• Soojin Lee, Sehoon Park, Min Woo Kang, Hai-Won Yoo, Kyungdo Han, Yaerim Kim, Jung Pyo Lee, Kwon Wook Joo, Chun Soo Lim, Yon Su Kim, Hyeongsu Kim, and Dong Ki Kim.
• Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea; Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.
• J Crit Care. 2019 Apr 1; 50: 92-98.

PurposeDialysis-requiring acute kidney injury (AKI-D) after cardiac surgery is a major cause of in-hospital mortality. However, the long-term outcome has not been previously examined.Materials And MethodsWe performed a nationwide, population-based cohort study using the claims data in the Korean National Health Insurance System. Patients who underwent cardiac surgery between 2006 and 2015 were considered.ResultsAmong 52,983 patients who underwent cardiac surgery, 1261 underwent dialysis postoperatively. During the median follow-up of 3.33 years, the AKI-D group had increased risk of all-cause mortality, end-stage renal disease (ESRD) progression, and risk of developing major adverse cardiovascular events (MACEs). These results remained consistent after multivariable analysis and propensity-score matching. Even after excluding patients who continued dialysis at discharge, the AKI-D group consistently exhibited worse mortality and an increased risk of MACEs compared to the control group. Patients who underwent continuous renal replacement therapy in the AKI-D group exhibited comparable mortality and risk of MACEs but reduced progression to ESRD compared to those who received intermittent renal replacement therapy.ConclusionsAKI-D following cardiac surgery was associated with worse long-term postdischarge mortality and elevated risks of dialysis dependency and MACE development. The outcomes were consistent even in the patients who recovered from the dialysis.Copyright © 2018 Elsevier Inc. All rights reserved.

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