The impact of relative hypotension on acute kidney injury progression after cardiac surgery: a multicenter retrospective cohort study

Kotani, Yuki; Yoshida, Takuo; Kumasawa, Junji; Kamei, Jun; Taguchi, Akihisa; Kido, Koji; Yamaguchi, Naoki; Kariya, Takayuki; Nakasone, Masato; Mikami, Noriko; Koga, Takahiro; Nakayama, Izumi; Shibata, Mami; Yoshida, Tomonao; Nashiki, Hiroshi; Karatsu, Shinsuke; Nogi, Kazutaka; Tokuhira, Natsuko; Izawa, Junichi

doi:10.1186/s13613-021-00969-4

Annals of Intensive Care

Table 1 Patient characteristics and perioperative management

From: The impact of relative hypotension on acute kidney injury progression after cardiac surgery: a multicenter retrospective cohort study

	All N = 746	AKI group N = 120	Non-AKI group N = 626	p value
Age, years	71 [63–77]	72 [64–77]	70 [63–77]	0.58
Males, n (%)	464 (62)	73 (61)	391 (63)	0.76
Chronic hypertension, n (%)	546 (73)	88 (73)	458 (73)	1.0
Previous cardiac surgery, n (%)	74 (9.9)	18 (15)	56 (8.9)	0.047
LVEF, n (%)				0.72
> 50%	596 (80)	95 (79)	50.1 (80)
35–50%	120 (16)	22 (18)	98 (16)
20–34%	28 (3.8)	3 (2.5)	25 (4.0)
< 20%	2 (0.3)	0 (0)	2 (0.3)
Baseline serum creatinine, mg/dL	0.85 [0.70–1.03]	0.90 [0.77–1.08]	0.83 [0.70–1.01]	0.0051
Baseline MPP, mmHg	80 [74–88]	78 [71–85]	81 [74–88]	0.020
Baseline MAP, mmHg	85 [78–92]	83 [77–89]	85 [78–92]	0.089
Baseline CVP, mmHg	3 [3–6]	3 [3–6]	3 [3–6]	0.0013
Type of surgery, n (%)
CABG	257 (35)	37 (30.8)	220 (35.1)	0.40
Mitral valve	245 (33)	51 (42.5)	194 (31.0)	0.019
Aortic valve	358 (48)	60 (50.0)	298 (47.6)	0.69
Tricuspid valve	138 (19)	31 (25.8)	107 (17.1)	0.029
Pulmonary valve	9 (1.2)	0	9 (1.4)	0.37
Surgery time, minutes	342 [277–428]	351 [300–443]	340 [273–426]	0.25
Cardiopulmonary bypass	650 (87)	106 (88)	544 (87)	0.77
Cardiopulmonary bypass time, minutes^a	178 [135–231]	199 [147–238]	174 [134–229]	0.040
Intraoperative fluid balance, mL	2297 [1212–3335]	2351 [1317–3208]	2259 [1206–3347]	0.83
APACHE II score	13 [11–15]	13 [11–15]	13 [11–15]	0.098
Vasopressors and inotropes within the first 24 h after ICU admission
Norepinephrine, n (%)	295 (40)	45 (38)	250 (40)	0.68
Maximal dose^b, µg/kg/min	0.08 [0.05–0.14]	0.06 [0.04–0.12]	0.08 [0.05–0.14]	0.51
Epinephrine, n (%)	6 (0.8)	0 (0)	6 (1.0)	0.60
Maximal dose^b, µg/kg/min	0.05 [0.03–0.07]	0	0.05 [0.03–0.07]
Dopamine, n (%)	128 (17)	16 (13)	112 (18)	0.29
Maximal dose^b, µg/kg/min	3.1 [1.9–4.1]	3.6 [1.9–4.8]	3.0 [1.9–4.1]	0.52
Vasopressin, n (%)	31 (4.2)	2 (1.7)	29 (4.6)	0.21
Phenylephrine, n (%)	10 (1.3)	0	10 (1.6)	0.38
Dobutamine, n (%)	406 (53)	74 (62)	332 (53)	0.089
Maximal dose^b, µg/kg/min	2.6 [1.7–3.5]	3.0 [1.6–3.7]	2.6 [1.7–3.5]	0.31
PDE inhibitors, n (%)	135 (18)	31 (26)	104 (17)	0.020
Blood products within the first 24 h after ICU admission, n (%)
Red blood cells, units	173 (23)	23 (19)	150 (24)	0.29

IQR interquartile range, APACHE Acute Physiology and Chronic Health Evaluation, SOFA Sequential Organ Failure Assessment, AIDS acquired immunodeficiency syndrome, LVEF left ventricular ejection fraction, ICU intensive care unit, CABG coronary artery bypass grafting, PDE phosphodiesterase
^aThe denominator was patients in whom cardiopulmonary bypass surgery was conducted
^bThe denominator was patients in whom each vasoactive agent was given during the first 24 h after ICU admission

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