title: Mortality and cost of acute and chronic kidney disease after cardiac surgery.
abstract: OBJECTIVE
  Acute and chronic kidney diseases (AKI and CKD) have far-reaching implications for surgical patients in regards to postoperative outcomes and hospital cost. We review the recent literature on the effects of AKI and CKD on morbidity, mortality, and resource utilization among cardiac surgery patients.
  
  
  RESULTS
  Both AKI and CKD increase the risk for short-term and long-term mortalities, morbidity, length of stay, and hospital cost among postoperative patients, with increasing disease stage correlating with worse outcomes. Even the mildest forms of AKI (RIFLE-R) and CKD (proteinuria without an observed reduction in estimated glomerular filtration rate) demonstrate worse clinical outcomes compared with patients with no AKI or CKD. Outcomes are worse even in patients who achieve full renal recovery before hospital discharge. These complications dramatically increase ICU length of stay, hospital length of stay, resource utilization, and both in-hospital and postdischarge costs, as evidenced by lower rates of discharges to home.
  
  
  CONCLUSIONS
  AKI and CKD remain prevalent, morbid, and costly conditions for cardiac surgery patients. Better risk stratification, early diagnosis, and earlier interventions are needed to prevent the consequences of these diseases.
authors.affiliation: aDepartment of Surgery bDepartment of Medicine cDepartment of Health Services Research, Management, and Policy, University of Florida, Gainesville, Florida, USA.
authors.forename: Nicholas
authors.initials: N
authors.lastname: Lysak
authors.forename: Azra
authors.initials: A
authors.lastname: Bihorac
authors.forename: Charles
authors.initials: C
authors.lastname: Hobson
mesh_terms: D058186:Acute Kidney Injury / Q000191:economics / Q000209:etiology / Q000401:mortality* / Q000628:therapy; D006348:Cardiac Surgical Procedures / Q000009:adverse effects* / Q000379:methods; D017281:Cost of Illness; D017052:Hospital Mortality; D006801:Humans; D015994:Incidence; D007902:Length of Stay / Q000706:statistics & numerical data; D059035:Perioperative Period / Q000191:economics / Q000401:mortality; D011183:Postoperative Complications / Q000191:economics / Q000209:etiology / Q000401:mortality* / Q000628:therapy; D051436:Renal Insufficiency, Chronic / Q000191:economics / Q000209:etiology / Q000401:mortality* / Q000628:therapy