Factores de riesgo de insuficiencia renal aguda en el posoperatorio de cirugía cardíaca

Ignacio M. Piaggio; Juan F. Furmento; Juan P. Costabel; Daniel Navia; Francisco A. Olivares; Alan Sigal; Mariano Vrancic; Fernando Piccinini; Leonardo A. Seoane

doi:10.47487/apcyccv.v6i3.491

Authors

Ignacio M. Piaggio Instituto Cardiovascular de Buenos Aires (ICBA), Buenos Aires, Argentina. https://orcid.org/0009-0007-8691-5429
Juan F. Furmento Servicio de Cardiología Crítica, Departamento de Cardiología. Instituto Cardiovascular de Buenos Aires (ICBA), Buenos Aires, Argentina. https://orcid.org/0000-0002-6818-9634
Juan P. Costabel Servicio de Cardiología Crítica, Departamento de Cardiología. Instituto Cardiovascular de Buenos Aires (ICBA), Buenos Aires, Argentina. https://orcid.org/0000-0003-0073-5739
Daniel Navia Servicio de Cirugía cardiovascular, Instituto Cardiovascular de Buenos Aires (ICBA), Buenos Aires, Argentina. https://orcid.org/0000-0001-8319-1399
Francisco A. Olivares Servicio de Cardiología Clínica, ICBA Instituto cardiovascular de Buenos Aires, Buenos Aires, Argentina. https://orcid.org/0009-0008-5060-4976
Alan Sigal Servicio de Cardiología Crítica, Departamento de Cardiología. Instituto Cardiovascular de Buenos Aires (ICBA), Buenos Aires, Argentina. https://orcid.org/0000-0002-2169-2101
Mariano Vrancic Servicio de Cirugía cardiovascular, Instituto Cardiovascular de Buenos Aires (ICBA), Buenos Aires, Argentina. https://orcid.org/0000-0002-4518-2085
Fernando Piccinini Servicio de Cirugía cardiovascular, Instituto Cardiovascular de Buenos Aires (ICBA), Buenos Aires, Argentina. https://orcid.org/0000-0003-0407-6347
Leonardo A. Seoane Servicio de Cardiología Crítica, Departamento de Cardiología. Instituto Cardiovascular de Buenos Aires (ICBA), Buenos Aires, Argentina. https://orcid.org/0000-0002-2039-5199

DOI:

https://doi.org/10.47487/apcyccv.v6i3.491

Keywords:

Acute Kidney Injury, Cardiac Surgery, Risk Factors, Extracorporeal Circulation, Mortality

Abstract

Objectives. To describe the frequency of postoperative acute kidney injury (AKI) following cardiac surgery and to analyse risk factors for its development. Materials and methods. We conducted an observational analytical cohort study using prospective data from adult patients who underwent cardiac surgery between 2003 and 2023 at a high-complexity centre in Argentina. AKI was defined according to KDIGO criteria. Risk factors were assessed using logistic regression. Results. A total of 13,215 patients were analysed, with a mean age of 64 years; most were men (75.7%). The frequency of AKI was 7.3%, with an in-hospital mortality of 4.7%. Independent risk factors included advanced age (OR: 1.05, p<0.001), urgent surgery (OR: 2.87, p<0.001), cardiopulmonary bypass (OR: 1.41, p<0.001), and comorbidities such as chronic obstructive pulmonary disease and preoperative anaemia. Asymptomatic status prior to surgery was identified as a protective factor. Conclusions. The frequency of postoperative AKI is comparable to international registries. The main predictors of risk were age, surgical urgency, and use of cardiopulmonary bypass. Identifying risk factors can improve perioperative prevention and management in cardiac surgery.

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