FREQUENCY RISK FACTORS AND OUTCOMES ACUTE KIDNEY INJURY IN THE EARLY PERIOD IN PATIENTS WITH CHRONIC KIDNEY DISEASE AFTER CABG SURGERY

AIM : To evaluate risk factors and prevalence of acute kidney injury (AKI) in patients with chronic kidney disease (CKD) in the early period after isolated coronary artery bypass graft (CABG). PATIENTS AND METHODS: The study included 830 patients with isolated CABG. All surgeries were performed in 2016. To evaluate kidney function in preoperative period glomerular filtration rate (GFR) was estimated by Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) formula. AKI was diagnosed according to KDIGO criteria. Patients were stratified into two groups according to estimated glomerular filtration rate (eGFR). RESULTS: The prevalence of AKI in patients group without CKD after CABG was 11,5% (n=59), in CKD-AKI group – 12,3% (n=39). In patients with CKD and after intraoperative inotropic/vasopressor therapy use of only 2 medicinal drugs of this group the probability of AKI development increases 11,16 times (OR 11,46; 95% CI 3,47- 37,83; р<0,01). During complete bypass (CB) when haematocrit decreases on 1% AKI probability increases on 12,36% (OR 0,89; 95% CI 0,81-0,98; р=0,02). The necessity of haemodialisys, duration of stay in intensive care unit and hospitalization duration were equal to all groups. AKI-CKD development significantly increases intrahospital mortality (p<0,05). CONCLUSIONS : History of CKD increases probability of severe AKI and also mortality in early postoperative period. Revealed risk factors for AKI development are potentially modifiable.