title: [A long-term outcome study of acute kidney injury after cardiac surgery].
abstract: OBJECTIVE
  To evaluate the long-term outcome of acute kidney injury (AKI) during hospitalization after cardiac surgery.
  
  
  METHODS
  1 770 patients underwent cardiac surgery in Fudan University Zhongshan Hospital from April 2009 to February 2011 were enrolled. Based on the Kidney Disease: Improving Global Outcomes (KDIGO) guideline of AKI, the patients were divided into the AKI and the non-AKI groups, and followed up for 2 years. The 2-year survival rate and incidence of the advanced chronic kidney disease (CKD) was compared between the two groups.Factors influencing the 2-year survival rate and incidence of the advanced CKD were also analyzed.
  
  
  RESULTS
  Among all the patients, 715 (40.4%) of them were developed AKT. (1) The 2-year survival rate of the AKI group was lower than that of the non-AKI group (83.2% vs 93.6%;P < 0.05). Compared with the non-AKI group, AKI group had an increased risk for death with the hazard ratio of 1.710 (95%CI 1.250-2.340). COX regression analysis showed that AKI was an independent factor for death with the risk intensity just less than diabetes and chronic cardiac insufficiency. The advanced age, the preoperative history of chronic cardiac insufficiency and the time of staying in ICU also significantly increased the risk of death. (2) Compared with patients without AKI (0.2%), the incidence of the 2-year of advanced CKD was higher in patients with AKI (6.7%;P < 0.05) with an hazard ratio of 31.220 (95%CI 7.550-129.110). COX regression analysis showed that AKI was still the independent risk factor for advanced CKD after adjustment of other factors.In addition, diabetes, the time of the cardiopulmonary bypass and the time of staying in ICU were also associated with the risk for the advanced CKD.
  
  
  CONCLUSIONS
  AKI is common after cardiac surgery, which was associated with a decrease in the 2-year survival rate and an increase in the incidence of advanced CKD of patients, which emphasized the importance of prevention and treatment of AKI, and close follow-up of renal function for the improvement of patient long-term prognosis.
authors.affiliation: Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai 200032, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Jiang
authors.affiliation: Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai 200032, China.
authors.forename: Xiaoqiang
authors.initials: X
authors.lastname: Ding
authors.affiliation: Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai 200032, China.
authors.forename: Wuhua
authors.initials: W
authors.lastname: Jiang
authors.affiliation: Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai 200032, China.
authors.forename: Jiarui
authors.initials: J
authors.lastname: Xu
authors.affiliation: Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai 200032, China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Fang
authors.affiliation: Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai 200032, China. Email: teng.jie@zs-hospital.sh.cn.
authors.forename: Jie
authors.initials: J
authors.lastname: Teng
mesh_terms: D058186:Acute Kidney Injury / Q000145:classification* / Q000209:etiology / Q000401:mortality* / Q000628:therapy; D006348:Cardiac Surgical Procedures / Q000009:adverse effects* / Q000379:methods / Q000401:mortality; D005260:Female; D006760:Hospitalization; D006801:Humans; D015994:Incidence; D008297:Male; D017063:Outcome Assessment, Health Care; D011183:Postoperative Complications / Q000401:mortality / Q000503:physiopathology / Q000628:therapy; D011379:Prognosis; D012044:Regression Analysis; D051436:Renal Insufficiency, Chronic; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate