Preoperative proteinuria predicts adverse renal outcomes after coronary artery bypass grafting.
Whether preoperative proteinuria associates with adverse renal outcomes after cardiac surgery is unknown. Here, we performed a secondary analysis of a prospectively enrolled cohort of adult patients undergoing coronary artery bypass grafting (CABG) at a medical center and its two affiliate hospitals between 2003 and 2007. We excluded patients with stage 5 CKD or those who received dialysis previously. We defined proteinuria, measured with a dipstick, as mild (trace to 1+) or heavy (2+ to 4+). Among a total of 1052 patients, cardiac surgery-associated acute kidney injury (CSA-AKI) developed in 183 (17.4%) patients and required renal replacement therapy (RRT) in 50 (4.8%) patients. In a multiple logistic regression model, mild and heavy proteinuria each associated with an increased odds of CSA-AKI, independent of CKD stage and the presence of diabetes mellitus (mild: OR 1.66, 95% CI 1.09 to 2.52; heavy: OR 2.30, 95% CI 1.35 to 3.90). Heavy proteinuria also associated with increased odds of postoperative RRT (OR 7.29, 95% CI 3.00 to 17.73). In summary, these data suggest that preoperative proteinuria is a predictor of CSA-AKI among patients undergoing CABG.
Division of Nephrology, Department of Internal Medicine, National Taiwan University Hospital, 7 Chung-Shan South Road, Zhong-Zheng District, Taipei 100, Taiwan.
Tao-Min
TM
Huang
Vin-Cent
VC
Wu
Guang-Huar
GH
Young
Yu-Feng
YF
Lin
Chih-Chung
CC
Shiao
Pei-Chen
PC
Wu
Wen-Yi
WY
Li
Hsi-Yu
HY
Yu
Fu-Chang
FC
Hu
Jou-Wei
JW
Lin
Yih-Sharng
YS
Chen
Yen-Hung
YH
Lin
Shoei-Shen
SS
Wang
Ron-Bin
RB
Hsu
Fan-Chi
FC
Chang
Nai-Kuan
NK
Chou
Tzong-Shinn
TS
Chu
Yu-Chang
YC
Yeh
Pi-Ru
PR
Tsai
Jenq-Wen
JW
Huang
Shuei-Liong
SL
Lin
Yung-Ming
YM
Chen
Wen-Je
WJ
Ko
Kwan-Dun
KD
Wu
D058186:Acute Kidney Injury / Q000453:epidemiology / Q000209:etiology* / Q000628:therapy; D000368:Aged; D015331:Cohort Studies; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D005260:Female; D005919:Glomerular Filtration Rate / Q000502:physiology; D006801:Humans; D007668:Kidney / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D057234:Preoperative Period; D011446:Prospective Studies; D011507:Proteinuria / Q000175:diagnosis* / Q000503:physiopathology; D017582:Renal Replacement Therapy; D012189:Retrospective Studies; D012307:Risk Factors