Renal replacement therapy after cardiac surgery; renal function recovers

Abstract

Objectives. To assess renal outcome in patients discharged from hospital following cardiac surgery-associated acute kidney injury (CSA-AKI) with need for renal replacement therapy. Design. In April 2012 we conducted a cross-sectional study of patients treated with renal replacement therapy following cardiac surgery during 2008–2010. We included all adult patients with a pre-operative serum creatinine (sCr) < 200 μM, surviving to discharge. Primary endpoint was use of renal replacement therapy after hospital discharge; secondary endpoint was a sCr > 200 μM at the time of follow-up. Results. We reviewed the records of 3828 patients receiving cardiac surgery in the defined period. A total of 107 adult patients with sCr concentrations < 200 μM were treated with post-operative renal replacement therapy of whom 70 survived to discharge. Fifty-six patients were alive at follow-up and none had required renal replacement therapy after initial discharge. Median sCr concentration at follow-up was 111 [56–257] μM and two patients had sCr above 200 μM. Conclusions. In this study, renal function recovered in patients discharged from hospital following renal replacement therapy after CSA-AKI. No patients needed further renal replacement therapy and only two (4%) had a sCr > 200 μM at follow-up.