Acute kidney injury after coronary artery bypass grafting: Does rhabdomyolysis play a role?
Acute kidney injury after coronary artery bypass grafting: Does rhabdomyolysis play a role?
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DOI：
10.1016/j.jtcvs.2010.03.028
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发表时间：
2010-08-01
影响因子：
6
通讯作者：
Sinatra, Riccardo
中科院分区：
文献类型：
--
作者：
Benedetto, Umberto;Angeloni, Emiliano;Sinatra, Riccardo
目的：在临床上横纹肌溶解症是常见的，肾功能不全与肌红蛋白血症是很好的描述。冠状动脉旁路移植术后，血清肌红蛋白浓度的迅速增加，一般看到，但是否可能独立增加急性肾损伤的风险仍有待确定。方法：研究人群包括731例连续接受冠状动脉旁路移植术的患者。术前和术后评估每例患者的肌酸激酶、肌红蛋白和肌酐浓度。急性肾损伤定义为血清肌酐浓度绝对增加0.3 mg/dL或更高。结果：总体而言，295（40.3%）的731例患者有急性肾损伤。急性肾损伤患者的风险状况明显更差，731例患者中有31例（4.2%）需要透析。急性肾损伤与主动脉开放1小时后血清肌红蛋白浓度升高相关（534 μ g/mL [分位数范围，354-733 μ g/mL] vs 377 μ g/mL [分位数范围，278-528 μ g/mL]，P
Objective: In clinical situations in which rhabdomyolysis is common, renal dysfunction association with myoglobinemia is well described. After coronary artery bypass grafting, a rapid increase in serum myoglobin concentration is generally seen, but whether it might independently increase the risk of acute kidney injury remains to be determined.Methods: The study population consisted of 731 consecutive patients undergoing coronary artery bypass grafting. Creatine kinase, myoglobin, and creatinine concentrations were assessed in each patient preoperatively and postoperatively. Acute kidney injury was defined as an absolute increase in serum creatinine concentration of 0.3 mg/dL or greater.Results: Overall, 295 (40.3%) of 731 patients had acute kidney injury. Patients' risk profiles were significantly worse in those with acute kidney injury, and 31 (4.2%) of 731 patients required dialysis. Acute kidney injury was associated with a higher increase in serum myoglobin concentration after 1 hour from aortic declamping (534 mu g/mL [interquantile range, 354-733 mu g/mL] vs 377 mu g/mL [interquantile range, 278-528 mu g/mL], P