Risk factors and in-hospital outcomes of acute kidney injury that developed after coronary artery bypass grafting in patients with stable angina.

Abstract

The aim of the study is to assess frequency, risk factors and in-hospital outcomes of acute kidney injury after coronary artery bypass grafting in patients with stable angina. The study included patients with stable angina pectoris and indications for coronary artery bypass grafting. We examined 93 patients aged 58±7.6 years, with duration of coronary heart disease 6±6.0 years. Previous myocardial infarction had 79.6% of patients. Arterial hypertension was present in 92.5% of patients. Multi-vessel coronary disease was registered in 94.6%, stenosis of the left main coronary artery > 50% was in 16.1% of patients. Coronary artery bypass grafting in conditions of artificial circulation was performed in 89.2% of patients, coronary grafting on working heart was held in 10.8% of patients. At initial stage, on the first and second days after coronary grafting the level of creatinine was determined by the method of Jaffe. The presence, the severity of acute kidney injury after (AKI) coronary artery bypass grafting was evaluated according to the criteria KDIGO (2012). We took into account in-hospital complications: cardiac death, intraoperative myocardial infarction (iMI), stroke, atrial fibrillation (AF), acute heart failure (AHF) according to requirement in intraaortic balloon pump, and the use of adrenaline. The proportion of persons with transient AKI stage 1 after coronary artery bypass grafting was 31.2%, those of 2 stage was 3.2%. The development of AKI was associated with cases of AHF. The increase in the duration of therapy with adrenaline - more than 1±1.8 days (median) - was connected with increase of the relative risk of AKI developing in 1.9 times. The incidence of cardiac death, iMI, strokes, paroxysmal AF did not differ among patients with AKI and without it. The frequency of transient AKI after coronary artery bypass grafting was 34.4%. The development of AKI is associated with AHF that occurred during coronary artery bypass grafting. The frequency of hospital complications did not differ among patients with AKI after coronary artery bypass grafting and without it.