title: Incidence and progression of cardiac surgery-associated acute kidney injury and its relationship with bypass and cross clamp time.
abstract: BACKGROUND
  Cardiac surgery-associated kidney injury (CSA-AKI) is common but relatively less is known about its progression. The present study is aimed at evaluating the incidence and course of CSA-AKI and its relationship with the different durations of cardiopulmonary bypass (CPB) and cross clamp times.
  
  
  METHODS
  Occurrences of CSA-AKI are evaluated as per the Akin Kidney Injury Network (AKIN) criteria over the course of 5 postoperative day (POD) in 100 patients. The relationship of different durations of CPB and aortic cross clamp time with CSA-AKI is analyzed by Chi-squared test for trend and other appropriate tests using INSTAT software.
  
  
  RESULTS
  One hundred (43 male, 57 female; mean age of 37.01 ± 12.28 years, and baseline mean serum creatinine 0.99 ± 0.20 mg %) patients undergone mostly valve replacement, and congenital heart disease correction was evaluated. Nearly 49% suffered CSA-AKI (81.63% AKIN Class I) with maximum numbers on 2 nd POD. Serum creatinine followed a falling trend 3 rd POD onward except in 8.16% cases of CSA-AKI. Oliguria was absent even in AKIN Class II. The CPB time >70 min and cross clamp time >60 min increase CSA-AKI risk by an OR of 4.76 and 2.84, respectively (P < 0.05).
  
  
  CONCLUSIONS
  CSA-AKI is very prevalent; mostly of AKIN Class I and increases with increasing CPB and cross clamp time. Urine output is not a reliable indicator of CSA-AKI. The AKIN Class II on the very 1 st POD or increasing trend of serum creatinine beyond 3 rd POD should alert for early intervention.
authors.affiliation: Department of Anaesthesiology, Andaman and Nicobar Island Institute of Medical Sciences, Port Blair, India.
authors.forename: Habib Md Reazaul
authors.initials: HM
authors.lastname: Karim
authors.affiliation: Department of Anaesthesiology and Critical Care, North Eastern Indira Gandhi Regional Institute of Medical and Health Sciences, Shillong, Meghalaya, India.
authors.forename: Mohd
authors.initials: M
authors.lastname: Yunus
authors.affiliation: Department of Cardio Thoracic Vascular Surgery, North Eastern Indira Gandhi Regional Institute of Medical and Health Sciences, Shillong, Meghalaya, India.
authors.forename: Manuj Kumar
authors.initials: MK
authors.lastname: Saikia
authors.affiliation: Department of Cardio Thoracic Vascular Surgery, North Eastern Indira Gandhi Regional Institute of Medical and Health Sciences, Shillong, Meghalaya, India.
authors.forename: Jyoti Prasad
authors.initials: JP
authors.lastname: Kalita
authors.affiliation: Perfusionist, Department of Cardio Thoracic Vascular Surgery, North Eastern Indira Gandhi Regional Institute of Medical and Health Sciences, Shillong, Meghalaya, India.
authors.forename: Mrinal
authors.initials: M
authors.lastname: Mandal
mesh_terms: D058186:Acute Kidney Injury / Q000209:etiology*; D000293:Adolescent; D000328:Adult; D000368:Aged; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D002315:Cardiopulmonary Bypass / Q000009:adverse effects*; D003250:Constriction; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology*; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D055815:Young Adult