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Revista Uruguaya de Cardiología

versão impressa ISSN 0797-0048versão On-line ISSN 1688-0420

Resumo

RAMOS, María Victoria; POUSO, Marcos  e  POUSO, Jorge. Accumulated incidence of acute renal failure in the postoperative period of cardiac surgery. Rev.Urug.Cardiol. [online]. 2018, vol.33, n.2, pp.35-53. ISSN 0797-0048.  https://doi.org/10.29277/cardio.33.2.3.

Introduction:

acute renal failure (ARF) is a frequent cause of morbidity and mortality in the postoperative period of cardiac surgery, with variable incidence depending on the definition used, factors derived from the patient and the surgical procedure.

Objective: determine the incidence of ARF in a cardiac surgery center, the presence of predictors and its association with surgical mortality.

Methods:

this is a prospective and observational study with analytical elements. All patients with normal renal function and no history of kidney disease undergoing cardiac surgery were included in the period from July 2014 to July 2015. Baseline creatininemia was determined, and 24 and 48 hours later, after surgery. Acute renal failure was defined using the RIFLE criterion. Surgical mortality, pre and intra-operative variables were assessed using univariate and multivariate analysis.

Results:

four hundred patients met the inclusion criteria. The incidence of acute renal failure by RIFLE criterion was 10,3% (95% CI 8,7-11,8), surgical mortality in this group reached 19,5% while in controls it was 1,9%. The variables associated with the presence of ARF were the higher EuroSCORE, combined surgery, use of extracorporeal circulation and aortic clamping. The CRM presented an inverse association and was an independent predictor in the multivariate analysis. The presence of ARF was an independent predictor of surgical death.

Conclusions:

the incidence of ARF is frequent in the postoperative period of cardiac surgery and is within the international values. Its presence implies greater surgical mortality.

Palavras-chave : Renal insufficiency; Thoracic surgery; Postoperative period; RIFLE; Extracorporeal circulation.

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