Current status of research on models for predicting acute kidney injury following cardiac surgery_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

WU Dongchen ¹ , WANG Qi ¹ ,  ZHANG Yangyang ²

1. Clinical Medical College of Nanjing Medical University, Nanjing, 210029, P.R.China;
2. Department of Cardiovascular Surgery, Dongfang Hospital Affiliated to Shanghai Tongji University, Shanghai, 200120, P.R.China;

Corresponding author：

ZHANG Yangyang, Email: zhangyangyang_md@sina.com

Keywords：

Cardiac surgery; acute kidney injury; risk prediction models

DOI：

10.7507/1007-4848.201612020

Video：

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Acute kidney injury (AKI) is a complication with high morbidity and mortality after cardiac surgery. In order to predict the incidence of AKI after cardiac surgery, many risk prediction models have been established worldwide. We made a detailed introduction to the composing features, clinical application and predictive capability of 14 commonly used models. Among the 14 risk prediction models, age, congestive heart failure, hypertension, left ventricular ejection fraction, diabetes, cardiac valve surgery, coronary artery bypass grafting (CABG) combined with cardiac valve surgery, emergency surgery, preoperative creatinine, preoperative estimated glomerular filtration rate (eGFR), preoperative New York Heart Association (NYHA) score>Ⅱ, previous cardiac surgery, cadiopulmonary bypass (CPB) time and low cardiac output syndrome (LCOS) are included in many risks prediction models (>3 times). In comparison to Mehta and SRI models, Cleveland risk prediction model shows the best discrimination for the prediction of renal replacement therapy (RRT)-AKI and AKI in the European. However, in Chinese population, the predictive ability of the above three risk prediction models for RRT-AKI and AKI is poor.

Citation： WU Dongchen, WANG Qi, ZHANG Yangyang. Current status of research on models for predicting acute kidney injury following cardiac surgery. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2018, 25(3): 237-248. doi: 10.7507/1007-4848.201612020 Copy

1.	Chertow GM, Levy EM, Hammermeister KE, et al. Independent association between acute renal failure and mortality following cardiac surgery. Am J Med, 1998, 104(4): 343-348.
2.	Mangano CM, Diamondstone LS, Ramsay JG, et al. Renal dysfunction after myocardial revascularization: risk factors, adverse outcomes, and hospital resource utilization. The Multicenter Study of Perioperative Ischemia Research Group. Ann Intern Med, 1998, 128(3): 194-203.
3.	Anderson RJ, O'brien M, MaWhinney S, et al. Renal failure predisposes patients to adverse outcome after coronary artery bypass surgery. VA Cooperative Study #5. Kidney Int, 1999, 55(3): 1057-1062.
4.	Conlon PJ, Stafford-Smith M, White WD, et al. Acute renal failure following cardiac surgery. Nephrol Dial Transplant, 1999, 14(5): 1158-1162.
5.	Andersson LG, Ekroth R, Bratteby LE, et al. Acute renal failure after coronary surgery--a study of incidence and risk factors in 2009 consecutive patients. Thorac Cardiovasc Surg, 1993, 41(4): 237-241.
6.	Conlon PJ, Stafford-Smith M, White WD, et al. Acute renal failure following cardiac surgery. Nephrol Dial Transplant, 1999, 14(5): 1158-1162.
7.	Mangano CM, Diamondstone LS, Ramsay JG, et al. Renal dysfunction after myocardial revascularization: risk factors, adverse outcomes, and hospital resource utilization. The Multicenter Study of Perioperative Ischemia Research Group. Ann Intern Med, 1998, 128(3): 194-203.
8.	Thakar CV, Liangos O, Yared JP, et al. ARF after open-heart surgery: Influence of gender and race. Am J Kidney Dis, 2003, 41(4): 742-751.
9.	Ostermann ME, Taube D, Morgan CJ, et al. Acute renal failure following cardiopulmonary bypass: a changing picture. Intensive Care Med, 2000, 26(5): 565-571.
10.	Rosner MH, Okusa MD. Acute kidney injury associated with cardiac surgery. Clin J Am Soc Nephrol, 2006, 1(1): 19-32.
11.	Lau G, Wald R, Sladen R, et al. Acute kidney injury in cardiac surgery and cardiac intensive care. Semin Cardiothorac Vasc Anesth, 2015, 19(4): 270-287.
12.	Corredor C, Thomson R, Al-Subaie N. Long-term consequences of acute kidney injury after cardiac surgery: A systematic review and meta-analysis. J Cardiothorac Vasc Anesth, 2016, 30(1): 69-75.
13.	Hansen MK, Gammelager H, Jacobsen CJ, et al. Acute kidney injury and long-term risk of cardiovascular events after cardiac surgery: A population-based cohort study. J Cardiothorac Vasc Anesth, 2015, 29(3): 617-625.
14.	Gude D, Jha R. Acute kidney injury following cardiac surgery. Ann Card Anaesth, 2012, 15(4): 279-286.
15.	Arora P, Kolli H, Nainani N, et al. Preventable risk factors for acute kidney injury in patients undergoing cardiac surgery. J Cardiothorac Vasc Anesth, 2012, 26(4): 687-697.
16.	Vives M, Wijeysundera D, Marczin N, et al. Cardiac surgery-associated acute kidney injury. Interact Cardiovasc Thorac Surg, 2014, 18(5): 637-645.
17.	Hashemzadeh K, Hashemzadeh S, Dehdilani M. Risk factors and outcomes of acute renal failure after open cardiac surgery. Asian Cardiovasc Thorac Ann, 2012, 20(3): 275-280.
18.	Palomba H, de Castro I, Neto AL, et al. Acute kidney injury prediction following elective cardiac surgery: AKICS Score. Kidney Int, 2007, 72(5): 624-631.
19.	何雨新, 张杨杨. 心脏术后急性肾损伤的研究进展. 外科研究与新技术. 2015, 4(1): 57-63.
20.	Chertow GM, Lazarus JM, Christiansen CL, et al. Preoperative renal risk stratification. Circulation, 1997, 95(4): 878-884.
21.	Thakar CV, Arrigain S, Worley S, et al. A clinical score to predict acute renal failure after cardiac surgery. J Am Soc Nephrol, 2005, 16(1): 162-168.
22.	Mehta RH, Grab JD, O'Brien SM, et al. Bedside tool for predicting the risk of postoperative dialysis in patients undergoing cardiac surgery. Circulation, 2006, 114(21): 2208-2216.
23.	刘上, 严玉澄. 心脏手术后急性肾损伤预测评分系统的建立和进展. 上海医学, 2011, 34(1): 81-84.
24.	Wijeysundera DN, Karkouti K, Dupuis JY, et al. Derivation and validation of a simplified predictive index for renal replacement therapy after cardiac surgery. JAMA, 2007, 297(16): 1801-1809.
25.	姜物华. 心脏手术后急性肾损伤发病预测模型的建立与临床验证. 复旦大学, 2013.1-30.
26.	Pannu N, Graham M, Klarenbach S, et al. A new model to predict acute kidney injury requiring renal replacement therapy after cardiac surgery. CMAJ, 2016, 188(15):1076-1083.
27.	Aronson S, Fontes ML, Miao Y, et al. Risk index for perioperative renal dysfunction/failure: critical dependence on pulse pressure hypertension. Circulation, 2007, 115(6): 733-742.
28.	Brown JR, Cochran RP, Leavitt BJ, et al. Multivariable prediction of renal insufficiency developing after cardiac surgery. Circulation, 2007, 116(11 Suppl): I139-I143.
29.	Mithiran H, Kunnath Bonney G, Bose S, et al. A Score for Predicting Acute Kidney Injury After Coronary Artery Bypass Graft Surgery in an Asian Population. J Cardiothorac Vasc Anesth, 2016, 30(5): 1296-1301.
30.	Nah CW, Ti LK, Liu W, et al. A clinical score to predict acute kidney injury after cardiac surgery in a Southeast-Asian population. Interact Cardiovasc Thorac Surg, 2016, 23(5): 757-761.
31.	Jorge-Monjas P, Bustamante-Munguira J, Lorenzo M, et al. Predicting cardiac surgery-associated acute kidney injury: The CRATE score. J Crit Care, 2016, 31(1): 130-138.
32.	Kim WH, Lee SM, Choi JW, et al. Simplified clinical risk score to predict acute kidney injury after aortic surgery. J Cardiothorac Vasc Anesth, 2013, 27(6): 1158-1166.
33.	Jiang W, Teng J, Xu J, et al. Dynamic predictive scores for cardiac surgery-associated acute kidney injury. J Am Heart Assoc, 2016, 5(8). pii: e003754.
34.	Englberger L, Suri RM, Li Z, et al. Validation of clinical scores predicting severe acute kidney injury after cardiac surgery. Am J Kidney Dis, 2010, 56(4): 623-631.
35.	Kristovic D, Horvatic I, Husedzinovic I, et al. Cardiac surgery-associated acute kidney injury: risk factors analysis and comparison of prediction models. Interact Cardiovasc Thorac Surg, 2015, 21(3): 366-373.
36.	高卿, 李辉, 陈生龙, 等. Cleveland 评分和 SRI 评分对于择期不停跳冠状动脉旁路移植术后急性肾功能损伤预测价值的探讨. 中国循环杂志, 2012, 27(5): 379-382.

1. Chertow GM, Levy EM, Hammermeister KE, et al. Independent association between acute renal failure and mortality following cardiac surgery. Am J Med, 1998, 104(4): 343-348.
2. Mangano CM, Diamondstone LS, Ramsay JG, et al. Renal dysfunction after myocardial revascularization: risk factors, adverse outcomes, and hospital resource utilization. The Multicenter Study of Perioperative Ischemia Research Group. Ann Intern Med, 1998, 128(3): 194-203.
3. Anderson RJ, O'brien M, MaWhinney S, et al. Renal failure predisposes patients to adverse outcome after coronary artery bypass surgery. VA Cooperative Study #5. Kidney Int, 1999, 55(3): 1057-1062.
4. Conlon PJ, Stafford-Smith M, White WD, et al. Acute renal failure following cardiac surgery. Nephrol Dial Transplant, 1999, 14(5): 1158-1162.
5. Andersson LG, Ekroth R, Bratteby LE, et al. Acute renal failure after coronary surgery--a study of incidence and risk factors in 2009 consecutive patients. Thorac Cardiovasc Surg, 1993, 41(4): 237-241.
6. Conlon PJ, Stafford-Smith M, White WD, et al. Acute renal failure following cardiac surgery. Nephrol Dial Transplant, 1999, 14(5): 1158-1162.
7. Mangano CM, Diamondstone LS, Ramsay JG, et al. Renal dysfunction after myocardial revascularization: risk factors, adverse outcomes, and hospital resource utilization. The Multicenter Study of Perioperative Ischemia Research Group. Ann Intern Med, 1998, 128(3): 194-203.
8. Thakar CV, Liangos O, Yared JP, et al. ARF after open-heart surgery: Influence of gender and race. Am J Kidney Dis, 2003, 41(4): 742-751.
9. Ostermann ME, Taube D, Morgan CJ, et al. Acute renal failure following cardiopulmonary bypass: a changing picture. Intensive Care Med, 2000, 26(5): 565-571.
10. Rosner MH, Okusa MD. Acute kidney injury associated with cardiac surgery. Clin J Am Soc Nephrol, 2006, 1(1): 19-32.
11. Lau G, Wald R, Sladen R, et al. Acute kidney injury in cardiac surgery and cardiac intensive care. Semin Cardiothorac Vasc Anesth, 2015, 19(4): 270-287.
12. Corredor C, Thomson R, Al-Subaie N. Long-term consequences of acute kidney injury after cardiac surgery: A systematic review and meta-analysis. J Cardiothorac Vasc Anesth, 2016, 30(1): 69-75.
13. Hansen MK, Gammelager H, Jacobsen CJ, et al. Acute kidney injury and long-term risk of cardiovascular events after cardiac surgery: A population-based cohort study. J Cardiothorac Vasc Anesth, 2015, 29(3): 617-625.
14. Gude D, Jha R. Acute kidney injury following cardiac surgery. Ann Card Anaesth, 2012, 15(4): 279-286.
15. Arora P, Kolli H, Nainani N, et al. Preventable risk factors for acute kidney injury in patients undergoing cardiac surgery. J Cardiothorac Vasc Anesth, 2012, 26(4): 687-697.
16. Vives M, Wijeysundera D, Marczin N, et al. Cardiac surgery-associated acute kidney injury. Interact Cardiovasc Thorac Surg, 2014, 18(5): 637-645.
17. Hashemzadeh K, Hashemzadeh S, Dehdilani M. Risk factors and outcomes of acute renal failure after open cardiac surgery. Asian Cardiovasc Thorac Ann, 2012, 20(3): 275-280.
18. Palomba H, de Castro I, Neto AL, et al. Acute kidney injury prediction following elective cardiac surgery: AKICS Score. Kidney Int, 2007, 72(5): 624-631.
19. 何雨新, 张杨杨. 心脏术后急性肾损伤的研究进展. 外科研究与新技术. 2015, 4(1): 57-63.
20. Chertow GM, Lazarus JM, Christiansen CL, et al. Preoperative renal risk stratification. Circulation, 1997, 95(4): 878-884.
21. Thakar CV, Arrigain S, Worley S, et al. A clinical score to predict acute renal failure after cardiac surgery. J Am Soc Nephrol, 2005, 16(1): 162-168.
22. Mehta RH, Grab JD, O'Brien SM, et al. Bedside tool for predicting the risk of postoperative dialysis in patients undergoing cardiac surgery. Circulation, 2006, 114(21): 2208-2216.
23. 刘上, 严玉澄. 心脏手术后急性肾损伤预测评分系统的建立和进展. 上海医学, 2011, 34(1): 81-84.
24. Wijeysundera DN, Karkouti K, Dupuis JY, et al. Derivation and validation of a simplified predictive index for renal replacement therapy after cardiac surgery. JAMA, 2007, 297(16): 1801-1809.
25. 姜物华. 心脏手术后急性肾损伤发病预测模型的建立与临床验证. 复旦大学, 2013.1-30.
26. Pannu N, Graham M, Klarenbach S, et al. A new model to predict acute kidney injury requiring renal replacement therapy after cardiac surgery. CMAJ, 2016, 188(15):1076-1083.
27. Aronson S, Fontes ML, Miao Y, et al. Risk index for perioperative renal dysfunction/failure: critical dependence on pulse pressure hypertension. Circulation, 2007, 115(6): 733-742.
28. Brown JR, Cochran RP, Leavitt BJ, et al. Multivariable prediction of renal insufficiency developing after cardiac surgery. Circulation, 2007, 116(11 Suppl): I139-I143.
29. Mithiran H, Kunnath Bonney G, Bose S, et al. A Score for Predicting Acute Kidney Injury After Coronary Artery Bypass Graft Surgery in an Asian Population. J Cardiothorac Vasc Anesth, 2016, 30(5): 1296-1301.
30. Nah CW, Ti LK, Liu W, et al. A clinical score to predict acute kidney injury after cardiac surgery in a Southeast-Asian population. Interact Cardiovasc Thorac Surg, 2016, 23(5): 757-761.
31. Jorge-Monjas P, Bustamante-Munguira J, Lorenzo M, et al. Predicting cardiac surgery-associated acute kidney injury: The CRATE score. J Crit Care, 2016, 31(1): 130-138.
32. Kim WH, Lee SM, Choi JW, et al. Simplified clinical risk score to predict acute kidney injury after aortic surgery. J Cardiothorac Vasc Anesth, 2013, 27(6): 1158-1166.
33. Jiang W, Teng J, Xu J, et al. Dynamic predictive scores for cardiac surgery-associated acute kidney injury. J Am Heart Assoc, 2016, 5(8). pii: e003754.
34. Englberger L, Suri RM, Li Z, et al. Validation of clinical scores predicting severe acute kidney injury after cardiac surgery. Am J Kidney Dis, 2010, 56(4): 623-631.
35. Kristovic D, Horvatic I, Husedzinovic I, et al. Cardiac surgery-associated acute kidney injury: risk factors analysis and comparison of prediction models. Interact Cardiovasc Thorac Surg, 2015, 21(3): 366-373.
36. 高卿, 李辉, 陈生龙, 等. Cleveland 评分和 SRI 评分对于择期不停跳冠状动脉旁路移植术后急性肾功能损伤预测价值的探讨. 中国循环杂志, 2012, 27(5): 379-382.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Current status of research on models for predicting acute kidney injury following cardiac surgery

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