title: Association of Pre-Operative Albuminuria with Post-Operative Outcomes after Coronary Artery Bypass Grafting.
abstract: The effect on post-operative outcomes after coronary artery bypass graft (CABG) surgery is not clear. Among 17,812 patients who underwent CABG during October 1,2006-September 28,2012 in any Department of US Veterans Affairs (VA) hospital, we identified 5,968 with available preoperative urine albumin-creatinine ratio (UACR) measurements. We examined the association of UACR<30, 30-299 and >=300 mg/g with 30/90/180/365-day and overall all-cause mortality, and hospitalization length >10 days, and with acute kidney injury(AKI). Mean ± SD baseline age and eGFR were 66 ± 8 years and 77 ± 19 ml/min/1.73 m(2), respectively. 788 patients (13.2%) died during a median follow-up of 3.2 years, and 26.8% patients developed AKI (23.1%-Stage 1; 2.9%-Stage 2; 0.8%-Stage 3) within 30 days of CABG. The median lengths of stay were 8 days (IQR: 6-13 days), 10 days (IQR: 7-14 days) and 12 days (IQR: 8-19 days) for groups with UACR < 30 mg/g, 30-299 mg/g and ≥300 mg/g, respectively. Higher UACR conferred 72 to 85% higher 90-, 180-, and 365-day mortality compared to UACR<30 mg/g (odds ratio and 95% confidence interval for UACR≥300 vs. <30 mg/g: 1.72(1.01-2.95); 1.85(1.14-3.01); 1.74(1.15-2.61), respectively). Higher UACR was also associated with significantly longer hospitalizations and higher incidence of all stages of AKI. Higher UACR is associated with significantly higher odds of mortality, longer post-CABG hospitalization, and higher AKI incidence.
authors.affiliation: Division of Nephrology, Department of Medicine, University of Tennessee Health Science Center, Memphis, 956 Court Ave, Memphis, TN, 38163, USA.|Regional One Health, Memphis, 877 Jefferson Ave, Memphis, TN, 38103, USA.
authors.forename: Lekha K
authors.initials: LK
authors.lastname: George
authors.affiliation: Division of Nephrology, Department of Medicine, University of Tennessee Health Science Center, Memphis, 956 Court Ave, Memphis, TN, 38163, USA.
authors.forename: Miklos Z
authors.initials: MZ
authors.lastname: Molnar
authors.affiliation: Division of Nephrology, Department of Medicine, University of Tennessee Health Science Center, Memphis, 956 Court Ave, Memphis, TN, 38163, USA.
authors.forename: Jun L
authors.initials: JL
authors.lastname: Lu
authors.affiliation: Division of Nephrology, University of California, Irvine, 101 The City Drive, Orange, CA 92868, USA.
authors.forename: Kamyar
authors.initials: K
authors.lastname: Kalantar-Zadeh
authors.affiliation: Regional One Health, Memphis, 877 Jefferson Ave, Memphis, TN, 38103, USA.|Division of Cardiology, Department of Medicine, University of Tennessee Health Sciences Center, Memphis, 956 Court Ave, Memphis, TN, 38163, USA.
authors.forename: Santhosh K G
authors.initials: SK
authors.lastname: Koshy
authors.affiliation: Division of Nephrology, Department of Medicine, University of Tennessee Health Science Center, Memphis, 956 Court Ave, Memphis, TN, 38163, USA.|Nephrology Section, Memphis Veterans Affairs Medical Center, Memphis, 1030 Jefferson Ave., Memphis TN 38104, USA.
authors.forename: Csaba P
authors.initials: CP
authors.lastname: Kovesdy
mesh_terms: D058186:Acute Kidney Injury / Q000453:epidemiology / Q000209:etiology / Q000401:mortality; D000368:Aged; D000419:Albuminuria / Q000150:complications*; D002423:Cause of Death; D015897:Comorbidity; D001026:Coronary Artery Bypass / Q000009:adverse effects; D003324:Coronary Artery Disease / Q000150:complications* / Q000453:epidemiology* / Q000401:mortality / Q000601:surgery; D005260:Female; D006760:Hospitalization; D006801:Humans; D015994:Incidence; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009026:Mortality; D063868:Patient Outcome Assessment; D057234:Preoperative Period; D011379:Prognosis; D016016:Proportional Hazards Models; D012307:Risk Factors