Risk factors for acute kidney injury in patients undergoing same admission coronary angiography and valve replacement

J Card Surg. 2013 Nov;28(6):627-31. doi: 10.1111/jocs.12222. Epub 2013 Sep 30.

Abstract

Background: We investigated risk factors for acute kidney injury (AKI) in patients undergoing same admission coronary angiography (CAG) and valve replacement.

Methods: Among 283 consecutive patients undergoing valve surgery between October 2010 and July 2012, 71 patients with same admission preoperative CAG were included in the study. Predictors of AKI were identified with a univariable model; then, logistic regression analysis was performed with the variables with p < 0.1 in univariable analysis and other known risk factors of AKI.

Results: Twenty-two (31.0%) patients developed AKI. Univariate analysis revealed that diabetes mellitus (p = 0.097), cerebrovascular disease (p = 0.03), atrial fibrillation (p = 0.097), one-stage procedure (p = 0.05), and concomitant tricuspid valvular replacement/repair (p = 0.033) were risk factors. Multivariate logistic regression analysis showed that diabetes mellitus (odds ratio [OR] 10.361, 95% CI 1.345-79.828, p = 0.025) and cerebrovascular disease (OR 26.070, 95% CI 1.695-400.939, p = 0.019) are risk factors for AKI in patients 50 years or older undergoing same admission CAG and valve replacement. One-stage procedure was not associated with a higher incidence of AKI.

Conclusion: Diabetes mellitus and cerebrovascular disease are risk factors for AKI. Same admission CAG and valve replacement should be performed with caution in this group of patients.

MeSH terms

  • Acute Kidney Injury / epidemiology*
  • Acute Kidney Injury / etiology*
  • Age Factors
  • Aged
  • Atrial Fibrillation
  • Cerebrovascular Disorders
  • Coronary Angiography / adverse effects*
  • Diabetes Mellitus
  • Female
  • Heart Valve Prosthesis Implantation / adverse effects*
  • Humans
  • Incidence
  • Logistic Models
  • Male
  • Middle Aged
  • Risk Factors
  • Time Factors
  • Time-to-Treatment
  • Tricuspid Valve / surgery