Continuous renal replacement therapy after cardiac surgery in patients with acute renal failure

摘要

Aim Acute renal failure is an important adverse effect of cardiopulmonarybypass that can result in high mortality or morbidityrates. It can be treated with continuous renal replacement therapyafter cardiac surgery. The purpose of this study was to determinethe factors associated with the mortality and incidence of acuterenal failure in patients of post cardiac surgery.Methods Patients (1564) who underwent cardiac surgery betweenJanuary 2007 and January 2012 and treated with continuous renalreplacement therapy were included (N=40). Patients with previousrenal disorders were excluded. A retrospective analysis wascarried out.Results Overall, continuous renal replacement therapy was usedin 40 (2.6%) patients. The mean age was 62.7±11 years. Meanduration of cardiopulmonary bypass was 166±80 min, and aortacross-clamping time was 97±35 min. The patients’ mean pretherapycreatinine level and mean creatinine level before hospitaldischarge were 3.3±1.1 mg/dL and 1.1±0.4 mg/dl, respectively.Thirty-day mortality was 35%. Only 6 patients required long-termrenal replacement therapy.Conclusion Acute renal failure requiring hemodialysis after cardiacsurgery is associated with higher mortality and morbidity andprolonged hospital stay. Early renal recovery with continuous renalreplacement therapy seems to offer an evident survival benefit.Continuous renal replacement therapy may represent an importanttherapy and reduce mortality rates. We believe that these rates mightdecrease even more with detailed preoperative evaluation andmeticulous postoperative care with collaborative management