title: Perioperative aminoglycoside treatment is associated with a higher incidence of postoperative dialysis in adult cardiac surgery patients.
abstract: BACKGROUND
  Aminoglycoside treatment has been associated with nephrotoxic effects. However, the effect of perioperative aminoglycoside treatment on the risk of acute kidney injury requiring dialysis among patients undergoing cardiac surgery remains uncertain.
  
  
  METHODS
  We performed a register study based on prospectively collected data from population-based health care databases of 3625 consecutive patients undergoing cardiac surgery at the Aarhus University Hospital, Skejby, Denmark. Patients requiring preoperative dialysis were excluded, leaving a total of 3587 patients (99% of original patient cohort), of whom 89 received perioperative aminoglycosides.
  
  
  RESULTS
  The cumulative risk of in-hospital dialysis-dependent acute kidney injury was 3.2% (n = 115). Perioperative use of aminoglycosides was associated with an increased risk of postoperative dialysis (adjusted odds ratio [OR], 4.41; 95% confidence interval [CI], 1.83-10.59). Other predictors included reoperation because of bleeding (adjusted OR, 2.80; 95% CI, 1.63-4.80), use of inotropic support during anesthesia (adjusted OR, 2.10; 95% confidence interval, 1.49-2.95), and cardiopulmonary bypass lasting longer than 120 minutes (adjusted OR, 1.95; 95% CI, 1.19-3.20) along with EuroSCORE variables. Postoperative dialysis was associated with higher 30-day mortality (10.9% vs 2.5%, P < .0001, χ(2) test), but use of aminoglycosides was not independently associated with mortality.
  
  
  CONCLUSIONS
  Perioperative use of aminoglycosides in adults undergoing cardiac surgery was associated with increased risk of postoperative dialysis.
authors.affiliation: Department of Anaesthesia and Intensive Care, Aarhus University Hospital, Skejby, Denmark.
authors.forename: Dorthe Viemose
authors.initials: DV
authors.lastname: Nielsen
authors.forename: Vibeke
authors.initials: V
authors.lastname: Hjortdal
authors.forename: Heidi
authors.initials: H
authors.lastname: Larsson
authors.forename: Søren Påske
authors.initials: SP
authors.lastname: Johnsen
authors.forename: Carl-Johan
authors.initials: CJ
authors.lastname: Jakobsen
mesh_terms: D058186:Acute Kidney Injury / Q000139:chemically induced* / Q000401:mortality; D000328:Adult; D000368:Aged; D000617:Aminoglycosides / Q000009:adverse effects*; D006348:Cardiac Surgical Procedures; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007668:Kidney / Q000187:drug effects; D008297:Male; D008875:Middle Aged; D059035:Perioperative Period; D011183:Postoperative Complications / Q000139:chemically induced*; D006435:Renal Dialysis / Q000706:statistics & numerical data*
chemical_list: D000617:Aminoglycosides