Preoperative 24-hour urine amount as an independent predictor of renal outcome in poor cardiac function patients after coronary artery bypass grafting

Chun Liang Lin, Kun Ying Pan, Po Yaur Hsu, Huan Yu Yang, Huey Liang Guo, Chiu Ching Huang*

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

13 Scopus citations

Abstract

Purpose: To investigate the incidence and the main pre-operative risk factors for the development of acute renal failure (ARF) in triple vessels coronary artery bypass grafting (CABG) with special reference to a subset of patients with poor cardiac function (ejection fraction <50%). Patients: The study included the patients (n = 66) requiring CABG from January 1, 1995 to January 1, 2002 in a medical center. Results: A high percentage (84.8%) of patients developed ARF and 57.6% of patients received hemodialysis (HD). Preoperative variables significantly associated with the development of ARF included increased age, increased preoperative serum creatinine, decreased preoperative 24-hour urine output and accepted emergent CABG. By the logistic multivariate regression model, increased age (OR = 1.16), preoperative serum creatinine (OR = 3.58,), decreased preoperative 24-hour urine amount (OR = 0.99,) and emergent CABG (OR = 2.01) were independently associated with ARF. As for the need for HD, those factors including, preoperative serum creatinine (2.11 ± 1.13 v 3.08 ± 1.67mg/dL) and preoperative 24-hour urine output (1358.6 ± 745.9 v 755.2 ± 572.1mL/day) were significantly associated with requirement of dialysis. Using multivariate logistic regression, the significant risk factors independently associated with dialysis were preoperative serum creatinine (OR = 1.34) and preoperative 24-hour urine output (OR = 0.99). Patients with non- oliguric renal failure had significantly greater chance of recovering their renal function after cardiac surgery compared to those with oliguria (36.9% v 10.0%, P < .05). Conclusion: Preoperative 24-hour urine amount and pre-operative serum creatinine can provide valuable information for predicting the likelihood of developing acute renal failure and requiring dialysis in this subgroup of patients.

Original languageEnglish
Pages (from-to)92-98
Number of pages7
JournalJournal of Critical Care
Volume19
Issue number2
DOIs
StatePublished - 06 2004

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