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International Journal of Nephrology - Volume 2015 2015, Article ID 237951, 8 pages -

Research Article

Division of Nephrology and Hypertension, Department of Medicine, Mayo Clinic College of Medicine, Rochester, MN 55905, USA

Division of Anesthesiology, Mayo Clinic College of Medicine, Rochester, MN 55905, USA

Department of Surgery, Mayo Clinic College of Medicine, Rochester, MN 55905, USA

Received 12 January 2015; Revised 5 April 2015; Accepted 23 April 2015

Academic Editor: Danuta Zwolinska

Copyright © 2015 Michael A. Mao et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. The study investigates the occurrence, severity, and outcomes of acute kidney injury AKI in octogenarians following heart valve surgery. Methods. All patients, age 80 years, not on dialysis and without kidney transplant, undergoing heart valve replacement at Mayo Clinic, Rochester, in the years 2002-2003 were enrolled. AKI was diagnosed based on AKIN criteria. Results. 209 octogenarians 88.0% aortic valve, 6.2% mitral valve, 1.0% tricuspid valve, and 4.8% multivalve with 58.4% and without CABG were studied. 34 16.3% had preexisting CKD. After surgery, 98 46.8% developed AKI. 76.5% of the AKI were in Stage 1, 9.2% in Stage 2, and 14.3% in Stage 3. 76.5% CKD patients developed AKI. Length of hospital stay was longer for AKI patients. More AKI patients were discharged to care facilities. Patient survival at 30 days and 1 year for AKI versus non-AKI was 88.8 versus 98.7%, , and 76.5 versus 88.3%, , respectively. With follow-up of years, Kaplan-Meier analysis showed a reduced survival for AKI octogenarians. Preexisting CKD and large volume intraoperative fluid administration were independent AKI predictors. Conclusions. Nearly half of the octogenarians developed AKI after valve replacement surgery. AKI was associated with significant functional impairment and reduced survival.





Autor: Michael A. Mao, Charat Thongprayoon, YiFan Wu, Vickram Tejwani, Myriam Vela-Ortiz, Joseph Dearani, and Qi Qian

Fuente: https://www.hindawi.com/



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