Incidence, risk factors and clinical outcomes of acute kidney injury after heart transplantation: a retrospective single center study
release_la73jvcnzfbbppnfbqco3jvpvy
by
Yi-Yao Jiang,
Xiang-Rong Kong,
Fen-Long Xue,
Hong-Lei Chen,
Wei Zhou,
Jun-Wu Chai,
Fei Wu,
Shan-Shan Jiang,
Zhi-Long Li,
Kai Wang
2020 Volume 15, Issue 1, p302
Abstract
<jats:title>Abstract</jats:title>
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<jats:title>Objectives</jats:title>
This study aimed to identify the incidence rate of Acute kidney injury (AKI) in our center and predict in-hospital mortality and long-term survival after heart transplantation (HTx).
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<jats:title>Methods</jats:title>
This single-center, retrospective study from October 2009 and March 2020 analyzed the pre-, intra-, and postoperative characteristics of 95 patients who underwent HTx. AKI was defined according to the Kidney Disease: Improving Global Outcomes (KDIGO) criteria. Risk factors were analyzed by multivariable logistic regression models. The log-rank test was used to compare long-term survival.
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<jats:title>Results</jats:title>
Thirty-three (34.7%) patients developed AKI. The mortality in hospital in HTx patients with and without AKI were 21.21 and 6.45%, respectively (<jats:italic>P</jats:italic> < 0.05). Recipients in AKI who required renal replacement therapy (RRT) had a hospital mortality rate of 43.75% compared to 6.45% in those without AKI or RRT (<jats:italic>P <</jats:italic> 0.0001). A long cardiopulmonary bypass (CPB) time (OR:11.393, 95% CI: 2.183 to 59.465, <jats:italic>P</jats:italic> = 0.0039) was positively related to the occurrence of AKI. A high intraoperative urine volume (OR: 0.031, 95% CI: 0.005 to 0.212, <jats:italic>P</jats:italic> = 0.0004) was negatively correlated with AKI. AKI requiring RRT (OR, 11.348; 95% CI, 2.418–53.267, <jats:italic>P</jats:italic> = 0.002) was a risk factor for mortality in hospital. Overall survival in patients without AKI at 1 and 3 years was not different from that in patients with AKI (<jats:italic>P</jats:italic> = 0.096).
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<jats:title>Conclusions</jats:title>
AKI is common after HTx. AKI requiring RRT could contribute powerful prognostic information to predict mortality in hospital. A long CPB time and low intraoperative urine volume are associated with the occurrence of AKI.
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