Risk of Acute Renal Failure Requiring Renal Replacement Therapy after Cardiac Surgery


Background: Acute renal failure is a rare but serious complication following
cardiac surgery and associated with increased mortality and morbidity.
Objective:To identify factors associated with mortality and mortality of
patients with acute renal failure after cardiac surgery treated with continuous
renal replacement therapy.
Method: This was a cohort retrospective study on cardiac surgery patients
who developed acute renal failure requiring renal replacement therapy after
surgery in Harapan Kita National Cardiac Center between January 2011
and April 2012. Data was retrieved from medical record and consisted
of pre-operative, intra-operative, and post-operative variables. Risk factor
identification was done using multivariate logistic regression analysis,
whereas relative risk analysis was applied to know the association between
risk factor and morbidity. Direct or indirect effect of variables on renal failure
was analyzed using Barttlet’s and anti-image correlation test.
Results: A total of 110 cases were obtained during the study period; 70
(63.3%) among them were men. Patients mean age was 57.6 years. Preoperative
renal failure, New York Heart Association Functional Classification
Class (NYHA) class IV, critical condition, coronary revascularization surgery
and bleeding, post-operative anemia, bleeding and venous saturation <65%
showed a trend of mortality and morbidity rate between 0.1 and 9.1. The
Keiser-Meyer-Olkin (KMO) value and Barttlet’s test showed that re-surgery,
bleeding and low inotropic score resulted in 31.63% probability of having
post-operative renal failure.
Conclusion: Re-surgery, bleeding and inotropic use may result in postoperative
renal failure.


Download data is not yet available.


Castelli P,Condemi A,Munari M.Intra-aortric balloon counter
pulsation:outcome in cardiac surgical patients. J CardiothoracVascAnesth. 2001;15:700-3.

Veli K, Faisal H, Cheema. Surgery for coronary artery disease. Coronary artery bypass grafting in patients with low ejection fraction. Circulation. 2005;112:344-50.

Hayashida N,Chihara S,Tayama E.Coronary.Coronary artery
bypass grafting in patients with mild renal insufficiency.Jpn Circ J. 2001;65:28-32.

Haase M, Bellomo R, Story D, Letis A. Effect of mean arterial pressure, haemoglobin and blood transfusion during cardiopulmonary bypass on post-operative acute kidney injury. Nephrol Dial Transplant.2011;0:1-8.

Edwards. Understanding continuous mixed venous oxygen saturation monitoring with the Swan-Ganz oximetry TD system.

Shahin J, DeVarennes B, Tse CW. The relationship between inotrope exposure, six-hour postoperative physiological variables, hospital mortality and renal dysfunction in patients undergoing cardiac surgery.Critical Care. 2011;15:R162.

Valdivieso JP, Monedero P, Vives M, Fernandez NG. Cardiacsurgery associated acute kidney injury requiring renal replacement therapy. A Spanish retrospective case-cohort study.BMC Nephrology. 2009;10:27.

Bhatti, Grayson AD, Grotte G, Fabri BM. The Logistic Euro
SCORE in cardiac surgery: How well does it predict operative
risk? Heart.2006;92(12):1817-20.

Hans JG, Phillip H, Sascha M. Risk stratification in heart surgery: comparison of six score systems. Eur J Cardio Thoracic Surg. 2000;17:400-6.

Bent P, Tan HK, Bellomo R. Early and intensive continuous
hemofiltration for severe renal failure after cardiac surgery. Ann Thorac Surg. 2001;71:832-7.

Mehta R. Acute renal failure and cardiac surgery: marching in place or moving ahead? J Am Soc Nephrol. 2005;1

Caenegem OV, Jacquet LM. Outcome of cardiac surgery patients
with complicated intensive care unit stay.CurrOpin Critical
Care. 2002;8:404-10.

Engelman DT, Adams DH, Byrne JG.Impact of body mass
index and albumin on morbidity and mortality after cardiac
surgery. J ThoracCardiovasc Surg. 1999;18:866-73.

Rosner M, Okusa MD. Acute kidney injury associated with
cardiac surgery.Circulation. 2009;119:495-502.

Haase M, Bellomo R. Novel biomarkers, oxidative stress, and
the role of labile iron toxicity in cardiopulmonary bypass-associated acute kidney injury. J Am CollCardiol. 2010;55:2024-33.
Views & Downloads
Abstract views: 105   
PDF downloads: 31   
How to Cite
Risk of Acute Renal Failure Requiring Renal Replacement Therapy after Cardiac Surgery. (2014). Indonesian Journal of Cardiology, 34(3), 147-53. https://doi.org/10.30701/ijc.v34i3.335
Clinical Research