AKI After Cardiac Surgery Linked to Worse Survival, Renal Outcomes

Acute kidney injury increased the likelihood of advanced chronic kidney disease in elderly patients.
Acute kidney injury increased the likelihood of advanced chronic kidney disease in elderly patients.

SEATTLE—Acute kidney injury (AKI) after cardiac surgery is associated with worse survival and renal outcomes among elderly patients, Chinese investigators reported at the 2016 Annual Dialysis Conference.

Jiawei Yu, MD, of the Shanghai Institute of Kidney and Dialysis, and colleagues retrospectively studied 393 elderly patients who underwent cardiac surgery. Of these, 214 (55.4%) had experienced post-operative AKI (148, 34, and 32 with AKI stage 1, 2, and 3, respectively) and 179 did not (45.6%). The investigators followed up patients for 2 years.

Patients in the AKI group were significantly older than those in the non-AKI group (71.1 vs. 69.9 years). The 1-year cumulative survival rate was significantly lower in the AKI than non-AKI group, but the 2-year rate did not differ significantly.

The patients with AKI stage 1, 2, and 3 had 1-year cumulative survival rates of 85.8%, 64.7%, and 62.5%, respectively, and 2-year cumulative survival rates of 79.1%, 46.9%, and 55.9%, respectively. In addition, the incidence of advanced chronic kidney disease (CKD) in the AKI patients after 2 years of follow-up was significantly higher than in the non-AKI group (7.9% vs. 0%). The incidence of advanced CKD in patients with AKI stage 1, 2, and 3 after 2 years was 4.1%, 8.8%, and 25%, respectively, according to the researchers.

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