: Grzegorz
authors.initials: G
authors.lastname: Włoczka
authors.forename: Tomasz
authors.initials: T
authors.lastname: Szary
authors.forename: Bronisław
authors.initials: B
authors.lastname: Czech
authors.forename: Jacek
authors.initials: J
authors.lastname: Wojarski
authors.forename: Jan
authors.initials: J
authors.lastname: Borzymowski
mesh_terms: D058186:Acute Kidney Injury / Q000209:etiology* / Q000401:mortality / Q000628:therapy*; D000368:Aged; D006348:Cardiac Surgical Procedures / Q000009:adverse effects* / Q000401:mortality*; D005260:Female; D006331:Heart Diseases / Q000601:surgery; D017583:Hemodiafiltration; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000209:etiology / Q000401:mortality / Q000517:prevention & control; D011044:Poland; D011183:Postoperative Complications / Q000401:mortality; D012044:Regression Analysis; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate