title: Acute kidney injury after cardiac surgery: does the time interval from contrast administration to surgery matter?
abstract: OBJECTIVE
  The authors sought to evaluate the association between the time interval from contrast administration to cardiac surgery and postoperative acute kidney injury (AKI).
  
  
  METHODS
  A retrospective observational study over a 1-year period.
  
  
  METHODS
  A US academic medical institution.
  
  
  METHODS
  Six hundred forty-four adult patients undergoing nonemergent cardiac surgery.
  
  
  METHODS
  No interventions were performed as part of the study.
  
  
  RESULTS
  AKI was defined as an increase in serum creatinine by ≥0.3 mg/dL or ≥50% above baseline within the first 2 postoperative days or the commencement of renal replacement therapy within the same period. Using a contrast-to-surgery time interval >7 days as the baseline, multivariable logistic regression analysis determined the association between a contrast-to-surgery time interval ≤1 day or 2 to 7 days and postoperative AKI adjusting for potential confounding variables. The incidence of AKI within the study cohort was 21.9%. After adjusting for other covariates, there was no association between the contrast-to-surgery time and AKI (odds ratio [OR] ≤1 day = 0.93; 95% confidence interval [CI], 0.52-1.66; p = 0.81; OR = 2-7 days = 1.28; 95% CI, 0.78-2.11; p = 0.34).
  
  
  CONCLUSIONS
  In an appropriately selected population, cardiac surgery can be performed within 1 day of cardiovascular catheterization and contrast administration without an increase in the incidence of postoperative AKI. Recommendations to delay cardiac surgery for a specified period after contrast administration to reduce the risk of postoperative AKI are premature. Additional evidence is required before making recommendations on optimal surgical timing after contrast exposure.
authors.affiliation: Department of Anesthesiology, Columbia University, College of Physicians and Surgeons, New York, NY 10032, USA. dm2655@columbia.edu
authors.forename: David R
authors.initials: DR
authors.lastname: McIlroy
authors.forename: M Clin
authors.initials: MC
authors.lastname: Epi
authors.forename: Michael
authors.initials: M
authors.lastname: Argenziano
authors.forename: David
authors.initials: D
authors.lastname: Farkas
authors.forename: Tianna
authors.initials: T
authors.lastname: Umann
mesh_terms: D058186:Acute Kidney Injury / Q000175:diagnosis* / Q000209:etiology / Q000517:prevention & control*; D000368:Aged; D000369:Aged, 80 and over; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D003287:Contrast Media / Q000008:administration & dosage*; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis* / Q000209:etiology / Q000517:prevention & control*; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors
chemical_list: D003287:Contrast Media