title: Mortality prediction in patients with dialysis-dependent acute kidney injury after cardiac surgery with cardiopulmonary bypass.
abstract: BACKGROUND
  To build a predictive model for patients with dialysis-dependent acute kidney injury (AKI-D) after cardiac surgery with the cardiopulmonary bypass (CPB), according to disease severity.
  
  
  METHODS
  A single-centre, retrospective cohort study was performed to determine the demographic and clinical parameters (including the specific factor, CPB duration) for risk of poor outcome in patients requiring RRT after cardiac surgery with CPB. A new model was built for mortality prediction in these patients on the basis of the identified risk factors and Sequential Organ Failure Assessment score.
  
  
  RESULTS
  The newly developed model showed good discriminatory ability for predicting death in patients with AKI-D after cardiac surgery with CPB. The area under the receiver-operating characteristic (ROC) curve for the score was 0.892 (95% confidence interval, 0.852-0.925). We also determined the criterion for the choice of RRT modality by applying this model. On applying the new model in intermittent haemodialysis patients, a score of ≤3.2 was found safe for selecting the RRT modality.
  
  
  CONCLUSIONS
  The new scoring system was valid and accurate in predicting death for AKI-D patients after open-heart surgery. This system and value for choice of RRT were determined for guidance only, to facilitate decision-making in difficult situations.
authors.affiliation: Department of Anesthesiology and Intensive Care, Research Institute of Circulation Pathology, Novosibirsk, Russian Federation. Electronic address: malov1967@gmail.com.
authors.forename: Andrey A
authors.initials: AA
authors.lastname: Malov
authors.affiliation: Department of Anesthesiology and Intensive Care, Research Institute of Circulation Pathology, Novosibirsk, Russian Federation.
authors.forename: Alexander S
authors.initials: AS
authors.lastname: Borisov
authors.affiliation: Department of Anesthesiology and Intensive Care, Research Institute of Circulation Pathology, Novosibirsk, Russian Federation.
authors.forename: Vladimir V
authors.initials: VV
authors.lastname: Lomivorotov
authors.affiliation: Department of Anesthesiology and Intensive Care, Research Institute of Circulation Pathology, Novosibirsk, Russian Federation.
authors.forename: Sergey M
authors.initials: SM
authors.lastname: Efremov
authors.affiliation: Department of Anesthesiology and Intensive Care, Research Institute of Circulation Pathology, Novosibirsk, Russian Federation.
authors.forename: Dmitry N
authors.initials: DN
authors.lastname: Ponomarev
authors.affiliation: Department of Anesthesiology and Intensive Care, Research Institute of Circulation Pathology, Novosibirsk, Russian Federation.
authors.forename: Tamara V
authors.initials: TV
authors.lastname: Mukhoedova
authors.affiliation: Department of Anesthesiology and Intensive Care, Research Institute of Circulation Pathology, Novosibirsk, Russian Federation.
authors.forename: Alexander M
authors.initials: AM
authors.lastname: Karaskov
mesh_terms: D058186:Acute Kidney Injury / Q000209:etiology / Q000401:mortality*; D000328:Adult; D000368:Aged; D002315:Cardiopulmonary Bypass; D006801:Humans; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D011237:Predictive Value of Tests; D006435:Renal Dialysis / Q000009:adverse effects*; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate
keywords: Acute kidney injury; Cardiac surgery; Dialysis-dependent; Mortality; Renal replacement therapy modality