title: [Acute kidney injury early after cardiac surgery with cardiopulmonary bypass: clinical analysis].
abstract: OBJECTIVE
  To explore the occurrence of acute kidney injury (AKI) in early stage after cardiac surgery under cardiopulmonary bypass (CPB) and discuss the perioperative risk factors and its impact on clinical outcome.
  
  
  METHODS
  Retrospective analysis was performed among 1472 adult patients undergoing cardiac surgery with CPB between January 2008 and April 2011. The postoperative occurrence of AKI following cardiac surgery was stratified according to the RIFLE criteria. And the perioperative risk factors of AKI and its impact on clinical outcome were analyzed.
  
  
  RESULTS
  AKI occurred in 437 patients (29.7%) within 72 hours postoperation. Of these, 292 (19.8%) fulfilled AKI-Risk, 110 (7.5%) AKI-Injury and 35 (2.4%) AKI-Failure. Logistic regression analysis showed that age, hypertension, chronic renal insufficiency, reoperation, aortic surgery, CPB duration, intraoperative transfused erythrocyte volume and perioperative use of intra-aortic balloon pump were independent risk factors for AKI. A postoperative elevation of AKI level was associated with a prolonged duration of mechanical ventilation, intensive care unit stay, postoperative hospital stay, delayed extubation, extubation failure and death. Receiver operator characteristic (ROC) curve showed that AKI classification was a postoperative predictor of delayed extubation, extubation failure and death.
  
  
  CONCLUSIONS
  As a common complication after cardiac surgery, AKI is associated with many perioperative risk factors. And the AKI classification is predicator of delayed extubation, extubation failure and death.
authors: Department of Cardiovascular Surgery of PLA General Hospital, Institute of Cardiac Surgery of People's Liberation Army, Beijing 100853, China. zhiyungong@yahoo.com
authors: Zhi-yun
authors: ZY
authors: Gong
authors: Chang-qing
authors: CQ
authors: Gao
authors: Bo-jun
authors: BJ
authors: Li
authors: Sheng-li
authors: SL
authors: Jiang
authors: Cang-song
authors: CS
authors: Xiao
authors: Rong
authors: R
authors: Wang
authors: Yang
authors: Y
authors: Wu
authors: Feng
authors: F
authors: Li
mesh_terms: D058186:Acute Kidney Injury / Q000209:etiology*; D002315:Cardiopulmonary Bypass / Q000009:adverse effects; D005112:Extracorporeal Circulation / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012307:Risk Factors