Age, body mass index, and diabetes mellitus are associated with an increased risk of acute kidney injury after coronary surgery: Retrospective cohort study

Abstract

Background/Aim: Cardiac surgery-associated acute kidney injury (CSA-AKI) is a significant complication of cardiac surgery and is associated with increased morbidity and mortality. Identifying risk factors can help clinicians alleviate the risk of developing CSA-AKI and associated complications. Therefore, this study aimed to identify pre-operative patient-related risk factors of CSA-AKI in patients undergoing coronary surgery.
 Methods: The current study was a single-center retrospective cohort study of adult patients undergoing coronary surgery with cardiopulmonary bypass (CPB) over an 8-month period. AKI was scored according to The Kidney Disease Improving Global Outcomes (KDIGO) scoring system. Patients’ age, gender, body mass index (BMI), comorbidities, KDIGO staging in AKI patients, and 30-day mortality rates were recorded. These variables were compared between AKI(−) and AKI (+) groups. Univariate binary regression analysis was performed between the variables that had statistically significant differences and AKI.
 Results: A total of 248 coronary surgery patients were analyzed. The overall incidence of CSA-AKI was 16.5%. Age, BMI, and the proportion of diabetic patients were significantly higher in the AKI (+) group (P = 0.04, P < 0.001, and P = 0.022, respectively). The proportion of gender, chronic obstructive pulmonary disease (COPD), hypertension (HT), baseline creatinine levels, aortic cross-clamping, cardiopulmonary bypass (CPB), total operation duration, and 30-day mortality were similar between the groups. Univariate analysis demonstrated that CSA-AKI was significantly associated with age ³ 65 years (odds ratio [OR] = 2.506; confidence interval [CI]: 1.265–4.967; P = 0.008), BMI of ³ 25 kg m-2 (OR = 8.994; CI: 1.199–67.980; P = 0.033), and diabetes mellitus (OR = 2.171; CI: 1.103–4.273; P = 0.025).
 Conclusion: The current study revealed that patients with increased age, BMI, and DM had a higher incidence of CSA-AKI. Therefore, even though these patient-related variables are known as non-modifiable parameters, more attention should be paid to preventing CSA-AKI during peri-operative management of these patients.