Author/Authors :
Janati, M Department of Cardiovascular Surgery , Mahmoodi, Y Department of Cardiology , Sharifian, M Nephrology Urology Research Center , Amooee, S Department of Obstetric and Gynecology - Shiraz University of Medical Sciences, Shiraz , Kojuri, J Department of Cardiology , Hekmati, P Nephrology Urology Research Center , Hamidian Jahromi, AR Renal Transplant Unit - St. Jeorge's Health Care - NHS Trust, London, UK , Afshariani, R Department of Public Health - School of Health and Nutrition , Roozbeh, J Trauma Research Center - Rajaee Hospital - Shiraz University of Medical Sciences, Shiraz, Iran
Abstract :
Background: Acute renal failure requiring renal replacement therapy after cardiac surgery is still a cause of
major morbidity and mortality worldwide. A number of risk factors for the development of acute renal injury after
cardiac surgery have been previously described and based on these variables; several scoring algorithms were
proposed. Predictive value of these algorithms in Iran is not described. This study investigates these risk factors
among our patients in southern Iran.
Methods: Two hundred and forty patients with normal kidney function who were candidates for cardiac surgery
were enrolled and their baseline data were collected. Diabetes mellitus and age were selected as more controversial
preoperative risk factors. Clamp and pump time were also selected as intra-operative risk factors and the
type of operation was also considered as an independent risk factor. The patients were categorized in two
groups including group 1: Patients with post-operation normal kidney function and group 2: Patients with postoperation
ARF. All patients were followed with serial measurement of serum creatinine post-operation.
Results: The incidence of acute renal failure was 11.25%. Mean age of the patients in group 1 was 54.24±15.88
and in group 2 was 52.85±18.20 years. There was not any significant correlation between duration of clamp time
and post operation acute renal failure. Clamp time in group 1 was 51.49±11.88 and in group 2 was 53.48±13.40
min. Duration of pump time in group 1 was 63.31±12.56 min and in group 2 was 78.07±10.85 min. The difference
was statistically significant. Forty two (20%) of the patients in group 1 and 13 (50%) in group 2 were diabetic.
Conclusion: Although several scoring algorithms are available for prediction of post-cardiac surgery complications,
these can also be matched with our patients’ criteria enhancing their accuracy for our situation.