title: Acute renal dysfunction: time from coronary angiography to cardiac surgery.
abstract: BACKGROUND
  The incidence of acute renal dysfunction has not changed much over the years, despite improvements in perioperative care. Our objectives were to evaluate the impact of timing of cardiac surgery after coronary angiography on acute renal dysfunction, to identify risk factors associated with development of acute renal dysfunction, and to measure the association between acute renal dysfunction and mortality.
  
  
  METHODS
  The patients were divided into 3 groups: group A (cardiac surgery 0-3 days after angiography), group B (surgery 4-6 days after angiography), and group C (surgery > 6 days after angiography). Endpoints were acute renal dysfunction, defined as serum creatinine > 25% of baseline on the 3rd postoperative day, and mortality.
  
  
  RESULTS
  In 749 patients, the incidence of acute renal dysfunction was 15%; 5% required dialysis. Hypertension, congestive heart failure, chronic obstructive pulmonary disease, ejection fraction < 40%, prolonged cardiopulmonary bypass time, intraaortic balloon pump use, and urgent surgery were risk factors for acute renal dysfunction after cardiac surgery. Patients in group C had a lower risk of acute renal dysfunction.
  
  
  CONCLUSIONS
  Acute renal dysfunction has a definite relationship with the time period between angiography and cardiac surgery. The causative factors for this condition are multiple and also show a consistent association with mortality.
authors.affiliation: Max Devki Devi Heart and Vascular Institute, New Delhi, India.
authors.forename: Kanwar A
authors.initials: KA
authors.lastname: Baloria
authors.forename: Biju S
authors.initials: BS
authors.lastname: Pillai
authors.forename: Sanjay
authors.initials: S
authors.lastname: Goel
authors.forename: Nandini
authors.initials: N
authors.lastname: Selot
mesh_terms: D058186:Acute Kidney Injury / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality; D000368:Aged; D015415:Biomarkers / Q000097:blood; D006348:Cardiac Surgical Procedures / Q000009:adverse effects* / Q000401:mortality; D017023:Coronary Angiography / Q000009:adverse effects* / Q000401:mortality; D003404:Creatinine / Q000097:blood; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D015994:Incidence; D007194:India / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D061665:Time-to-Treatment; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D003404:Creatinine
keywords: Acute kidney injury; cardiopulmonary bypass; coronary artery bypass; postoperative complications; renal dialysis