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 |
| DOI: | https://doi.org/10.1186/s13019-019-0873-3 |
| ISSN: | 1749-8090 |
| Status: | Published / Disseminated |
| Refereed: | Yes |
| Related URLs: | |
| URI: | http://nectar.northampton.ac.uk/id/eprint/12827 |
Actions (login required)
 |
Edit Item |
Altmetric
Altmetric
Altmetric