Skip to main content
Journal cover image

The risk of acute kidney injury with co-occurrence of anemia and hypotension during cardiopulmonary bypass relative to anemia alone.

Publication ,  Journal Article
Sickeler, R; Phillips-Bute, B; Kertai, MD; Schroder, J; Mathew, JP; Swaminathan, M; Stafford-Smith, M
Published in: Ann Thorac Surg
March 2014

BACKGROUND: Postoperative acute kidney injury (AKI) is a common serious consequence of cardiac surgery. One recent study found higher AKI rates when anemia and hypotension occurred during cardiopulmonary bypass (CPB) relative to anemia alone. To revalidate this post hoc observation we analyzed detailed data from a large cardiac surgery cohort. METHODS: Patient, procedural, and outcome data were collected for nonemergent aortocoronary bypass and valve surgeries between July 2001 and September 2012. The occurrence of AKI (as defined by the Acute Kidney Injury Network criteria) was analyzed relative to known renal risk factors, and CPB hematocrit and blood pressure determinations in univariate and multivariable linear regression analyses. RESULTS: In our 3,963-patient cohort, we did not observe different AKI rates with the co-occurrence of anemia and hypotension relative to anemia alone (41.6% versus 44.3%; p = 0.39). Secondary analyses using linear definitions for AKI, CPB anemia, and hypotensive burden, and assessing for coincident timing also did not demonstrate significant association of anemia and hypotension with AKI risk relative to anemia alone. CONCLUSIONS: In a large cohort of cardiac surgery patients, we did not confirm any association of cardiac surgery-related AKI risk with the co-occurrence of hypotension and anemia during CPB relative to anemia alone. More detailed analyses also failed to support an anemia-hypotension interaction. Additional studies are required to better understand the relationship among anemia, hypotension during CPB, and postoperative AKI, but existing evidence is insufficient to support changes in clinical practice.

Duke Scholars

Published In

Ann Thorac Surg

DOI

EISSN

1552-6259

Publication Date

March 2014

Volume

97

Issue

3

Start / End Page

865 / 871

Location

Netherlands

Related Subject Headings

  • Risk Factors
  • Retrospective Studies
  • Respiratory System
  • Postoperative Complications
  • Middle Aged
  • Male
  • Intraoperative Complications
  • Hypotension
  • Humans
  • Female
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Sickeler, R., Phillips-Bute, B., Kertai, M. D., Schroder, J., Mathew, J. P., Swaminathan, M., & Stafford-Smith, M. (2014). The risk of acute kidney injury with co-occurrence of anemia and hypotension during cardiopulmonary bypass relative to anemia alone. Ann Thorac Surg, 97(3), 865–871. https://doi.org/10.1016/j.athoracsur.2013.09.060
Sickeler, Robert, Barbara Phillips-Bute, Miklos D. Kertai, Jacob Schroder, Joseph P. Mathew, Madhav Swaminathan, and Mark Stafford-Smith. “The risk of acute kidney injury with co-occurrence of anemia and hypotension during cardiopulmonary bypass relative to anemia alone.Ann Thorac Surg 97, no. 3 (March 2014): 865–71. https://doi.org/10.1016/j.athoracsur.2013.09.060.
Sickeler R, Phillips-Bute B, Kertai MD, Schroder J, Mathew JP, Swaminathan M, et al. The risk of acute kidney injury with co-occurrence of anemia and hypotension during cardiopulmonary bypass relative to anemia alone. Ann Thorac Surg. 2014 Mar;97(3):865–71.
Sickeler, Robert, et al. “The risk of acute kidney injury with co-occurrence of anemia and hypotension during cardiopulmonary bypass relative to anemia alone.Ann Thorac Surg, vol. 97, no. 3, Mar. 2014, pp. 865–71. Pubmed, doi:10.1016/j.athoracsur.2013.09.060.
Sickeler R, Phillips-Bute B, Kertai MD, Schroder J, Mathew JP, Swaminathan M, Stafford-Smith M. The risk of acute kidney injury with co-occurrence of anemia and hypotension during cardiopulmonary bypass relative to anemia alone. Ann Thorac Surg. 2014 Mar;97(3):865–871.
Journal cover image

Published In

Ann Thorac Surg

DOI

EISSN

1552-6259

Publication Date

March 2014

Volume

97

Issue

3

Start / End Page

865 / 871

Location

Netherlands

Related Subject Headings

  • Risk Factors
  • Retrospective Studies
  • Respiratory System
  • Postoperative Complications
  • Middle Aged
  • Male
  • Intraoperative Complications
  • Hypotension
  • Humans
  • Female