Postoperative Blood Pressure Could Be a Modifiable Risk Factor for Acute Kidney Injury After Coronary Bypass Surgery

• Main Authors: Doğan Kahraman, Ozan Emiroğlu
• Format: Article
• Language: English
• Published: Galenos Yayinevi 2020-06-01
• Series: Haseki Tıp Bülteni
• Subjects: off-pump coronary artery bypass; acute kidney injury; blood pressure
• Online Access: http://www.hasekidergisi.com/archives/archive-detail/article-preview/postoperative-blood-pressure-could-be-a-modifiable/38672

Aim:Acute kidney injury (AKI) is a common complication associated with coronary surgery. This study aims to define perioperative modifiable risk factors for AKI development.Methods:We prospectively observed perioperative parameters, laboratory tests, and outcome variables of 319 consecutive patients. The patients were divided into groups according to on-pump or off-pump coronary bypass.Results:The off-pump patients were older (65.15±9.247 years vs 60.81±9.659; p=0.001) but he frequency of AKI development was similar between the groups (22% vs 19.9%, p=0.659). Preoperative hypertension, advanced age, high body weight, and prolonged cross-clamp time were associated with postoperative AKI, but postoperative high blood pressure and higher ejection fraction were likely to be protective against AKI development. Expected in-hospital survival in a patient developing AKI after off-pump surgery was better than those with on-pump surgery (88.9% and 84.6%, respectively; p<0.001).Conclusion:Managing postoperative blood pressure according to preoperative level could have the potential to reduce AKI incidence.