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Clinical and subclinical characteristics of patients with acute kidney injury following cardiac surgery in the Intensive Care Unit at Military Hospital 175
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Abstract
Objective: To describe the clinical and paraclinical characteristics and the impact of acute kidney injury (AKI) following cardiac surgery in the Intensive Care Unit of Military Hospital 175.
Subjects and Methods: A cross-sectional, longitudinal, controlled comparative study was conducted on 52 patients diagnosed with AKI and 50 patients without AKI after cardiac surgery from January 2023 to December 2024.
Results: The AKI group had a significantly higher prevalence of NYHA class III - IV heart failure (32.7% vs. 16%, p = 0.04), lower SpO₂ (92% vs. 96%, p < 0.001), higher heart rate (85 vs. 78 bpm, p = 0.03), higher incidence of oliguria (23.1% vs. 0%, p < 0.001), pre-existing chronic kidney disease (15.4% vs. 4%, p = 0.04), and pulmonary hypertension (63.5% vs. 36%, p < 0.01). Postoperatively, the AKI group exhibited significant renal impairment (peak creatinine: 210.6 vs. 90.2 µmol/L; lowest eGFR: 32.4 vs. 85.1 mL/min/1.73m²; both p < 0.001), along with elevated lactate and CRP levels, electrolyte imbalances, and metabolic acidosis. Most patients were classified as KDIGO stage I (73.1%), with 7.7% requiring renal replacement therapy. Independent risk factors for AKI included oliguria (OR = 6.8; p < 0.001), preoperative chronic kidney disease (OR = 4.1; p = 0.036), elevated serum lactate (OR = 1.9; p < 0.001), NYHA class III–IV heart failure (OR =2.8; p = 0.041), pulmonary hypertension (OR = 2.95; p = 0.01), low SpO₂ (OR = 0.81; p = 0.001), tachycardia (OR = 1.05; p = 0.042), and lower systolic blood pressure (OR = 0.96; p = 0.049).
Conclusion: Postoperative AKI is associated with multiple preoperative clinical and hemodynamic abnormalities, particularly impaired oxygenation, cardiorenal dysfunction, and reduced tissue perfusion.
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Keywords
Acute kidney injury, cardiac surgery, KDIGO
References
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