Northampton Electronic Collection of Theses and Research

Arterial stiffness is a predictor for acute kidney injury following coronary artery bypass graft surgery

Greenwood, S. A., Mangahis, E., Castle, E. M., Wang, J., Campbell, J., Deshpande, R. and Jayawardene, S. (2019) Arterial stiffness is a predictor for acute kidney injury following coronary artery bypass graft surgery. Journal of Cardiothoracic Surgery. 14(1), p. 51. 1749-8090.

Item Type: Article
Abstract: BACKGROUND: Cardiac surgery-associated acute kidney injury (CSA-AKI) is a serious postoperative complication of cardiac surgery, an episode of which impacts on patient morbidity and mortality. Pulse wave velocity (PWV; a non-invasive measurement tool to assess arterial stiffness) has been shown to predict kidney disease progression, and cardiovascular and all-cause mortality in patients with chronic kidney disease. We hypothesised that PWV would also predict acute kidney injury in subjects who have undergone non-valve repair elective coronary artery bypass graft (CABG) surgery . METHODS: This was a prospective, observational, exploratory study. PWV was determined with a Vicorder device, together with standard clinical and biochemical parameters. AKI staging was defined according to the Kidney Disease Improving Global Outcomes (KDIGO) Clinical Practice Guidelines. RESULTS: 137 patients were included in the study. 85% were male, and mean age was 66.3 years (SD = 9.7 years). There were 40 episodes (29%) of CSA-AKI. Each 1 unit increase in PWV score was associated with a 1.5 fold greater odds of a CSA-AKI event (p = 0.006(odds ratio = 1.5; confidence interval:1.13-2.10). A 1 unit increase in estimated glomerular filtration rate resulted in an estimated 85% decrease in the odds of developing AKI, each year, men have an odds reduction of 15% of developing AKI compared with females and each 1 year increase in age lowered the odds of developing AKI by 87%. CONCLUSIONS: This pilot exploratory study revealed that PWV, assessed prior to non-valve repair elective CABG surgery, independently predicts CSA-AKI events. PWV is a simple, non-invasive technique that could potentially be used to risk stratify for CSA- AKI following elective cardiac surgery. TRIAL REGISTRATION: ClinTrial.Gov NCT02364427 . Registered 18 February 2015.
Uncontrolled Keywords: Acute Kidney Injury/diagnosis, Aged, Coronary Artery Bypass/adverse effects, Coronary Disease/physiopathology, Female, Glomerular Filtration Rate, Humans, Male, Middle Aged, Pilot Projects, Predictive Value of Tests, Prospective Studies, Pulse Wave Analysis, Risk Factors, Vascular Stiffness/physiology
Creators: Greenwood, Sharlene A., Mangahis, Emmanuel, Castle, Ellen M., Wang, Joe, Campbell, Jackie, Deshpande, Ranjit and Jayawardene, Satish
Faculties, Divisions and Institutes: Faculties > Faculty of Health & Society > Nursing
Research Centres > Northamptonshire Dementia Research & Innovation Centre
Research Centres > Centre for Physical Activity and Life Sciences
Date: 7 March 2019
Date Type: Publication
Page Range: p. 51
Journal or Publication Title: Journal of Cardiothoracic Surgery
Volume: 14
Number: 1
Number of Pages: 5
Language: English
ISSN: 1749-8090
Status: Published / Disseminated
Refereed: Yes
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