title: Acute kidney injury following coronary artery bypass graft surgery in a tertiary public hospital in Malaysia: an analysis of 1228 consecutive cases.
abstract: Acute kidney injury (AKI) following cardiac surgery is well established but the reported incidence is variable due to varying definitions and criteria. Furthermore there is a paucity of such data from Southeast Asia.
  
  
  
  To determine the incidence of AKI, the associated risk factors, and its impact on early mortality and intensive care unit/hospital stay.
  
  
  
  This is a single centre retrospective observational study to evaluate outcomes on 1260 consecutive patients from a multi-ethnic Southeast Asian population who underwent a primary isolated coronary artery bypass graft (CABG) operation. Data was collected from the hospital's electronic database and analysed using basic descriptive statistics and logistic regression.
  
  
  
  Overall incidence was 36.2% including 5.5% of patients who required renal replacement therapy (RRT). Multivariate analysis identified age, insulin-dependent diabetes mellitus (IDDM), baseline serum creatinine level (SCr), recent myocardial infarction (MI), cardiopulmonary bypass (CPB) time and intra-aortic balloon pump (IABP) use as independent risk factors for AKI. For patients who required RRT, the SCr and IDDM remained independent predictors. Early 30-day mortality (11.5% vs 0.9%) was significantly higher in patients who developed AKI following CABG. Similarly, AKI was associated with a slight but statistically significant increase in intensive care unit (ICU) and hospital stay.
  
  
  
  Better prognostication and preventative strategies are required to better risk stratify patients undergoing CABG and optimise utilisation of limited healthcare resources.
authors: Hospital Serdang, Department of Cardiothoracic Surgery, Jalan Puchong, Kajang, Selangor 43000, Malaysia. kheechun@live.com.
authors: K C
authors: KC
authors: Hiew
authors: Hospital Serdang, Department of Cardiothoracic Surgery, Jalan Puchong, Kajang, Selangor 43000, Malaysia.
authors: A
authors: A
authors: Sachithanandan
authors: Hospital Serdang, Department of Cardiothoracic Surgery, Jalan Puchong, Kajang, Selangor 43000, Malaysia.
authors: M
authors: M
authors: Arif
authors: Hospital Serdang, Department of Cardiothoracic Surgery, Jalan Puchong, Kajang, Selangor 43000, Malaysia.
authors: B
authors: B
authors: Badmanaban
authors: Hospital Serdang, Department of Cardiothoracic Surgery, Jalan Puchong, Kajang, Selangor 43000, Malaysia.
authors: A
authors: A
authors: Muiz
authors: Hospital Serdang, Department of Cardiothoracic Surgery, Jalan Puchong, Kajang, Selangor 43000, Malaysia.
authors: I
authors: I
authors: Faisal
authors: Hospital Serdang, Department of Cardiothoracic Surgery, Jalan Puchong, Kajang, Selangor 43000, Malaysia.
authors: L
authors: L
authors: Hamdan
authors: Hospital Serdang, Clinical Research Centre, Jalan Puchong, Kajang, Selangor 43000, Malaysia.
authors: O
authors: O
authors: Evi Diana
mesh_terms: D058186:Acute Kidney Injury / Q000209:etiology*; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D006779:Hospitals, Public; D006801:Humans; D008296:Malaysia; D012189:Retrospective Studies; D012307:Risk Factors