Table 1.
Descriptive Characteristics.
| Parameter | AKI Status | P-value | |
|---|---|---|---|
| No, n=814 (49.6%) KDIGO 0 |
Yes, n=827 (50.4%) KDIGO 1, 2, 3 |
||
| Patient Demographics | |||
| Age (years) | 61.8±12.8 | 64.3±11.9 | 0.001b |
| BMI (kg/m2) | 28.8±8.1 | 29.5±6.3 | 0.001b |
| Female | 271(33.3%) | 266(32.2%) | 0.626a |
| Male | 543(66.7%) | 561(67.8%) | |
| DM Type 1 | 5(0.61%) | 4(0.48%) | 0.751d |
| DM Type 2 | 157(19.3%) | 215(26%) | 0.001a |
| Essential hypertension | 400(49.1%) | 448(54.2%) | 0.041a |
| Pulmonary hypertension | 24(3%) | 52(6.3%) | 0.001a |
| Hyperlipidemia | 276(33.9%) | 287(34.7%) | 0.734a |
| CAD | 358(44%) | 423(51.1%) | 0.004a |
| STEMI | 42(5.7%) | 52(7%) | 0.299a |
| NSTEMI | 64(8.4%) | 74(9.7%) | 0.390a |
| PVD | 34(4.2%) | 35(4.2%) | 0.956a |
| Atrial fibrillation | 115(14.1%) | 137(16.6%) | 0.171a |
| Atrial flutter | 15(1.8%) | 20(2.4%) | 0.420a |
| History of atrial fibrillation | 35(4.3%) | 38(4.6%) | 0.772a |
| Angina pectoris | 82(10%) | 70(8.4%) | 0.261a |
| CHF | 221(27.2%) | 232(28%) | 0.682a |
| LVEF≤40% | 25(3.1%) | 33(4%) | 0.313a |
| COPD | 55(6.8%) | 60(7.3%) | 0.693 |
| Procedural Parameters | |||
| CUF (mL/kg)-Median (IQR) | 17.6(9.9, 30.0) | 20.8 (11.1, 35.4) | <0.001b |
| Last Hct Prior to Surgery | 39±5 | 38±5 | <0.001b |
| AoX-Clamp (min) | 98.7±46.4 | 106.8±53.7 | 0.013b |
| CPB (min) | 193.4±75.2 | 211.7±88.1 | <0.001b |
| TM50 (mmHg•min) | 359.1±277.2 | 386.2±321.4 | 0.115a |
| Lowest Intraoperative Hct (%) | 31.0±4.0 | 31.0±4.0 | 0.778b |
| Lowest Hgb on CPB (g/dL) | 10.5±1.4 | 10.4±1.3 | 0.387b |
| Patients with PRBC Transfusion | 137(16.5%) | 197(23.8%) | <0.001a |
| PRBC Transfusion Volume (mL) | 653±466.7 | 782±586.78 | 0.010b |
| Vasoactive Infusion Score | 3.4(6.4) | 6.13(13.7) | <0.001 |
| Renal Function | |||
| Preoperative CrCl (mL/min) | 74.7±21.6 | 71.7±26.7 | 0.001b |
| Postoperative CrCl (mL/min) | 68.7±18.8 | 45.9±18.6 | <0.001b |
| Baseline Serum Cr (mg/dL) | 1.06±0.33 | 1.19±0.73 | 0.006a |
| Peak Postoperative Serum Cr (mg/dL) | 1.13±0.32 | 1.83±1.20 | <0.001a |
| Baseline to Peak Creatinine (ΔCr,%) | 7.0±15.0 | 65.0±79.0 | <0.001a |
Chi-Square
Wilcoxon
Equal Variance T-Test
Fisher Exact
Values are n (%) or standard deviation
AKI “No”=KDIGO Stage-0; AKI “Yes”=KDIGO Stages-1,-2, or-3; AoX-Clamp=aortic cross-clamp; CAD=coronary artery disease; CHF=congestive heart failure; COPD=chronic obstructive pulmonary disease; CPB=cardiopulmonary bypass; Cr=creatinine; CrCl=creatinine clearance; CUF=conventional ultrafiltration; DM=diabetes mellitus; Hct=hematocrit; Hgb=hemoglobin; LVEF=left ventricular ejection fraction; NSTEMI=non-ST-elevation myocardial infarction; PRBC=packed red blood cells; PVD=peripheral vascular disease; STEMI=ST-elevation myocardial infarction; TM50=time-mean arterial pressure integral <50mmHg on CPB.
g CUF (3rd Quartile,Q3). Higher volume removed by CUF was associated with worsening AKI. (B) Kaplan-Meier curve of 30-day survival, stratifying AKI patients that died by Youden criterion CUF volume (orange line, ≥32.9mL/kg removed, n=7; red line, <32.9ml/kg, n=15). Four patients died in the non-AKI group (blue line). Although patients with AKI had increased 30-day mortality, the relationship between mortality and CUF volume was unclear based on our results. Abbreviations:AKI=acute kidney injury; CUF=conventional ultrafiltration; KDIGO=Kidney Disease: Improving Global Outcomes.