PMID- 21360471
OWN - NLM
STAT- MEDLINE
DCOM- 20120418
LR  - 20120427
IS  - 1724-6059 (Electronic)
IS  - 1121-8428 (Linking)
VI  - 24
IP  - 6
DP  - 2011 Nov-Dec
TI  - Preoperative left ventricular dysfunction predisposes to postoperative acute 
      kidney injury and long-term mortality.
PG  - 764-70
LID - 10.5301/JN.2011.6384 [doi]
AB  - BACKGROUND: Both preoperative left ventricular dysfunction (LVD) and acute kidney 
      injury (AKI) in the postoperative period are independently associated with 
      mortality. We evaluated the prevalence and prognostic implications of AKI in a 
      cohort of vascular surgery patients. METHODS: Before vascular surgery, 1,158 
      patients were screened for LVD. Development of AKI, defined by RIFLE 
      classification, was detected by serial serum creatinine measurements at days 1 to 
      3 after surgery. Primary end point was cardiovascular mortality during a median 
      follow-up of 2.2 years (interquartile range [IQR] 1.0-4.0). RESULTS: LVD was 
      present in 558 patients (48%), and 120 patients (10%) developed postoperative 
      AKI. Subjects with LVD developed postoperative AKI more often than patients 
      without LVD (8% vs. 13%, p=0.01). Patients were categorized as (i) no LVD, 
      without AKI (n=551, 48%), (ii) LVD without AKI (n=487, 42%), (iii) no LVD, with 
      AKI (n=49, 4%) and (iv) LVD with AKI (n=71/6%). Patients with LVD prior to 
      surgery who developed postoperative AKI had the highest cardiovascular mortality 
      risk (hazard ratio = 4.9; 95% confidence interval, 2.9-8.2). CONCLUSION: Patients 
      with preoperatively LVD have an increased risk of developing AKI after vascular 
      surgery. The occurrence of AKI in patients with LVD has an incremental predictive 
      value toward cardiovascular mortality risk during long-term follow-up.
FAU - van Kuijk, Jan-Peter
AU  - van Kuijk JP
AD  - Department of Vascular Surgery, Erasmus Medical Center, Rotterdam, The 
      Netherlands.
FAU - Flu, Willem-Jan
AU  - Flu WJ
FAU - Valentijn, Tabita M
AU  - Valentijn TM
FAU - Chonchol, Michel
AU  - Chonchol M
FAU - Voute, Michiel T
AU  - Voute MT
FAU - Kuiper, Ruud J
AU  - Kuiper RJ
FAU - Verhagen, Hence J M
AU  - Verhagen HJ
FAU - Bax, Jeroen J
AU  - Bax JJ
FAU - Poldermans, Don
AU  - Poldermans D
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - Italy
TA  - J Nephrol
JT  - Journal of nephrology
JID - 9012268
SB  - IM
MH  - Acute Kidney Injury/*epidemiology
MH  - Aged
MH  - Aged, 80 and over
MH  - Aortic Aneurysm, Abdominal/*surgery
MH  - Cardiovascular Diseases/diagnosis/*mortality
MH  - Carotid Artery Diseases/*surgery
MH  - Causality
MH  - Cohort Studies
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Kaplan-Meier Estimate
MH  - Male
MH  - Middle Aged
MH  - *Postoperative Period
MH  - *Preoperative Period
MH  - Prevalence
MH  - Prognosis
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Survival Rate
MH  - Ventricular Dysfunction, Left/*complications/diagnosis
EDAT- 2011/03/02 06:00
MHDA- 2012/04/19 06:00
CRDT- 2011/03/02 06:00
PHST- 2010/11/26 00:00 [accepted]
PHST- 2011/03/02 06:00 [entrez]
PHST- 2011/03/02 06:00 [pubmed]
PHST- 2012/04/19 06:00 [medline]
AID - 666C91E5-26A1-4C68-A3FE-98C3D3FD55C6 [pii]
AID - 10.5301/JN.2011.6384 [doi]
PST - ppublish
SO  - J Nephrol. 2011 Nov-Dec;24(6):764-70. doi: 10.5301/JN.2011.6384.