Risk of Acute Renal Failure Requiring Renal Replacement Therapy after Cardiac Surgery

Abstract

Background: Acute renal failure is a rare but serious complication following
cardiac surgery and associated with increased mortality and morbidity.
Objective:To identify factors associated with mortality and mortality of
patients with acute renal failure after cardiac surgery treated with continuous
renal replacement therapy.
Method: This was a cohort retrospective study on cardiac surgery patients
who developed acute renal failure requiring renal replacement therapy after
surgery in Harapan Kita National Cardiac Center between January 2011
and April 2012. Data was retrieved from medical record and consisted
of pre-operative, intra-operative, and post-operative variables. Risk factor
identification was done using multivariate logistic regression analysis,
whereas relative risk analysis was applied to know the association between
risk factor and morbidity. Direct or indirect effect of variables on renal failure
was analyzed using Barttlet’s and anti-image correlation test.
Results: A total of 110 cases were obtained during the study period; 70
(63.3%) among them were men. Patients mean age was 57.6 years. Preoperative
renal failure, New York Heart Association Functional Classification
Class (NYHA) class IV, critical condition, coronary revascularization surgery
and bleeding, post-operative anemia, bleeding and venous saturation <65%
showed a trend of mortality and morbidity rate between 0.1 and 9.1. The
Keiser-Meyer-Olkin (KMO) value and Barttlet’s test showed that re-surgery,
bleeding and low inotropic score resulted in 31.63% probability of having
post-operative renal failure.
Conclusion: Re-surgery, bleeding and inotropic use may result in postoperative
renal failure.