Intraoperative renal regional oxygen desaturation can be a predictor for acute kidney injury after cardiac surgery.
OBJECTIVE
To evaluate the usefulness of renal regional oxygen saturation (renal rSO2) in predicting the risk of acute kidney injury (AKI) after cardiac surgery.


METHODS
A prospective observational study.


METHODS
Tertiary care university hospital.


METHODS
One hundred patients undergoing cardiac surgery.


METHODS
Renal rSO2 was monitored continuously by near-infrared spectroscopy (NIRS) throughout the anesthetic period.


RESULTS
Postoperative AKI was defined using the Risk, Injury, Failure, Loss, and End-stage (RIFLE) criteria. Of 95 patients who were included in the final analysis, 34 patients developed AKI after surgery. Recorded renal rSO2 data were used to calculate the total duration of the time when renal rSO2 was below the threshold values of 70%, 65%, 60%, 55%, and 50%. The total periods when the renal rSO2 level was below each of the threshold values were significantly longer in patients with AKI than in those without AKI (p = 0.001 or p<0.001). Receiver operating characteristic (ROC) curve analysis was used to evaluate the predictive power of renal rSO2 for AKI. The ROC curve analysis showed that renal rSO2 could predict the risk of AKI with statistical significance and that a renal rSO2<55% had the best performance (area under the curve-ROC, 0.777; 95% CI, 0.669-0.885; p<0.001). Multivariate logistic regression analysis revealed that AKI significantly correlated with the duration of renal rSO2<55% (p = 0.002) and logistic EuroSCORE (p = 0.007).


CONCLUSIONS
Intraoperative renal regional oxygen desaturation can be a good predictor of AKI in adult patients undergoing cardiac surgery.
Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Dae-Kee
DK
Choi
Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Wook-Jong
WJ
Kim
Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Ji-Hyun
JH
Chin
Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Eun-Ho
EH
Lee
Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Kyung
K
Don Hahm
Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Ji
J
Yeon Sim
Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. Electronic address: icchoi@amc.seoul.kr.
In
I
Cheol Choi
D058186:Acute Kidney Injury / Q000453:epidemiology* / Q000209:etiology*; D000368:Aged; D006348:Cardiac Surgical Procedures / Q000009:adverse effects / Q000379:methods*; D001026:Coronary Artery Bypass; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D000860:Hypoxia / Q000150:complications*; D007431:Intraoperative Complications / Q000209:etiology*; D007668:Kidney / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology* / Q000209:etiology*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D019265:Spectroscopy, Near-Infrared; D016896:Treatment Outcome
acute kidney injury; cardiac surgery; near-infrared spectroscopy