Association between preoperative level of hemoglobin A1c and the incidence of acute kindey injury after coronary artery bypass grafting surgery: a cohort study
Abstract Background The development of acute kidney injury (AKI) is an important indicator of clinical outcomes after cardiac surgery. Elevated preoperative hemoglobin A1c level may be associated with acute kidney injury in patients undergoing coronary artery bypass grafting. This study will investi...
Main Authors: | , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
SpringerOpen
2021-06-01
|
Series: | Ain Shams Journal of Anesthesiology |
Subjects: | |
Online Access: | https://doi.org/10.1186/s42077-021-00161-7 |
id |
doaj-cf9a16deb2fd4a05ace4ea5872b87ed5 |
---|---|
record_format |
Article |
spelling |
doaj-cf9a16deb2fd4a05ace4ea5872b87ed52021-06-13T11:51:29ZengSpringerOpenAin Shams Journal of Anesthesiology2090-925X2021-06-011311810.1186/s42077-021-00161-7Association between preoperative level of hemoglobin A1c and the incidence of acute kindey injury after coronary artery bypass grafting surgery: a cohort studyGhada Mohamed Samir0Omar Mohamed Ali Mohamed Omar1Madiha Metwally Zidan2Hazem Abd El Rahman Fawzy3Marwa Mamdouh Mohamed El Far4Department of Anesthesiology, Intensive care and Pain Management, Faculty of Medicine, Ain-Shams UniversityDepartment of Anesthesiology, Intensive care and Pain Management, Faculty of Medicine, Ain-Shams UniversityDepartment of Anesthesiology, Intensive care and Pain Management, Faculty of Medicine, Ain-Shams UniversityDepartment of Anesthesiology, Intensive care and Pain Management, Faculty of Medicine, Ain-Shams UniversityDepartment of Anesthesiology, Intensive care and Pain Management, Faculty of Medicine, Ain-Shams UniversityAbstract Background The development of acute kidney injury (AKI) is an important indicator of clinical outcomes after cardiac surgery. Elevated preoperative hemoglobin A1c level may be associated with acute kidney injury in patients undergoing coronary artery bypass grafting. This study will investigate the association of preoperative HbA1c levels with AKI after isolated coronary artery bypass grafting (CABG). Results Forty patients undergoing elective CABG were enrolled in this cohort study. Patients are divided into 2 equal groups who underwent isolated coronary artery bypass grafting (CABG): patients with preoperative HbA1c 5.7–6.4% (group A) (prediabetics) and patients with preoperative HbA1c > or = 6.5% (group B) (diabetics). Acute kidney injury according to the Kidney Disease: Improving Global Outcomes criteria developed in 11 patients (27.5%). There was a significant difference between the two groups as regards postoperative urinary NGAL, creatinine level on the 1st day, creatinine level on the 2nd day, urine output on the 1st day, and urine output on the 2nd day (p value was 0.001, 0.002, 0.006, 0.0002, and 0.012 respectively). Postoperative ICU stay duration was statistically significant in the diabetic group (P value 0.009). The need for renal replacement therapy was higher in the diabetic group, but it was not statistically significant between the two groups. Roc analysis shows AUC 0.922 with a significant p value (< 0.0001) and cut of value (≥ 7) with sensitivity 81.82 and specificity 93.10. Conclusion This study revealed that elevated preoperative HbA1c level above 7% showed an increase in incidence of post CABG acute kidney injury along with increase length of postoperative ICU stay.https://doi.org/10.1186/s42077-021-00161-7Acute renal injuryHemoglobin A1cNeutrophil gelatinase-associated lipocalinSerum creatinineCoronary artery bypass grafting surgery |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Ghada Mohamed Samir Omar Mohamed Ali Mohamed Omar Madiha Metwally Zidan Hazem Abd El Rahman Fawzy Marwa Mamdouh Mohamed El Far |
spellingShingle |
Ghada Mohamed Samir Omar Mohamed Ali Mohamed Omar Madiha Metwally Zidan Hazem Abd El Rahman Fawzy Marwa Mamdouh Mohamed El Far Association between preoperative level of hemoglobin A1c and the incidence of acute kindey injury after coronary artery bypass grafting surgery: a cohort study Ain Shams Journal of Anesthesiology Acute renal injury Hemoglobin A1c Neutrophil gelatinase-associated lipocalin Serum creatinine Coronary artery bypass grafting surgery |
author_facet |
Ghada Mohamed Samir Omar Mohamed Ali Mohamed Omar Madiha Metwally Zidan Hazem Abd El Rahman Fawzy Marwa Mamdouh Mohamed El Far |
author_sort |
Ghada Mohamed Samir |
title |
Association between preoperative level of hemoglobin A1c and the incidence of acute kindey injury after coronary artery bypass grafting surgery: a cohort study |
title_short |
Association between preoperative level of hemoglobin A1c and the incidence of acute kindey injury after coronary artery bypass grafting surgery: a cohort study |
title_full |
Association between preoperative level of hemoglobin A1c and the incidence of acute kindey injury after coronary artery bypass grafting surgery: a cohort study |
title_fullStr |
Association between preoperative level of hemoglobin A1c and the incidence of acute kindey injury after coronary artery bypass grafting surgery: a cohort study |
title_full_unstemmed |
Association between preoperative level of hemoglobin A1c and the incidence of acute kindey injury after coronary artery bypass grafting surgery: a cohort study |
title_sort |
association between preoperative level of hemoglobin a1c and the incidence of acute kindey injury after coronary artery bypass grafting surgery: a cohort study |
publisher |
SpringerOpen |
series |
Ain Shams Journal of Anesthesiology |
issn |
2090-925X |
publishDate |
2021-06-01 |
description |
Abstract Background The development of acute kidney injury (AKI) is an important indicator of clinical outcomes after cardiac surgery. Elevated preoperative hemoglobin A1c level may be associated with acute kidney injury in patients undergoing coronary artery bypass grafting. This study will investigate the association of preoperative HbA1c levels with AKI after isolated coronary artery bypass grafting (CABG). Results Forty patients undergoing elective CABG were enrolled in this cohort study. Patients are divided into 2 equal groups who underwent isolated coronary artery bypass grafting (CABG): patients with preoperative HbA1c 5.7–6.4% (group A) (prediabetics) and patients with preoperative HbA1c > or = 6.5% (group B) (diabetics). Acute kidney injury according to the Kidney Disease: Improving Global Outcomes criteria developed in 11 patients (27.5%). There was a significant difference between the two groups as regards postoperative urinary NGAL, creatinine level on the 1st day, creatinine level on the 2nd day, urine output on the 1st day, and urine output on the 2nd day (p value was 0.001, 0.002, 0.006, 0.0002, and 0.012 respectively). Postoperative ICU stay duration was statistically significant in the diabetic group (P value 0.009). The need for renal replacement therapy was higher in the diabetic group, but it was not statistically significant between the two groups. Roc analysis shows AUC 0.922 with a significant p value (< 0.0001) and cut of value (≥ 7) with sensitivity 81.82 and specificity 93.10. Conclusion This study revealed that elevated preoperative HbA1c level above 7% showed an increase in incidence of post CABG acute kidney injury along with increase length of postoperative ICU stay. |
topic |
Acute renal injury Hemoglobin A1c Neutrophil gelatinase-associated lipocalin Serum creatinine Coronary artery bypass grafting surgery |
url |
https://doi.org/10.1186/s42077-021-00161-7 |
work_keys_str_mv |
AT ghadamohamedsamir associationbetweenpreoperativelevelofhemoglobina1candtheincidenceofacutekindeyinjuryaftercoronaryarterybypassgraftingsurgeryacohortstudy AT omarmohamedalimohamedomar associationbetweenpreoperativelevelofhemoglobina1candtheincidenceofacutekindeyinjuryaftercoronaryarterybypassgraftingsurgeryacohortstudy AT madihametwallyzidan associationbetweenpreoperativelevelofhemoglobina1candtheincidenceofacutekindeyinjuryaftercoronaryarterybypassgraftingsurgeryacohortstudy AT hazemabdelrahmanfawzy associationbetweenpreoperativelevelofhemoglobina1candtheincidenceofacutekindeyinjuryaftercoronaryarterybypassgraftingsurgeryacohortstudy AT marwamamdouhmohamedelfar associationbetweenpreoperativelevelofhemoglobina1candtheincidenceofacutekindeyinjuryaftercoronaryarterybypassgraftingsurgeryacohortstudy |
_version_ |
1714522689938391040 |