Acute Post-cardiac Surgery Renal Failure: Prevention Through Individualized Intensive Hemodynamic Management

Launched by HOSPITAL CLINIC OF BARCELONA · Jul 1, 2019

Keywords

ClinConnect Summary

BACKGROUND:

The incidence of acute kidney injury (AKI) in patients undergoing cardiac surgery can reach 35% and between 2 and 5% require kidney replacement therapy during the AKI episode. The development of AKI n this context is independently associated with higher long-term mortality (5-10 years). In addition, there is strong evidence that an episode of AKI in the hospital increases the risk of developing chronic kidney disease in the medium-long term. That is why the prevention of AKI is essential to reduce the morbidity that these patients suffer in the hospital and out-of-hospital envi...

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Eligibility criteria

• Inclusion Criteria:
• • Patients undergoing elective or urgent heart surgery with extracorporeal circulation at the Hospital Clínic de Barcelona.
• • Valve and/or aortocoronary bypass surgery
• • Risk of AKI \>30% according to the Leicester Cardiosurgery scale
• Exclusion Criteria:
• • End-stage kidney disease stage V
• • Patients with AKI in the 7 days prior to surgery
• • Interstitial glomerulonephritis or vasculitis
• • Pregnancy
• • Kidney transplant
• • Endocarditis
• • Patients with mechanical assistance devices (ECMO, LVAD, RVAD, IABP)
• • Inclusion in another clinical intervention test during the intervention period
• • Emergence surgery
• • Patients in need of pressure-directed therapy of cerebral infusion.
• • Constrictive pericarditis