Please use this identifier to cite or link to this item: https://doi.org/10.1186/s12882-017-0476-y
Title: Acute kidney injury increases the risk of end-stage renal disease after cardiac surgery in an Asian population: a prospective cohort study
Authors: Chew S.T.H. 
Ng R.R.G.
Liu W. 
Chow K.Y.
Ti L.K. 
Keywords: creatinine
acute kidney failure
adult
Article
Asian
cohort analysis
creatinine blood level
disease association
disease course
disease severity
end stage renal disease
estimated glomerular filtration rate
female
follow up
heart surgery
hemodialysis
human
incidence
major clinical study
male
middle aged
mortality
mortality risk
outcome assessment
postoperative complication
postoperative period
prevalence
prospective study
renal replacement therapy
risk assessment
risk factor
Singapore
acute kidney failure
aged
cardiorenal syndrome
causality
chronic kidney failure
clinical trial
comorbidity
epidemiology
heart surgery
mortality
postoperative complication
statistics and numerical data
survival rate
very elderly
Acute Kidney Injury
Adult
Aged
Aged, 80 and over
Cardiac Surgical Procedures
Cardio-Renal Syndrome
Causality
Cohort Studies
Comorbidity
Female
Humans
Incidence
Kidney Failure, Chronic
Male
Middle Aged
Postoperative Complications
Prospective Studies
Risk Factors
Singapore
Survival Rate
Issue Date: 2017
Publisher: BioMed Central Ltd.
Citation: Chew S.T.H., Ng R.R.G., Liu W., Chow K.Y., Ti L.K. (2017). Acute kidney injury increases the risk of end-stage renal disease after cardiac surgery in an Asian population: a prospective cohort study. BMC Nephrology 18 (1) : 60. ScholarBank@NUS Repository. https://doi.org/10.1186/s12882-017-0476-y
Abstract: Background: Acute kidney injury (AKI) after cardiac surgery is associated with increased morbidity and mortality. The long-term association between AKI and end-stage renal disease (ESRD) in an Asian population is unknown. Given the high prevalence of diabetes and a younger age of presentation for cardiac surgery, it is important to track this progression of kidney disease. Therefore, we studied the long-term risk of ESRD and mortality in our Asian patients who developed AKI after cardiac surgery. Methods: With ethics approval, we prospectively recruited 3008 patients who underwent cardiac surgery in Singapore between 2008 and 2012, and followed them up till 2014. ESRD and mortality information were obtained from the Singapore Renal Registry and Singapore Registry of Births and Deaths respectively. AKI was defined using the Acute Kidney Injury Network (AKIN) criteria, and ESRD was defined as stage 5 chronic kidney disease requiring renal replacement therapy. The Cox proportional hazards regression model was used to analyze associations between AKI and the primary outcome of ESRD and the secondary outcome of death. Results: The AKI incidence was 29.1%. During a mean follow-up of 4.4 ± 2.8 years, 0.9% developed ESRD. The hazard ratio (HR) for developing ESRD was 4.7 (95% C.I. = 1.736-12.603, p = 0.002) for AKIN stage 1 patients, and 5.8 (95% C.I. = 1.769-18.732, p = 0.004) for AKIN stage 2 and 3 patients; while the HR for mortality was 1.7 (95% C.I. = 1.165-2.571, p = 0.007) for AKIN stage 1 patients, and 2.5 (95% C.I. = 1.438-4.229, p < 0.001) for AKIN stage 2 and 3 patients. Conclusions: AKI is associated with ESRD and mortality after cardiac surgery in our Asian population. The trajectory from AKI to ESRD is rapid within 5 years of cardiac surgery. A concerted periodic follow-up assessment is advocated for AKI patients post-cardiac surgery. © 2017 The Author(s).
Source Title: BMC Nephrology
URI: https://scholarbank.nus.edu.sg/handle/10635/173864
ISSN: 14712369
DOI: 10.1186/s12882-017-0476-y
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