AUTHOR=Molina Andújar Alícia , Escudero Victor Joaquin , Piñeiro Gaston J. , Lucas Alvaro , Rovira Irene , Matute Purificación , Ibañez Cristina , Blasco Miquel , Quintana Luis F. , Sandoval Elena , Sánchez Marina Chorda , Quintana Eduard , Poch Esteban 

TITLE=Impact of cardiac surgery associated acute kidney injury on 1-year major adverse kidney events

JOURNAL=Frontiers in Nephrology

VOLUME=Volume 3 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/nephrology/articles/10.3389/fneph.2023.1059668

DOI=10.3389/fneph.2023.1059668

ISSN=2813-0626

ABSTRACT=Background: the incidence of acute kidney injury following cardiac surgery (CSA-AKI) is up to 30%, and an increased risk of chronic kidney disease has been found when compared to AKI-free population. The aim of our study was to assess the risk of Major Adverse Kidney Events (25% or greater decline in eGFR, new hemodialysis, and death [MAKE]) after cardiac surery in a Spanish cohort and to evaluate the utility of the score developed by Legouis D et al (CSA-CKD score) in the prediction of MAKE.
Methods: unicentric retrospective study of patients that required cardiac surgery with cardio-pulmonary bypass (CPB) during 2015  with one-year follow-up after intervention. The inclusion criteria were: patients over 18 years old who were operated on for cardiac surgery (valve substitution [VS], Coronary Artery Bypass Graft [CABG] or a combination of both procedures.
Results: the number of patients with CKD (eGFR <60 ml/min) increased from 74 (18.3%) to 97 (24%) one year after surgery. Median eGFR declined from 85 to 82 ml/min in the no-CSA-AKI patients and from 73 to 65 ml/min in those who suffered CSA-AKI (p=0.024). Fifty-eight patients (14.4%)  presented one-year MAKE. Multivariate logistic regression analysis showed that the only variable  associated with MAKE was CSA-AKI (OR 2.386 [1.31-4.35], p=0.004). Median CSA-CKD score was higher in the MAKE cohort (3 [2-4] vs 2[1-3], p<0.001), but discrimination was poor, with AUC of 0.682 (0.611-0.754).
Conclusion:  CSA-AKI of any stage is associated with one-year MAKE. Further Research to disclose new scores that identify patients at risk are needed to provide appropiate follow-up.