Abstract:

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 the 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 the preoperative level could have the potential to reduce AKI incidence.