title: Incidence- and mortality-related risk factors of acute kidney injury requiring hemofiltration treatment in patients undergoing cardiac surgery: a single-center 6-year experience.
abstract: OBJECTIVE
  To evaluate the incidence and mortality risk factors of severe acute kidney injury (AKI) requiring hemofiltration treatment after cardiac surgery.
  
  
  METHODS
  A single-center, retrospective, case-control study.
  
  
  METHODS
  A post-cardiac-surgical intensive care unit at a university hospital.
  
  
  METHODS
  Nine thousand two hundred twenty-two consecutive adult cardiac surgical patients, among whom 107 developed severe AKI.
  
  
  METHODS
  Continuous venovenous hemofiltration.
  
  
  RESULTS
  The overall incidence of severe AKI was 1.2%, but it differed with the type of surgical procedure including coronary artery bypass graft surgery, 0.4%; heart valves, 1.7%; aorta surgery, 5.4%; ventricle septum rupture, 52.6%; and other, 6.5%. From 6 predictors of 30-day mortality identified by univariate logistic regression (age, preoperative serum creatinine, New York Heart Association class, resternotomy, postoperative myocardial infarction, and postoperative use of intra-aortic balloon pump [IABP]), only the need for the postoperative use of IABP (odds ratio, 2.9; p = 0.01) and resternotomy (odds ratio, 3.4; p = 0.005) proved stable in multivariate analysis. Kaplan-Meier analysis identified the following overall mortality risk factors: age (p = 0.03), New York Heart Association class ≥II (p = 0.0004), resternotomy (p = 0.02), postoperative myocardial infarction (p = 0.01), and IABP (p = 0.03).
  
  
  CONCLUSIONS
  The risk of developing severe AKI depended on the type of cardiac surgical procedure. Thirty-day mortality was associated with severe perioperative circulation impairment or bleeding, but overall long-term mortality was additionally predicted by age, postoperative myocardial infarct, and preoperative circulation status.
authors.affiliation: Department of Cardiac Anesthesiology, Medical University of Gdańsk, Gdańsk, Poland. mkowalik@gumed.edu.pl
authors.forename: Maciej M
authors.initials: MM
authors.lastname: Kowalik
authors.forename: Romuald
authors.initials: R
authors.lastname: Lango
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Klajbor
authors.forename: Violetta
authors.initials: V
authors.lastname: Musiał-Światkiewicz
authors.forename: Magdalena
authors.initials: M
authors.lastname: Kołaczkowska
authors.forename: Rafał
authors.initials: R
authors.lastname: Pawlaczyk
authors.forename: Jan
authors.initials: J
authors.lastname: Rogowski
mesh_terms: D058186:Acute Kidney Injury / Q000453:epidemiology / Q000209:etiology* / Q000401:mortality / Q000628:therapy; D000368:Aged; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D015331:Cohort Studies; D005260:Female; D006440:Hemofiltration; D006801:Humans; D015994:Incidence; D007423:Intra-Aortic Balloon Pumping; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors