Predictors of acute kidney injury after coronary artery surgery in Jordanians.
BACKGROUND
Acute kidney injury after coronary artery bypass surgery is associated with increased morbidity and mortality. We investigated the predictors of acute kidney injury in a major hospital in Jordan.


METHODS
A retrospective analysis was conducted of clinical, operative, and outcome data of 867 patients (mean age 59 ± 9.8 years) who underwent isolated coronary bypass surgery with cardiopulmonary bypass. Acute kidney injury postoperatively, defined as ≥100% increase in serum creatinine level, was the outcome variable. Retrospective clinical, laboratory, and demographic data, and medication use, were obtained from electronic medical records.


RESULTS
Univariate analysis revealed that chronic obstructive pulmonary disease, recent myocardial infarction, emergency surgery, preoperative intraaortic balloon pump use, left atrial size >4 cm, grade 1 mitral regurgitation, pneumonia, intensive care unit stay, prolonged vasopressor support, and stroke or transient ischemic attack were significantly associated with postoperative renal failure. On multivariate logistic regression, emergency surgery (adjusted odds ratio = 2.17, p = 0.017), grade 1 mitral regurgitation (adjusted odds ratio = 2.05, p = 0.020), prolonged support (adjusted odds ratio = 3.16, p = 0.000), and stroke (adjusted odds ratio = 20.1, p = 0.004) were independent predictors of kidney injury following coronary bypass surgery.


CONCLUSIONS
Emergency coronary surgery, mitral regurgitation, prolonged inotropic support, and stroke or transient ischemic attack are independent predictors of acute kidney injury following coronary bypass surgery. Further studies involving patients with isolated coronary bypass surgery as well as valve and combined surgeries may be necessary to complete our understanding of this subject.
Princess Muna Heart Center, King Abdullah University Hospital, Irbid, Jordan Division of Cardiac Surgery, Department of General Surgery, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan Ksibrahim@just.edu.jo.
Khalid
K
Ibrahim
Department of Public Health, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan.
Khalid
K
Kherallah
Princess Muna Heart Center, King Abdullah University Hospital, Irbid, Jordan Division of Cardiac Surgery, Department of General Surgery, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan.
Nizar
N
AlWaqfi
Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan.
Fadia
F
Mayyas
Princess Muna Heart Center, King Abdullah University Hospital, Irbid, Jordan.
Sager
S
Abdallat
Princess Muna Heart Center, King Abdullah University Hospital, Irbid, Jordan.
Murtada
M
Alawami
D058186:Acute Kidney Injury / Q000175:diagnosis* / Q000453:epidemiology*; D015897:Comorbidity; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007597:Jordan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011183:Postoperative Complications / Q000175:diagnosis* / Q000453:epidemiology*; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors