• Tao-Min Huang, Vin-Cent Wu, Guang-Huar Young, Yu-Feng Lin, Chih-Chung Shiao, Pei-Chen Wu, Wen-Yi Li, Hsi-Yu Yu, Fu-Chang Hu, Jou-Wei Lin, Yih-Sharng Chen, Yen-Hung Lin, Shoei-Shen Wang, Ron-Bin Hsu, Fan-Chi Chang, Nai-Kuan Chou, Tzong-Shinn Chu, Yu-Chang Yeh, Pi-Ru Tsai, Jenq-Wen Huang, Shuei-Liong Lin, Yung-Ming Chen, Wen-Je Ko, Kwan-Dun Wu, and National Taiwan University Hospital Study Group of Acute Renal Failure.
• Division of Nephrology, Department of Internal Medicine, National Taiwan University Hospital, 7 Chung-Shan South Road, Zhong-Zheng District, Taipei 100, Taiwan.
• J. Am. Soc. Nephrol. 2011 Jan 1;22(1):156-63.

AbstractWhether 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.

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