Preoperative Proteinuria Predicts Adverse Renal Outcomes after Coronary Artery Bypass Grafting
- 1 January 2011
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Journal of the American Society of Nephrology
- Vol. 22 (1), 156-163
- https://doi.org/10.1681/asn.2010050553
Abstract
Whether preoperative proteinuria associates with adverse renal outcomes after cardiac surgery is unknown. Here, we performed a secondary analysis of a prospectively enrolled cohort of adult patients undergoing coronary artery bypass grafting (CABG) at a medical center and its two affiliate hospitals between 2003 and 2007. We excluded patients with stage 5 CKD or those who received dialysis previously. We defined proteinuria, measured with a dipstick, as mild (trace to 1+) or heavy (2+ to 4+). Among a total of 1052 patients, cardiac surgery–associated acute kidney injury (CSA-AKI) developed in 183 (17.4%) patients and required renal replacement therapy (RRT) in 50 (4.8%) patients. In a multiple logistic regression model, mild and heavy proteinuria each associated with an increased odds of CSA-AKI, independent of CKD stage and the presence of diabetes mellitus (mild: OR 1.66, 95% CI 1.09 to 2.52; heavy: OR 2.30, 95% CI 1.35 to 3.90). Heavy proteinuria also associated with increased odds of postoperative RRT (OR 7.29, 95% CI 3.00 to 17.73). In summary, these data suggest that preoperative proteinuria is a predictor of CSA-AKI among patients undergoing CABG.Keywords
This publication has 34 references indexed in Scilit:
- Acute Kidney Injury Is Associated With Increased Long-Term Mortality After Cardiothoracic SurgeryCell Metabolism, 2009
- Combining GFR and Albuminuria to Classify CKD Improves Prediction of ESRDJournal of the American Society of Nephrology, 2009
- Acute Kidney Injury After Cardiac SurgeryCell Metabolism, 2009
- Intensity of Renal Support in Critically Ill Patients with Acute Kidney InjuryNew England Journal of Medicine, 2008
- The risk of acute renal failure in patients with chronic kidney diseaseKidney International, 2008
- All-cause mortality attributable to chronic kidney disease: a prospective cohort study based on 462 293 adults in TaiwanThe Lancet, 2008
- Early Renal Replacement Therapy in Patients with Postoperative Acute Liver Failure Associated with Acute Renal Failure: Effect on Postoperative OutcomesJournal of the American College of Surgeons, 2007
- A Clinical Score to Predict Acute Renal Failure after Cardiac SurgeryJournal of the American Society of Nephrology, 2005
- Proximal tubular cell synthesis and secretion of endothelin-1 on challenge with albumin and other proteinsAmerican Journal of Kidney Diseases, 1995
- Contrast Material-Induced Renal Failure in Patients with Diabetes Mellitus, Renal Insufficiency, or BothNew England Journal of Medicine, 1989