Relation between Prolonged Cardiopulmonary Bypass Time in Cardiac Surgery in Adult Patients and Post-Operative Acute Kidney Injury

Abstract

Cardiac-surgery associated acute kidney injury (CSA-AKI) remains an important and frequent complication in patients undergoing cardiac surgery and is associated with a poor short- and long-term prognosis. The incidence for CSA-AKI according to Acute Kidney Injury Network criteria (AKIN) varies between 3% and 50%. CSA-AKI requiring temporary renal replacement therapy (RRT) occurs in 5% to 20% of these patients and is associated with a high mortality rate. To decrease the incidence AKI after cardiac surgery, numerous interventions have been tested, but none has proved efficient. In the absence of proven interventions, a reasonable strategy would be to identify modifiable risk factors for AKI in this setting. These modifiable risk factors might serve as therapeutic targets for preventing AKI. Previous studies have identified several important risk factors for AKI after cardiac surgery. Patient-related risk factors like female gender, chronic obstructive pulmonary disease, diabetes mellitus, peripheral vascular disease, renal insufficiency, congestive heart failure, left ventricular (LV) ejection fraction <35%, need for emergent surgery, cardiogenic shock requiring IABP, total circulatory arrest, left main coronary artery disease, etc., are the important factors associated with AKI-CS.