Evaluating the Predictive Performance of Estimated Glomerular Filtration Rate Equations for Acute Kidney Injury Following Coronary Artery Bypass Grafting Surgery: A Multicenter Retrospective Cohort Study.

OBJECTIVES

Coronary artery bypass grafting (CABG) is widely used worldwide to treat the growing incidence of coronary artery disease due to population growth and aging. However, postoperative complications, especially acute kidney injury, are a major concern affecting patient outcomes. We aimed to evaluate different estimated glomerular filtration rate calculation methods to predict postoperative acute kidney injury after CABG, highlighting their importance in assessing surgical risk and renal function preoperatively.

DESIGN

Retrospective data collection followed by calculation and comparison.

SETTING

A multicenter retrospective study.

PARTICIPANTS

There were 4,904 patients who underwent CABG at four centers (Shanghai Chest Hospital, Qilu Hospital, Jiangsu Province Hospital, and Ningxia General Hospital) from January 2010 to December 2023.

INTERVENTIONS: None.

MEASUREMENTS AND MAIN

RESULTS

The research utilized a range of evaluative methodologies, including the receiver operating characteristic curve, polar plot, decision curve analysis, net reclassification index, and integrated discrimination improvement, to evaluate and compare the predictive performance and applicability of the Cockcroft-Gault equation, the Berlin Initiative Study equation, the Chronic Kidney Disease Epidemiology Collaboration equation, and the full age spectrum equation (FAS) across the entire cohort, with particular attention to elderly individuals aged 70 years and older. The FAS equation performed best with an area under the curve of 0.752. In the elderly subgroup, the FAS, Berlin Initiative Study, and Chronic Kidney Disease Epidemiology Collaboration equations demonstrated similar predictive abilities and clinical utility.

CONCLUSIONS

The FAS equation demonstrated superior predictive performance for the incidence of AKI in both the entire cohort and the elderly cohorts.