The effect of time between angiography and coronary artery bypass grafting on postoperative acute kidney injury in patients with diabetes mellitus Diabetes mellituslu hastalarda anjiyografi ve koroner arter baypas greftleme arasindaki zamanin ameliyat sonrasi akut böbrek hasari üzerine etkisi
Turkish Journal of Thoracic and Cardiovascular Surgery, cilt.27, sa.1, ss.1-8, 2019 (SCI-Expanded, Scopus, TRDizin)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 27 Sayı: 1
- Basım Tarihi: 2019
- Doi Numarası: 10.5606/tgkdc.dergisi.2019.16216
- Dergi Adı: Turkish Journal of Thoracic and Cardiovascular Surgery
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, TR DİZİN (ULAKBİM)
- Sayfa Sayıları: ss.1-8
- Anahtar Kelimeler: Acute kidney injury, coronary angiography, coronary artery bypass grafting, diabetes mellitus
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Background: This study aims to investigate the effect of time interval between coronary angiography and coronary artery bypass grafting surgery on postoperative acute kidney injury in patients with diabetes mellitus. Methods: Between December 2013 and November 2016, a total of 421 diabetic patients (274 males, 147 females; mean age 60±9.2 years; range, 31 to 84 years) who underwent coronary artery bypass grafting were included in the study. Data including demographic characteristics of the patients, comorbidities, medical, and surgical histories, previous coronary angiographies, and operative and laboratory results were retrospectively analyzed. The patients were divided into two groups as those with acute kidney injury (n=108) and those without acute kidney injury (n=313). The Risk, Injury, Failure, Loss, End-Stage Kidney Disease (RIFLE) criteria were used to define acute kidney injury. The patients were further classified into three subgroups according to the time interval: 0-3 days, 4-7 days, and > 7 days. Results: There was no statistically significant difference in the median time between coronary angiography and coronary artery bypass grafting between the patients with and without acute kidney injury (11.5 and 12.0 days; respectively p=0.871). There was no significant difference in the risk factors for acute kidney injury among the subgroups. Multivariate analysis revealed that previous myocardial infarction (odds ratio [OR]: 5.192, 95% confidence interval [CI]: 2.176-12.38; p < 0.001) and the increase in the creatinine levels in the first postoperative day (OR: 4.102 and 95% CI: 1.278- 13.17; p=0.018) were independent predictors of acute kidney injury. Conclusion: Coronary artery bypass grafting can be performed without any delay after coronary angiography without an increase in the postoperative risk of acute kidney injury in patients with diabetes mellitus. Amaç: Bu çalişmada diabetes mellituslu hastalarda koroner anjiyografi ve koroner arter baypas greftleme arasinda geçen zamanin ameliyat sonrasi akut böbrek hasari üzerindeki etkisi araştirildi. çalişma plani: Aralik 2013 - Kasim 2016 tarihleri arasinda koroner arter baypas greftleme yapilan toplam 421 hasta (274 erkek, 147 kadin; ort. yaş 60±9.2 yil; dağilim 31-84 yil) çalişmaya alindi. Hastalarin demografik özellikleri, eşlik eden hastaliklari, tibbi ve cerrahi öyküleri, daha önce yapilan koroner anjiyografileri ve cerrahi ve laboratuvar sonuçlari dahil olmak üzere veriler retrospektif olarak incelendi. Hastalar akut böbrek hasari olanlar (n=108) ve akut böbrek hasari olmayanlar (n=313) olmak üzere iki gruba ayrildi. Akut böbrek hasari, Risk, Hasar, Yetmezlik, Kayip, Son Dönem Böbrek Hastaliği (RIFLE) kriterlerine göre tanimlandi. Ayrica hastalar zaman araliğina göre üç alt gruba ayrildi: 0-3 gün, 4-7 gün ve > 7 gün. Bulgular: Koroner anjiyografi ve koroner arter baypass greftleme arasinda geçen medyan süre açisindan akut böbrek hasari olan ve olmayan hastalar arasinda istatistiksel olarak anlamli bir fark yoktu (sirasiyla, 11.5 ve 12.0 gün; p=0.871). Akut böbrek hasari risk faktörleri açisindan alt gruplar arasinda anlamli bir fark yoktu. çok değişkenli analizde geçirilmiş miyokard enfarktüsü (olasilik orani [OR]: 5.192, %95 güven araliği [GA]: 2.176-12.38; p < 0.001) ve ameliyat sonrasi birinci gün kreatinin düzeylerindeki artişin [OR: 4.102, %95 GA: 1.278-13.17; p=0.018) akut böbrek hasarinin bağimsiz belirleyicileri olduğu bulundu. Sonuç: Diabetes mellituslu hastalarda koroner anjiyografiden sonra, akut böbrek hasari riskinde artiş olmaksizin, herhangi bir gecikme olmadan koroner arter baypas greftleme yapilabilir.