title: Intraoperative administration of vasopressin during coronary artery bypass surgery is associated with acute postoperative kidney injury.
abstract: BACKGROUND
  Severe vasodilatation is commonly seen upon weaning from cardiopulmonary bypass (CPB). We examined the effects of vasopressin (arginine vasopressin [AVP]) on acute kidney injury (AKI) in postoperative period.
  
  
  METHODS
  The records of 483 patients undergoing coronary bypass surgery on CPB from 2004 to 2008 were retrospectively reviewed. Demographic, anthropometric, comorbid condition, and perioperative clinical/laboratory data were collected along with postoperative complications. Patients were grouped based on the perioperative use of AVP, and AKI was used as the primary end point. Univariate and multivariate logistic regression analyses were used, followed by propensity score matching for AKI. Null hypothesis was rejected at P < .05.
  
  
  RESULTS
  Postoperative AKI occurred in 14.5% of patients. Arginine vasopressin was administered to 280 patients during the perioperative period. The prevalence of AKI in AVP was 20%, whereas it was 6.1% in controls (P < .0001). Arginine vasopressin was an independent factor that predicted the occurrence of AKI (odds ratio, 3.60; 95% confidence interval, 1.22-10.62; P = .02). However, after propensity score matching, the association between AKI and AVP was lost (P = .073).
  
  
  CONCLUSIONS
  Acute kidney injury is a common complication after cardiac surgery, and vasopressin use increases its incidence; however, this effect may rely on several clinical factors, and its true effect should be examined by large randomized trials.
authors.affiliation: SUNY-Buffalo, Buffalo, NY 14214. Electronic address: jahanpor@buffalo.edu.
authors.forename: Jahan
authors.initials: J
authors.lastname: Porhomayon
authors.affiliation: SUNY-Buffalo, Buffalo, NY 14214. Electronic address: sinadava@buffalo.edu.
authors.forename: Sina
authors.initials: S
authors.lastname: Davari-Farid
authors.affiliation: SUNY-Buffalo, Buffalo, NY 14214. Electronic address: carlos.li@va.gov.
authors.forename: Carlos M
authors.initials: CM
authors.lastname: Li
authors.affiliation: SUNY-Buffalo, Buffalo, NY 14214. Electronic address: pradeep.arora@va.gov.
authors.forename: Pradeep
authors.initials: P
authors.lastname: Arora
authors.affiliation: Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran. Electronic address: leili.p@gmail.com.
authors.forename: Leili
authors.initials: L
authors.lastname: Pourafkari
authors.affiliation: SUNY-Buffalo, Buffalo, NY 14214. Electronic address: Nnader@buffalo.edu.
authors.forename: Nader D
authors.initials: ND
authors.lastname: Nader
mesh_terms: D058186:Acute Kidney Injury / Q000139:chemically induced*; D001127:Arginine Vasopressin / Q000009:adverse effects*; D002315:Cardiopulmonary Bypass / Q000009:adverse effects; D016022:Case-Control Studies; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007430:Intraoperative Care / Q000379:methods; D008297:Male; D008875:Middle Aged; D020105:Milrinone / Q000627:therapeutic use; D016017:Odds Ratio; D011183:Postoperative Complications / Q000209:etiology; D057216:Propensity Score; D012189:Retrospective Studies; D012307:Risk Factors; D014662:Vasoconstrictor Agents / Q000009:adverse effects*
chemical_list: D014662:Vasoconstrictor Agents; D001127:Arginine Vasopressin; D020105:Milrinone
keywords: Acute kidney injury; Arginine vasopressin; Coronary bypass surgery; Milrinone; Mortality