title: The duration of acute kidney injury after cardiac surgery increases the risk of long-term chronic kidney disease.
abstract: BACKGROUND
  Acute kidney injury (Dasta et al., Nephrol Dial Transplant 23(6):1970-1974, 2008) following cardiac surgery is associated with higher perioperative morbidity and mortality, but its impact on long term development of chronic kidney disease (CKD) is uncertain.
  
  
  METHODS
  A total of 350 patients submitted to elective cardiac surgery were evaluated for AKI, defined as an increase in serum creatinine (SCr) ≥ 0.3 mg/dL over baseline value. Univariate and multivariate analysis were used to study pre, intra and postoperative parameters associated with occurrence CKD after 12 months of follow-up.
  
  
  RESULTS
  AKI incidence was 41 % (n = 88). The 12-month prevelence of CKD was 9 % (n = 19) in non-AKI patients versus 25 % (n = 54, p < 0.0001) in the AKI group. The factors identified as independent risk factors for long-term CKD development in the multivariate logistic regression model were age >60 years, hospitalization serum creatinine >0.8 mg/dL, peripheral artery disease, hemorrhage and AKI duration > 3 days.
  
  
  CONCLUSIONS
  Patients developing AKI after cardiac surgery presented high prevalence of long-term incident CKD. The duration of AKI was a strong independent risk factor for this late CKD development. Recognition of predictive factors for CKD development following cardiac surgery-associated AKI may help to develop strategies to prevent or halt CKD progression in this population.
authors.affiliation: Critical Care Department, Hospital Israelita Albert Einstein, Rua Jovina 66 ap 61, São Paulo, SP, 04363-080, Brazil. henriquepalomba@gmail.com.
authors.forename: Henrique
authors.initials: H
authors.lastname: Palomba
authors.affiliation: Division of Nephrology, University of Sao Paulo Medical School, São Paulo, SP, Brazil.
authors.forename: Isac
authors.initials: I
authors.lastname: Castro
authors.affiliation: Division of Nephrology, University of Sao Paulo Medical School, São Paulo, SP, Brazil.
authors.forename: Luis
authors.initials: L
authors.lastname: Yu
authors.affiliation: Division of Nephrology, University of Sao Paulo Medical School, São Paulo, SP, Brazil.
authors.forename: Emmanuel A
authors.initials: EA
authors.lastname: Burdmann
mesh_terms: D058186:Acute Kidney Injury / Q000175:diagnosis / Q000453:epidemiology*; D000367:Age Factors; D000368:Aged; D015415:Biomarkers / Q000097:blood; D001938:Brazil / Q000453:epidemiology; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D015897:Comorbidity; D003404:Creatinine / Q000097:blood; D017558:Elective Surgical Procedures; D005260:Female; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D015995:Prevalence; D051436:Renal Insufficiency, Chronic / Q000175:diagnosis / Q000453:epidemiology*; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D003404:Creatinine
keywords: Acute kidney injury; Cardiac surgery; Chronic kidney disease