title: Determinants of renal replacement therapy after adult cardiac surgery.
abstract: BACKGROUND
  Acute renal injury requiring renal replacement therapy after cardiac surgery develops in 1%-5% of patients, and is strongly associated with perioperative morbidity and mortality. The prognostic risk factors for development acute renal injury requiring renal replacement therapy are identified in this study.
  
  
  METHODS
  2585 adult patients who underwent cardiac surgery during a 1-year period (November 2010 to October 2011) were studied. The patients who developed acute renal injury requiring renal replacement therapy were compared with matched controls. Logistic regression analysis was applied to determine the predictors of acute renal injury requiring renal replacement therapy.
  
  
  RESULTS
  44 patients developed acute renal injury requiring renal replacement therapy following cardiac surgery. On multivariate logistic analysis, the following factors independently predicted acute renal injury requiring renal replacement therapy (p < 0.05): preoperative critical state, pre-existing renal dysfunction, preoperative diastolic dysfunction, and combined cardiac surgery.
  
  
  CONCLUSIONS
  The risk of acute renal injury requiring renal replacement therapy can be fairly accurately predicted and quantified on the basis of available preoperative and intraoperative data. These predictors may be used by physicians to estimate the risk and target high-risk groups for interventions that prevent, reduce, or ameliorate the occurrence of renal failure needing acute renal replacement therapy.
authors.affiliation: Department of Anesthesia and Intensive Care, Narayana Hrudayalaya Hospitals, Bangalore, Karnataka, India.
authors.forename: Kanchi
authors.initials: K
authors.lastname: Muralidhar
authors.forename: Kakade
authors.initials: K
authors.lastname: Bhagyashri
authors.forename: Ratan
authors.initials: R
authors.lastname: Guptha
authors.forename: Nitin
authors.initials: N
authors.lastname: Hegde
authors.forename: Isthiaq
authors.initials: I
authors.lastname: Ahmed
authors.forename: Lloyd
authors.initials: L
authors.lastname: Vincent
mesh_terms: D058186:Acute Kidney Injury / Q000175:diagnosis / Q000209:etiology / Q000401:mortality / Q000628:therapy*; D000328:Adult; D000367:Age Factors; D000368:Aged; D006348:Cardiac Surgical Procedures / Q000009:adverse effects* / Q000401:mortality; D016022:Case-Control Studies; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D017582:Renal Replacement Therapy / Q000009:adverse effects / Q000401:mortality; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
keywords: Acute kidney injury; cardiac surgical procedures; postoperative complications; renal dialysis; risk assessment