Abstract

Plain Language SummaryCardiac surgery-related acute kidney injury (CSA-AKI) is serious complication that can result in higher mortality and morbidity after cardiac surgery. Although previous studies have highlighted that preoperative kidney dysfunction is a risk factor for AKI, there is limited information of the impact of preoperative serum creatinine change preceding surgery on CSA-AKI. We found that approximately 85% of patients experienced elevation in preoperative serum creatinine. Elevation in preoperative serum creatinine was associated with CSA-AKI, even mild elevation was associated with a 3.8-fold higher risk of postoperative CSA-AKI. Furthermore, patients with pronounced elevation in preoperative serum creatinine also exhibited a higher risk of severe AKI and non-recovery from AKI. This study emphasizes the importance of extending scrutiny beyond mere preoperative serum creatinine values, highlighting the assessment of fluctuations in preoperative serum creatinine; this aids in identifying individuals at high risk, enabling clinicians to intervene more earlier and potentially improve prognosis.

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