Risk of Acute Renal Failure Requiring Renal Replacement Therapy after Cardiac Surgery

Abstract

Background: Acute renal failure is a rare but serious complication following cardiac surgery and associated with increased mortality and morbidity. Objective:To identify factors associated with mortality and mortality of patients with acute renal failure after cardiac surgery treated with continuous renal replacement therapy. Method: This was a cohort retrospective study on cardiac surgery patients who developed acute renal failure requiring renal replacement therapy after surgery in Harapan Kita National Cardiac Center between January 2011 and April 2012. Data was retrieved from medical record and consisted of pre-operative, intra-operative, and post-operative variables. Risk factor identification was done using multivariate logistic regression analysis, whereas relative risk analysis was applied to know the association between risk factor and morbidity. Direct or indirect effect of variables on renal failure was analyzed using Barttlets and anti-image correlation test. Results: A total of 110 cases were obtained during the study period; 70 (63.3%) among them were men. Patients mean age was 57.6 years. Preoperative renal failure, New York Heart Association Functional Classification Class (NYHA) class IV, critical condition, coronary revascularization surgery and bleeding, post-operative anemia, bleeding and venous saturation <65% showed a trend of mortality and morbidity rate between 0.1 and 9.1. The Keiser-Meyer-Olkin (KMO) value and Barttlets test showed that re-surgery, bleeding and low inotropic score resulted in 31.63% probability of having post-operative renal failure. Conclusion: Re-surgery, bleeding and inotropic use may result in postoperative renal failure.

Keywords

• Keywordstherapy
• car
• dfiaacct osurr gaenrayly sis
• renal failure
• continuous renal replacement therapy
• cardiac surgery