• Kanchi Muralidhar, Kakade Bhagyashri, Ratan Guptha, Nitin Hegde, Isthiaq Ahmed, and Lloyd Vincent.
• Department of Anesthesia and Intensive Care, Narayana Hrudayalaya Hospitals, Bangalore, Karnataka, India.
• Asian Cardiovasc Thorac Ann. 2013 Oct 1;21(5):533-8.

BackgroundAcute renal injury requiring renal replacement therapy after cardiac surgery develops in 1%-5% of patients, and is strongly associated with perioperative morbidity and mortality. The prognostic risk factors for development acute renal injury requiring renal replacement therapy are identified in this study.Methods2585 adult patients who underwent cardiac surgery during a 1-year period (November 2010 to October 2011) were studied. The patients who developed acute renal injury requiring renal replacement therapy were compared with matched controls. Logistic regression analysis was applied to determine the predictors of acute renal injury requiring renal replacement therapy.Results44 patients developed acute renal injury requiring renal replacement therapy following cardiac surgery. On multivariate logistic analysis, the following factors independently predicted acute renal injury requiring renal replacement therapy (p < 0.05): preoperative critical state, pre-existing renal dysfunction, preoperative diastolic dysfunction, and combined cardiac surgery.ConclusionThe risk of acute renal injury requiring renal replacement therapy can be fairly accurately predicted and quantified on the basis of available preoperative and intraoperative data. These predictors may be used by physicians to estimate the risk and target high-risk groups for interventions that prevent, reduce, or ameliorate the occurrence of renal failure needing acute renal replacement therapy.

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