Risk factors, outcomes, and early prediction of cardiac surgery-associated acute kidney injury: a<i> post</i><i> hoc</i> subgroup analysis of the Epidemiology of Surgery Associated Acute Kidney Injury study
BRITISH JOURNAL OF ANAESTHESIA, cilt.136, sa.1, ss.34-42, 2026 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 136 Sayı: 1
- Basım Tarihi: 2026
- Doi Numarası: 10.1016/j.bja.2025.08.043
- Dergi Adı: BRITISH JOURNAL OF ANAESTHESIA
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, BIOSIS, CINAHL, EMBASE, MEDLINE, Academic Search Ultimate (EBSCO), Biomedical Reference Collection: Corporate Edition (EBSCO), Health Research Premium Collection (ProQuest), Pharma Collection (ProQuest)
- Sayfa Sayıları: ss.34-42
- Karadeniz Teknik Üniversitesi Adresli: Evet
Özet
Background: Cardiac surgery-associated acute kidney injury (CSA-AKI) is a common and important complication. The risk factors for CSA-AKI remain poorly described. We aimed to identify risk factors for CSA-AKI and develop a risk score for persistent CSA-AKI. Methods: We performed a post hoc subgroup analysis restricted to patients who underwent cardiac surgery within the Epidemiology of Surgery Associated Acute Kidney Injury (EPIS-AKI) study. CSA-AKI was defined as AKI (according to the Kidney Disease: Improving Global Outcomes criteria) within 72 h after surgery. Persistent CSA-AKI was defined as CSA-AKI lasting >48 h. We performed multivariable logistic regression analyses to identify risk factors for CSA-AKI and related outcomes. Results: The original EPIS-AKI study included 3101 cardiac surgery patients. Of these, 802 (25.9%) developed CSA-AKI. On follow-up, 279 of the 802 patients (34.8%) developed persistent CSA-AKI. We identified independent risk factors for CSA-AKI, moderate/severe CSA-AKI, and persistent CSA-AKI. Patients with persistent CSA-AKI had a higher ICU and hospital mortality compared with patients with transient CSA-AKI. We developed a risk score for predicting persistent CSA-AKI with an area under the receiver operating characteristic curve of 0.79 (95% confidence interval, 0.7355-0.8457). Conclusions: Overall, 25% of cardiac surgery patients developed cardiac surgery-associated acute kidney injury, and 33% of these patients experienced persistent cardiac surgery-associated acute kidney injury, which was associated with poor outcomes. We developed a risk score for predicting persistent cardiac surgery-associated acute kidney injury, the 'EPIS CSA-AKI risk score'. Pending further external validation, the score might be used to identify patients who have a high risk for developing persistent cardiac surgery-associated acute kidney injury.