Journal of the American Society of Nephrology : JASN · 2010
Preoperative proteinuria predicts adverse renal outcomes after coronary artery bypass grafting.
СтатьяМногоцентровое исследованиеПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод пока не подготовлен
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Huang Tao-Min, Wu Vin-Cent, Young Guang-Huar, Lin Yu-Feng, Shiao Chih-Chung, Wu Pei-Chen, Li Wen-Yi, Yu Hsi-Yu, Hu Fu-Chang, Lin Jou-Wei, Chen Yih-Sharng, Lin Yen-Hung, Wang Shoei-Shen, Hsu Ron-Bin, Chang Fan-Chi, Chou Nai-Kuan, Chu Tzong-Shinn, Yeh Yu-Chang, Tsai Pi-Ru, Huang Jenq-Wen, Lin Shuei-Liong, Chen Yung-Ming, Ko Wen-Je, Wu Kwan-Dun, National Taiwan University Hospital Study Group of Acute Renal Failure
Аннотация
Whether preoperative proteinuria associates with adverse renal outcomes after cardiac surgery is unknown. Here, we performed a secondary analysis of a prospectively enrolled cohort of adult patients undergoing coronary artery bypass grafting (CABG) at a medical center and its two affiliate hospitals between 2003 and 2007. We excluded patients with stage 5 CKD or those who received dialysis previously. We defined proteinuria, measured with a dipstick, as mild (trace to 1+) or heavy (2+ to 4+). Among a total of 1052 patients, cardiac surgery-associated acute kidney injury (CSA-AKI) developed in 183 (17.4%) patients and required renal replacement therapy (RRT) in 50 (4.8%) patients. In a multiple logistic regression model, mild and heavy proteinuria each associated with an increased odds of CSA-AKI, independent of CKD stage and the presence of diabetes mellitus (mild: OR 1.66, 95% CI 1.09 to 2.52; heavy: OR 2.30, 95% CI 1.35 to 3.90). Heavy proteinuria also associated with increased odds of postoperative RRT (OR 7.29, 95% CI 3.00 to 17.73). In summary, these data suggest that preoperative proteinuria is a predictor of CSA-AKI among patients undergoing CABG.