Palestinian Medical and Pharmaceutical Journal (Pal. Med. Pharm. J.)

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Abstract: Overview: Acute kidney injury (AKI) accounts for one to five percent of all hospital admissions. The most frequent cause of AKI in the intensive care unit (ICU) following infection is AKI following heart surgery. AKI is a frequent and dangerous side effect that occurs in 30–40% of adults and kids following CPB. Up to 5% of AKI cases require dialysis, and the death rate is close to 80%. On the other hand, mortality following heart surgery without AKI is within the range of 1% to 8%. Methodology: Observational prospective quantitative design study, 103 participants were included, preoperative risk factors, serum creatinine, demographic data collected, AKI post-cardiac surgery identified according to KDIGO criteria based on serum creatinine and urine output, the dynamic predictive scoring system used for risk prediction of AKI post-cardiac surgery. Results: The occurrence of acute kidney injury (AKI) among patients undergoing cardiac surgery at three large hospitals in the west bank was twenty-seven cases (26.2%) and 76 (26.2%) normal cases according to diagnostic criteria. The result showed that stage 1 (19.4%) was the highest group of patients, followed by 4.9% of cases were stage 2, and the lowest group was stage 3. Regarding sociodemographic and clinical data, the results showed no statistical significance between patients with and without AKI (P>0.05). The results showed that oliguria time was statistically significant among patients with AKI than those without (P<0.05). Also, vasopressors (Noradrenaline, Adrenaline, Dopamine, and Dobutamine) time higher statistically significant among patients with AKI compared to those without AKI (P<0.05). Serum creatinine on day 3 was statistically significantly higher among patients with AKI than those without AKI (P<0.05). In contrast, the table showed that it is not statistically significantly different between patients with and without AKI regarding other days, urine output, oliguria time, hypotension, and vasopressors such as Noradrenaline, Adrenaline, Dopamine, and Dobutamine (P>0.05). Conclusion: The incidence of acute kidney injury (AKI) among patients undergoing cardiac surgery is (26.2%), and the highest percentage was in stage 1 (19.4%), followed by (4.9%) in stage 2, and the lowest group was stage 3. AKI on day 3 post cardiac surgery showed a higher increase in serum creatinine, The oliguria time >6hrs, and Serum creatinine on day three are associated with the incidence of AKI. Recommendation: Further studies must be conducted in experimental design with a control group and a larger sample. Awareness about AKI post-cardiac surgery has to be increased including protocols and policies in the therapy regimen.

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Abstract: Overview: Acute kidney injury (AKI) accounts for one to five percent of all hospital admissions. The most frequent cause of AKI in the intensive care unit (ICU) following infection is AKI following heart surgery. AKI is a frequent and dangerous side effect that occurs in 30–40% of adults and kids following CPB. Up to 5% of AKI cases require dialysis, and the death rate is close to 80%. On the other hand, mortality following heart surgery without AKI is within the range of 1% to 8%. Methodology: Observational prospective quantitative design study, 103 participants were included, preoperative risk factors, serum creatinine, demographic data collected, AKI post-cardiac surgery identified according to KDIGO criteria based on serum creatinine and urine output, the dynamic predictive scoring system used for risk prediction of AKI post-cardiac surgery. Results: The occurrence of acute kidney injury (AKI) among patients undergoing cardiac surgery at three large hospitals in the west bank was twenty-seven cases (26.2%) and 76 (26.2%) normal cases according to diagnostic criteria. The result showed that stage 1 (19.4%) was the highest group of patients, followed by 4.9% of cases were stage 2, and the lowest group was stage 3. Regarding sociodemographic and clinical data, the results showed no statistical significance between patients with and without AKI (P>0.05). The results showed that oliguria time was statistically significant among patients with AKI than those without (P<0.05). Also, vasopressors (Noradrenaline, Adrenaline, Dopamine, and Dobutamine) time higher statistically significant among patients with AKI compared to those without AKI (P<0.05). Serum creatinine on day 3 was statistically significantly higher among patients with AKI than those without AKI (P<0.05). In contrast, the table showed that it is not statistically significantly different between patients with and without AKI regarding other days, urine output, oliguria time, hypotension, and vasopressors such as Noradrenaline, Adrenaline, Dopamine, and Dobutamine (P>0.05). Conclusion: The incidence of acute kidney injury (AKI) among patients undergoing cardiac surgery is (26.2%), and the highest percentage was in stage 1 (19.4%), followed by (4.9%) in stage 2, and the lowest group was stage 3. AKI on day 3 post cardiac surgery showed a higher increase in serum creatinine, The oliguria time >6hrs, and Serum creatinine on day three are associated with the incidence of AKI. Recommendation: Further studies must be conducted in experimental design with a control group and a larger sample. Awareness about AKI post-cardiac surgery has to be increased including protocols and policies in the therapy regimen.